Balagangadhar Totapally, MD

Director, Division of Critical Care Medicine
Medical Director, Pediatric Intensive Care Unit
Director, Pediatric Critical Care Fellowship Program

Pediatric Specialty:
Critical Care Medicine

Primary Office:

3100 SW 62 Avenue
Miami, FL 33155
305-662-2639

Gender: Male

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Biography

Director of the Division of Critical Care Medicine
Medical Director of the Pediatric Intensive Care Unit
Director of the Pediatric Critical Care Fellowship Program
Section Director of Research, Division of Pediatric Critical Care Medicine
Section Director of Resuscitation, Division of Pediatric Critical Care Medicine
Medical Director of the PALS Program
Clinical Professor of Pediatrics, Herbert Wertheim College of Medicine, FIU

A native of India, Dr. Balagangadhar R. Totapally earned his MBBS, MD and DCH degrees (postgraduate diploma in child health) at Osmania University, Hyderabad, India. Dr. Totapally completed his Pediatric Residency at Hurley Medical Center, Flint, Michigan, a one year of Fellowship training in Neonatology at the Hospital for Sick Children, Toronto, Canada, and a Fellowship in Pediatric Critical Care Medicine at Nicklaus Children’s Hospital, Miami, Florida.

Dr. Totapally is a diplomat of the American Board of Pediatrics with subspecialty certification in Pediatric Critical Care and Neurocritical Care. Dr. Totapally is a member of the Royal College of Physicians (United Kingdom) and of the Society of Pediatric Research; he is also a Fellow of the Society of Critical Care Medicine, the American Academy of Pediatrics, and the American College of Chest Physicians. He has published more than sixty scientific articles and book chapters and is involved in several current research projects. His present areas of research interest include the effects of carbon dioxide in sepsis and resuscitation, neurocritical care monitoring, and database research. He is a recipient of several federal and industry-sponsored research grants. He is a research mentor for several fellows, residents and medical students.

Dr. Totapally is actively involved in several committees and quality improvement programs at Nicklaus Children’s Hospital. He is a member of ICU committee, GME, Bioethics and P&T committees. He led the implementation of the Rapid Response Team and the Pediatric Early Warning Scoring at Nicklaus Children’s Hospital. He has been a physician leader for several blue-chip initiatives of the Nicklaus Children’s Hospital quality pillar: including, reduction in bloodstream infections, ventilator associated pneumonias, and catheter associated UTIs and improved safety of TPN administration. Dr. Totapally is passionate about teaching residents and fellows. Over the years he received several Best Teacher awards from the residents. He is the Director of the Division of Critical Care Medicine at Nicklaus Children’s Hospital, the Director of the Pediatric Critical Care Fellowship Program and the Medical Director of the PICU. Dr. Totapally is also the Medical Director of PALS program at Nicklaus Children’s Hospital. He has been appointed as a Clinical Professor of Pediatrics at Herbert Wertheim College of Medicine, FIU.

Dr. Totapally actively participates in the national PICU-focus group sponsored by NACHRI and is the Nicklaus Children’s Hospital Medical Director for the VPS database. In addition, he represents Nicklaus Children’s at the national PICU-BSI collaborative. Dr. Totapally oversees Nicklaus Children’s Hospital’s participation in the National Registry for CPR (NRCPR).

Board Certifications
American Board of Pediatrics (Pediatrics) - Certified
American Board of Pediatrics (Ped Critical Care Med) - Certified
United Council for Neurologic Subspecialties (Neurocritical Care) - Certified

Publications

Beltramo, F., DiCarlo, J., Gruber, J.B., Taylor, T., Totapally, B.R. (2019). Renal Replacement Therapy Modalities in Critically Ill Children. Pediatric critical care medicine, 20(1), e1-e9. View in Pubmed

Totapally, B.R., Raszynski, A., Khan D., Amjad, I., Biehler, J. (2019). Extremity Arterial Thromboses in Hospitalized Children: A National Database Analysis of Prevalence and Therapeutic Interventions. Pediatric critical care medicine, 20(3), e154-e159. View in Pubmed

Chegondi, M., Ten, I., Totapally, B. (2018). Dapsone-induced Methemoglobinemia in a Child with End-stage Renal Disease: A Brief Review. Curēus, 10(4), e2513. View in Pubmed

