In this podcast, recorded at the Top Articles of 2025 Session at PEDICRITICON 2025, Dr. Traci Wolbrink interviews Drs. Ashish Agarwal and Ramesh Kumar Ramachandran about two randomized controlled trials. These studies comparing 0.9% normal saline with Ringer’s lactate in diabetic ketoacidosis and the efficacy of high flow nasal cannula versus nasal prong bubble CPAP in bronchiolitis. The conversation reveals challenges in resource-limited settings, emphasizing the importance of protocol adherence, mentorship, and resource management. Valuable insights into fluid management, respiratory support, and research execution are offered for healthcare professionals keen on advancing clinical practice and research knowledge.
Learning Objectives
- Recognize the limitations of using normal saline in diabetic ketoacidosis
- Understand the physiological benefits of balanced fluids like Ringer’s Lactate
- Identify the logistical challenges in conducting trials in resource-limited settings
- Appreciate the role of teamwork and protocol adherence in research success
AUTHORS
Ashish Agarwal, MD
Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
Ramachandran Rameshkumar, MD, DM, FRCPCH
Division of Pediatric Critical Care, Department of Pediatrics,
Jawaharlal Institute of Postgraduate Medical Education and
Research (JIPMER), Puducherry, India
Pediatric Intensive Care Unit, Department of Pediatrics,
Mediclinic City Hospital, Mohammed Bin Rashid University
of Medicine and Health Sciences, Dubai, United Arab Emirates
Traci Wolbrink, MD, MPH
Co-Director, OPENPediatrics
Senior Associate in Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine
Boston Children's Hospital
Associate Professor of Anesthesia
Harvard Medical School
DATE
Initial publication date: July 1, 2026.
ARTICLES REFERENCED
Agarwal A, Jayashree M, Nallasamy K, Dayal D, Attri SV. 0.9% Saline versus Ringer's lactate as initial fluid in children with diabetic ketoacidosis: a double-blind randomized controlled trial. BMJ Open Diabetes Res Care. 2025;13(2):e004623. https://pubmed.ncbi.nlm.nih.gov/40194836/
Maya M, Rameshkumar R, Selvan T, Delhikumar CG. High-Flow Nasal Cannula Versus Nasal Prong Bubble Continuous Positive Airway Pressure in Children With Moderate to Severe Acute Bronchiolitis: A Randomized Controlled Trial. Pediatr Crit Care Med. 2024;25(8):748-757. https://pubmed.ncbi.nlm.nih.gov/38639564/
TRANSCRIPT
https://cdn.bfldr.com/D6LGWP8S/as/szcrpthcfg3w4398gkvf9ch/202606_Pedicriticon_Podcast_2025_Transcript
Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu
CITATION
Agarwal A, Rameshkumar R, Wolbrink TA. PEDICRITICON 2025: Top Articles in PICU Research. 07/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/pedicriticon-2025-top-articles-in-picu-research.
