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A Vision for Growth in Pediatric Anesthesiology and Critical Care Medicine

sapna_kudchadkar

Sapna Kudchadkar

Sapna Kudchadkar started her pediatrics residency at Johns Hopkins planning to be a general pediatrician. Then she began her rotations in the pediatric intensive care unit and operating rooms — and found her calling.

“I loved the high acuity, how everything was constantly changing, how you had to make decisions in the moment but still had to have a very broad understanding of pediatric medicine. That really appealed to me and my personality,” says Kudchadkar.

During her nearly 20 years at Johns Hopkins since then, Kudchadkar completed a residency in anesthesiology, fellowships in pediatric anesthesiology and critical care medicine, and a doctorate at the Johns Hopkins Bloomberg School of Public Health; joined the faculty in anesthesiology and critical care medicine and in pediatrics; and directed the pediatric critical care clinical research program — all while developing her own research path.

In January, she took on an important new role: vice chair for pediatric anesthesiology and critical care medicine (pediatric ACCM) and anesthesiologist-in-chief of Johns Hopkins Children’s Center.

Kudchadkar says her vision is to grow the innovative work happening in pediatric ACCM across the perioperative home and critical care space. One aim is to expand outpatient anesthesia services, as the Division of Pediatric Anesthesiology has done by facilitating specialized pediatric anesthesiologists and nurse anesthetists at Johns Hopkins Health Care and Surgery Center — Green Spring Station in Lutherville, Maryland, for outpatient procedures.

“I think there are more opportunities like that — as well as in critical care — for us to expand community outreach with hospitals, building on our exceptional pediatric transport team,” she says.

Additionally, she’ll look to develop and disseminate cutting-edge programs cultivated by faculty members in pediatric ACCM, including pediatric extracorporeal membrane oxygenation, transport medicine, machine learning, resuscitation, sepsis recognition and treatment, airway management and pain management (including regional anesthesia). The pediatric difficult airway response team and program, for example, takes a proactive approach to reduce the likelihood of airway emergencies and complications during hospitalization, Kudchadkar says, and is ripe for expansion to other centers. Code Busters, a program in which teams meet weekly to discuss any cardiac arrests among pediatric patients, review data and discuss lessons learned to improve CPR quality and teamwork, has already had broad impact.

And, she’d like to support community outreach in areas such as gun violence prevention and asthma prevention. “Preventive medicine isn’t generally associated with our fields, but it should be,” she says. “Anything we can do to optimize vaccinations or preventive care and prevent trauma, so that kids aren’t ending up in our intensive care units and operating rooms, is what we must focus on for our communities.”

Kudchadkar’s research concentrates on integrating sleep promotion, sedation optimization and delirium prevention to promote early mobility and improve functional outcomes for critically ill children and those recovering from surgery. After she developed and implemented a program called PICU Up! to promote early mobilization for pediatric patients in the intensive care unit, Kudchadkar made news headlines and presented a TEDx talk on her work. Her protocol — which involves increased physical and occupational therapy and early ambulation — has been adapted into a National Institutes of Health-funded randomized trial at 10 hospitals, which she is directing.

Kudchadkar is the lead principal investigator for the international Prevalence of Acute Rehab for Kids in the PICU (PARK-PICU) study, which involves more than 200 sites in the United States, Canada, Brazil, Europe and Australia. The study aims to determine the factors, and any treatment-related barriers, related to physical and occupational therapists’ involvement in PICU patients’ care, and how that associates with progress in patient mobility.

“Every day I get to work with the most incredible interprofessional team imaginable,” Kudchadkar says. “There’s nowhere more than a pediatric ICU or operating room where you have the opportunity to work with more different specialties and professions, all with you in the moment, doing the best for every kid, every day.”


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