Chegondi, M., Francis, T., Lin, W.C., Naqvi, S., Raszynski, A., Totapally, B.R. (2018). Effects of Closed Endotracheal Suctioning on Systemic and Cerebral Oxygenation and Hemodynamics in Children. Pediatric Critical Care Medicine, 19(1), e23-e30. View in Pubmed

Chegondi, M., Sasaki, J., Naqvi, S., Lin, W.C., Raszynski, A., Totapally, B.R. (2018). Heart Rate Variability in Children Following Drowning Injury. Indian Journal of Critical Care Medicine, 22(1), 53-55. View in Pubmed

Brooten, D., Youngblut, J.M., Caicedo, C., Del Moral, T., Cantwell, G.P., Totapally B. (2018). Parents' Acute Illnesses, Hospitalizations, and Medication Changes During the Difficult First Year After Infant or Child NICU/PICU Death.. The American journal of hospice & palliative care, 35(1), 75-82. View in Pubmed

Totapally, B.R., Shah, A.H., Niazi, T. (2018). Epidemiology and short-term surgical outcomes of children presenting with cerebellar tumors. Clinical neurology and neurosurgery, 168(), 97-101. View in Pubmed

Alsheikh, B., Chegondi, M., Totapally, B. (2017). Platelet Transfusion Thresholds Among Children Admitted to a Pediatric Intensive Care Unit. Curēus, 9(10), e1797. View in Pubmed

Totapally, B.R. (2017). Epidemiology and Outcomes of Hospitalized Children With Necrotizing Soft-Tissue Infections. The Pediatric infectious disease journal, 36(7), 641-644. View in Pubmed

Totapally, A., Leoncio, M., Beltramo, F., Meyer, K., Raszynski, A., Totapally, B.R. (2017). Epidemiology and outcomes of children with accidental hypothermia: A propensity-matched study. Journal of Trauma and Acute Care Surgery, 82(2), 362-367. View in Pubmed

Chegondi, M., Sasaki, J., Raszynski, A., Totapally, B.R. (2016). Hemoglobin Threshold for Blood Transfusion in a Pediatric Intensive Care Unit. Transfusion Medicine and Hemotherapy, 43(4), 297-301. View in Pubmed

Martinez, P.A., Totapally, B.R. (2016). The epidemiology and outcomes of pediatric in-hospital cardiopulmonary arrest in the United States during 1997 to 2012. Resuscitation, 105(), 177-181. View in Pubmed

Brooten, D., Youngblut, J.M., Caicedo, C., Seagrave, L., Cantwell, G.P., Totapally, B. (2016). Cause of Death of Infants and Children in the Intensive Care Unit: Parents' Recall vs Chart Review. American Journal of Critical Care, 25(3), 235-242. View in Pubmed

Hon, K.L., Tsang, Y.C., Chan, L.C., Tsang, H.W., Wong, K.Y., ..., Totapally, B.R. (2016). Outcome of Encephalitis in Pediatric Intensive Care Unit. Indian Journal of Pediatrics, 83(10), 1098-1103. View in Pubmed

Chegondi, M., Totapally, B.R. (2016). Spurious Hyperchloremia and Negative Anion Gap in a Child with Refractory Epilepsy. Case Reports in Critical Care, 2016(), 7015463. View in Pubmed

Humphreys, S., Totapally, B.R. (2016). Rapid Response Team Calls and Unplanned Transfers to the Pediatric Intensive Care Unit in a Pediatric Hospital. American Journal of Critical Care, 25(1), e9-e13. View in Pubmed

Chegondi, M., Raszynski, A., Totapally, B.R. (2016). Epinephrine induced cardiomyopathy in a child with anaphylaxis- case report. Signa Vitae, 11(1), 207-213.

Patten, W., Naqvi, S.Z., Raszynski, A., Totapally, B.R. (2015). Complications during the management of pediatric refractory status epilepticus with benzodiazepine and pentobarbital infusions. Indian Journal of Critical Care Medicine, 19(5), 275-277. View in Pubmed

Totapally, B.R. (2015). Reliable assessment of perfusion is the Holy Grail of intensive care. Indian Journal of Critical Care Medicine, 19(1), 1-2. View in Pubmed

Chegondi, M., Loux, T., Totapally, B., Burnweit, C. (2015). Unusual etiology for upper gastrointestinal bleeding in a previously healthy child. Journal of Pediatric Surgery Case Reports, 3(5), 182-184.

