Clara H. Song, MD 

I was lucky enough to catch this three-day event for the first time since my fellowship over a decade ago. Much has changed, and much of the great stuff has stayed the same. Trainees and early career neonatal intensivists within two years of graduation are still welcome to the “Life After Fellowship: Exploring Career Opportunities and Practical Considerations for New Neonatologists,” the pre-conference event organized by Dr. Rangasamy Ramanathan. This unique set-up allows intensivists in the TECaN stage to interact with a panel of MidCaN (Mid-Career Neonatologists) and WECaN (Well-Established Career Neonatologists) of various career trajectories and backgrounds. A great addition- that is new for me- is the CPQCC collaboration. The 2021 CPQCC Improvement Palooza, moderated by Dr. Elizabeth Rogers, focused this year on “Advancing Anti-Racism in the NICU Through Teamwork and Family Centeredness.” An annual update from CAN leadership accompanied the lunch break- Chair Dr. Bob Kahle Secretary Dr. Meena Sankar, and AAP SONPM executive committee members. Highlighted within this hour was an update from Past SONPM 

The 2021 Cool Topics meeting officially kicked off with an evening keynote lecture from Dr. Annemarie Stroustrup, from Cohen Children’s Medical Center, on “NICU Care in the Midst of a Pandemic: The Impact of Covid 19 on the NICU: Staff, Patient and Family Perspectives”. Opening night also recognized all 2021 accepted abstracts in the Virtual Poster Session, a trailblazing QI champion and an early career neonatal intensivist for outstanding scholarly work. The 2021 David Wirtschafter Awardee was Dr. Malathi Balasundaram for her QI leadership, presented by Dr. Wirtschafter himself this year. Dr. Rangasamy Ramanathan presented the Bhatt-Ramanathan Award to rising star Dr. Elizabeth Couch from UCSF. 

The weekend meeting continued with a focus on this year’s meeting star- the extremely low birth weight infant born at the limits of viability. The following one-and-a-half-day conference was filled with early management strategies to optimize this fragile population’s outcomes. Day one included a discussion on fetal management from Maternal-Fetal Medicine Specialist, Dr. Andrew Combs, of the MEDNAX Center for Research, Education, Quality & Safety, with “Management of the High-Risk Pregnancy at the Threshold of Viability: PPROM, IUGR, PIH,” the first in the preemie alphabet soup. Dr. Alexis Davis from Stanford University carried on the conversation torch to discuss “The Prenatal Consult at the Threshold of Viability: Clinical and Parental Perspective.” Dr. Georg Schmolzer, the Director of the Center for the Studies of Asphyxia and Resuscitation (CSAR), presenting from Edmonton, Alberta, reviewed “Delivery Room Management of the ELBW infant.” Dr. Jonathan Klein of the University of Iowa dove into “Respiratory Management from Birth to Discharge fo the Periviable Infant at 22 to 23 weeks Gestation: First Intention High-Frequency Jet Ventilation”. Also from Iowa, Dr. Patrick McNamara spoke on the “Cardiovascular Support of the ELBW: BP Management, Assessing Cardiac Function, Targeted Neonatal Echocardiography.” The Philip Sunshine Professor in Neonatology from Stanford University and the 2020 AAP Section on Neonatal-Perinatal Medicine Avroy Fanaroff Education Awardee took a microscope to the age-old question, “PDA: To Treat or Not to Treat: When and How?” Dr. Rangasamy Ramanathan from University of Southern California (USC) presented “Pulmonary Hypoplasia and Pulmonary Hypertension: iNO in the ELBW Infant,” using the brilliant and mesmerizing illustrations of Dr. Satyan Lakshminrusimha of University of California, Davis. The day concluded with Dr. Ishminder Kaur of UCLA discussing “Early and Late-Onset Neonatal Sepsis: Opportunities for Antibiotic Stewardship.” 

Day two highlighted prevention and outcomes. Dr. Elizabeth Rogers returned to examine “Neuroprotection: Prevention of Intraventricular Hemorrhage in the ELBW Infant.” Dr. Bobbi Pineda from USC took over the presentation baton to describe “Optimizing the NICU Environment for the ELBW Infant.” Dr. Talkad S. Raghuveer from the University of Kansas reviewed “Strategies for the Prevention of Retinopathy of Prematurity.” Dr. Brenda Poindexter from Emory University detailed the “Fluid and Nutrition Management of the ELBW Infant” in her early days to set-up for future success. This half-day concluded with a rundown of “NEC/SIP: the NEST Trial” from pediatric surgeon Dr. Marty Blakely from Vanderbilt University. The fun continued for the lucky ones that grabbed a coveted seat at the Neonatal Point-of-Care Ultrasound (POCUS) Virtual Workshop, chaired by Dr. Jae Kim of Cincinnati Children’s and Dr. Jennifer Shepherd from Children’s Hospital Los Angeles. 

My memory of the annual CAN meeting years back is heartily associated with catching up with old friends on Coronado Island and the opportunity to meet new ones in District IX. This was a great educational getaway weekend. The virtual transition maintained the educational integrity and incorporated a central digital station to view the pre-recorded and live sessions, which was a major advantage for those viewing at various times. The chat function for many virtual meetings is disabled for logistical reasons and helps maintain control over time. Inadvertently, it also mutes conversation and networking, which are some of the best things about our neonatal meet-ups, particularly CAN Cool Topics. This is a tricky decision to make when coordinating a virtual meeting- do we focus on delivering content at the expense of interaction? Or do we set-up opportunities for interaction and communication and levy a time limit on lectures? Hybrid meeting options are in the foreseeable future and may be a great compromise to pull the best of both worlds. 

Until then, in case you missed it, catch all the #CANcool2021 highlights here: 

https://wke.lt/w/s/vGb2Ge