In this episode of At the Bedside, the discussion focuses on real-world volume management in patients with chronic kidney disease. The conversation breaks down how impaired kidney function affects fluid balance, why added volume becomes a serious problem in CKD patients, and how techniques like ultrafiltration and hemoconcentration are used to safely remove excess fluid during care.

The episode highlights practical bedside decision-making, including when ultrafiltration is necessary, what tools are used in the circuit, and why ending a case volume-positive in advanced CKD patients can create significant downstream issues.

This is a grounded, clinician-to-clinician conversation designed for nurses and healthcare professionals who want to understand not just what to do, but why it matters at the bedside.

Welcome to the very first episode of At the Bedside, where nursing knowledge meets real-world clinical practice.

In this episode, host Vicki Carlisle, an ICU nurse and adult ECMO specialist, is joined by perfusionist Samir Patel for an in-depth discussion on Cold Agglutinin Disease (CAD) — a rare but critical autoimmune hemolytic anemia that can have serious implications in the ICU, operating room, and cardiac surgery.

🔍 What you’ll learn in this episode:

• What Cold Agglutinin Disease is and how it affects red blood cells
• The step-by-step pathophysiology behind cold-triggered hemolysis
• Differences between primary CAD and secondary cold agglutinin syndrome
• Common triggers include infections like Mycoplasma pneumonia
• ICU signs and symptoms: anemia, Raynaud’s phenomenon, acrocyanosis, renal injury, and thrombosis
• Bedside clues nurses may notice during routine blood draws
• Why temperature management is critical for these patients
• Medication, plasmapheresis, and treatment considerations
• Surgical and perfusion challenges during cardiopulmonary bypass
• A real-world cardiac surgery case illustrating how devastating CAD can be when undiagnosed

This episode blends clinical science, bedside nursing insight, and real OR experience, making it essential listening for ICU nurses, perfusionists, CRNAs, and anyone caring for critically ill patients.

🎧 Whether you’re on shift, commuting, or winding down, this episode will sharpen your clinical awareness and deepen your understanding of a rare but high-risk condition.

👉 Subscribe for upcoming episodes, including our next discussion on post-operative bleeding after cardiac surgery.

💬 Have a question or a case you’d like featured on the show? Drop a comment or reach out — we’d love to hear from you.

Hosted by Vicki Carlisle

See you At the Bedside.