Totapally, B.R. (2014). Utility of end-tidal carbon dioxide monitoring in critically ill children. Indian Journal of Critical Care Medicine, 18(6), 341-342. View in Pubmed

Sasaki, J., Khalil, P.A., Chegondi, M., Raszynski, A., Meyer, K.G., Totapally, B.R. (2014). Coral snake bites and envenomation in children: a case series. Pediatric Emergency Care, 30(4), 262-265. View in Pubmed

Sasaki, J., Chegondi, M., Raszynski, A., Totapally, B.R. (2014). Outcome of Children With Acute Encephalitis and Refractory Status Epilepticus. Journal of Child Neurology, 29(12), 1638-1644. View in Pubmed

Totapally, B.R., Machado, J., Lee, H., Paredes, A., Raszynski, A. (2013). Acute kidney injury during vancomycin therapy in critically ill children . Pharmacotherapy , 33(6), 598-602. View in Pubmed

Kimura, D., Raszynski, A., Totapally, B.R. (2012). Admission and treatment factors associated with the duration of acidosis in children with diabetic ketoacidosis. Pediatric Emergency Care, 28(12), 1302-1306. View in Pubmed

Skaletzky, S.M., Raszynski, A., Totapally, B.R. (2012). Validation of a modified pediatric early warning system score: a retrospective case-control study. Clinical Pediatrics, 51(5), 431-435. View in Pubmed

Goodman, D.M., Winkler, M.K., Fiser, R.T., Abd-Allah, S., Mathur, M., Rivero, N., Weiss, I.K., Peterson, B., Cornfield, D.N., Mink, R., Nozik Grayck, E., McCabe, M.E., Schuette, J., Nares, M.A., Totapally, B., et al. (2011). The Accreditation Council for Graduate Medical Education proposed work hour regulations. Pediatric Critical Care Medicine, 12(1), 120-121. View in Pubmed

Hanson, S.J., Lawson, K.A., Brown, A.M., Christie, L.M., McArthur, J.A., Totapally, B., Higgerson, R.A. (2011). Current treatment practices of venous thromboembolism in children admitted to pediatric intensive care units. Pediatric Anesthesia, 21(10), 1052-1057. View in Pubmed

Higgerson, R.A., Lawson, K.A., Christie, L.M., Brown, A.M., McArthur, J.A., Totapally, B.R., Hanson, S.J., National Association of Children’s Hospitals and Related Institution’s Pediatric Intensive Care Unit FOCUS Group (2011). Incidence and risk factors associated with venous thrombotic events in pediatric intensive care unit patients. Pediatric Critical Care Medicine, 12(6), 628-634. View in Pubmed

Norozian, F.M., Leoncio, M., Torbati, D., Meyer, K., Raszynski, A., Totapally, B.R. (2011). Therapeutic hypercapnia enhances inflammatory response to endotoxemia in the rat lung. Critical Care Medicine, 39(6), 1400-1406. View in Pubmed

MacCarrick, M.J., Torbati, D., Kimura, D., Raszynski, A., Zeng, W., Totapally, B.R. (2010). Does hypercapnia ameliorate hyperoxia-induced lung injury in neonatal rats?. Lung, 188(3), 235-240. View in Pubmed

Koppada, R., Norozian, F.M., Torbati, D., Kalomiris, S., Ramachandran, C., Totapally, B.R. (2009). Physiologic effects of a novel immune stimulator drug, (1,4)-alpha-d-glucan, in rats. Basic & Clinical Pharmacology & Toxicology, 105(4), 217-221.

Shaik, S.S., Soltan, T.D., Chaturvedi, G., Totapally, B.R., Hagood, J.S., Andrews, W.W., Athar, M., Voitenok, N.N., Killingsworth, C.R., Patel, R.P., Fallon, M.B., Maheshawari, A. (2009). Low-intensity sheer stress increases endothelial ELR+CXC chemokine production via a PAK-P38β Mark-NF-κB pathway. The Journal of Biological Chemistry, 284(9), 5945-5955. View in Pubmed

Valcourt, K., Norozian, F., Lee, H., Raszynski, A., Torbati, D., Totapally, B. R. (2009). Drug use density in critically ill children and newborns: analysis of various methodologies. Pediatric Critical Care Medicine, 10(4), 495-499. View in Pubmed

Velazquez, E., Kimura, D., Torbati, D., Ramachandran, C., Totapally, B.R. (2009). Immunological response to (1,4)-alpha-D-glucan in the lung and spleen of endotoxin-stimulated juvenile rats. Basic & Clinical Pharmacology & Toxicology, 105(5), 301-306. View in Pubmed

Kimura, D., Totapally, B. R., Raszynski, A., Ramachandran, C., Torbati, D. (2008). The effects of CO2 on cytokine concentrations in endotoxin-stimulated human whole blood. Critical Care Medicine, 36(10), 2823-2827. View in Pubmed

Torbati, D., Totapally, B. R., Raszynski, A., Osborne, J., Zyl, L., Kalomiris, S., Wolfsdorf, J. (2008). Age and sex differences in brain gene expression in neonatal rats. Neuropediatrics, 39(4), 219-225. View in Pubmed

Koul, P.B., Minarik, M., Totapally, B.R. (2007). Lactic acidosis in children with acute exacerbation of severe asthma. European Journal of Emergency Medicine, 14(1), 56-58. View in Pubmed

Meyappan, R.T., Raszynski, A., Bohorquez, J., et al (2007). Carbon dioxide clearance in rabbits during expiratory phase intratracheal pulmonary ventilation. ASAIO journal , 53(2), 163-167. View in Pubmed

Hon, K.L., Olsen, H., Totapally, B., Leung, T.F. (2006). Air versus ground transportation of artificially ventilated neonates: comparative differences in selected cardiopulmonary parameters. Pediatric Emergency Care, 22(2), 107-112. View in Pubmed

Torbati, D., Tan, G.H., Smith, S., Frazier, K.S., Gelvez, J., Fakioglu, H., Totapally, B.R. (2006). Multiple-organ effect of normobaric hyperoxia in neonatal rats. Journal of Critical Care, 21(1), 85-94. View in Pubmed

Tan, G.H., Totapally, B.R., Torbati, D., Wolfsdorf, J. (2006). End-of-life decisions and palliative care in a children's hospital. Journal of Palliative Medicine, 9(2), 332-342. View in Pubmed

Hon, K.L., Olsen, H., Totapally B, Leung TF (2005). Hyperventilation at referring hospitals is common before transport in intubated children with neurological diseases. Pediatric Emergency Care, 21(10), 662-666. View in Pubmed

Fakioglu, H., Totapally, B.R., Torbati, D., Raszynski, A., Sussmane, J.B., Wolfsdorf, J. (2005). Hypoxic respiratory failure in term newborns: clinical indicators for inhaled nitric oxide and extracorporeal membrane oxygenation therapy. Journal of Critical Care, 20(3), 288-293. View in Pubmed

Gelvez, J., Fakioglu, H., Olarte, J.L., Soliz, A., Totapally, B.R., Torbati, D. (2004). Effect of aerosolized milrinone during drug-induced pulmonary hypertension in lambs. Pharmacological research, 50(1), 87-91. View in Pubmed

Totapally, B.R., Sussmane, J.B., Torbati, D., et al (2004). Cardiovascular stability during arteriovenous extracorporeal therapy: a randomized controlled study in lambs with acute lung injury. Critical Care, 8(6), R495-R503. View in Pubmed

Olarte, J.L., Gelvez, J., Fakioglu, H., Torbati, D., Frazier, K.S., Totapally, B.R., Raszynski, A. (2003). Tracheobronchial injury during intratracheal pulmonary ventilation in rabbits. Critical Care Medicine, 31(3), 913-923. View in Pubmed

Totapally, B.R., Fakioglu, H., Torbati, D., Wolfsdorf, J. (2003). Esophageal capnometry during hemorrhagic shock and after resuscitation in rats. Critical Care, 7(1), 79-84. View in Pubmed

Offices

Primary Office

Address:

Children's Critical Care Specialists, PA

3100 SW 62 Avenue

Miami, FL 33155

Phone Number:

305-662-2639

Education and Credentials

Education

Medical School - Osmania University

Residency - Hurley Medical Center

Fellowship - Nicklaus Children's Hospital

Board Certifications

American Board of Pediatrics (Pediatrics) - Certified

United Council for Neurological Subspecialties - Certified

American Board of Pediatrics (Ped Critical Care Med) - Certified

Balagangadhar Totapally, MD