|SCCM Pod-357 Initial Crystalloid Resuscitation in Sepsis and Septic Shock
Ludwig Lin, MD, speaks with Daniel E. Leisman, BS, about the article, “Patterns and Outcomes Associated With Timeliness of Initial Crystalloid Resuscitation in a Prospective Sepsis and Septic Shock Cohort,” published in Critical Care Medicine. Mr. Leisman addresses the controversy of the role of fluids in management of sepsis. Study findings showed that earlier crystalloid initiation was associated with better patient outcomes, including decreased mortality, mechanical ventilation, ICU utilization, and length of stay. Comorbidities and severity did not modify this effect. Mr. Leisman is a clinical researcher in the Department of Emergency Medicine at Hofstra-Northwell School of Medicine, and MD/MSCR candidate at Mount Sinai School of Medicine in New York, New York. Crit Care Med. 2017; 45(10):1596-1606. Released: 1/11/18
SCCM Pod-356 Repeated Critical Illness and Unplanned Readmissions to PICUs
Margaret Parker, MD, MCCM, speaks with Jeffrey D. Edwards, MD, MA, MAS, about the article, “Repeated Critical Illness and Unplanned Readmissions Within 1 Year to PICUs,” published in the August 2017 issue of Critical Care Medicine. Dr. Edwards discusses how critical illness impacts children with complex chronic conditions and how these medically complex children impact critical care services. Dr. Edwards is an Assistant Professor in the Division of Pediatric Critical Care in the Department of Pediatrics at Columbia University College of Physician and Surgeons in New York. Crit Care Med. 2017; 45(8):1276-1284. Released: 1/2/18
SCCM Pod-355 The Epidemiology of Hospital Death Following Pediatric Severe Sepsis
Margaret Parker, MD, MCCM, speaks with Scott L. Weiss, MD, MSCE, about the article, “The Epidemiology of Hospital Death Following Pediatric Severe Sepsis: When, Why, and How Children With Sepsis Die,” published in the September 2017 issue of Pediatric Critical Care Medicine. Dr. Weiss discusses research findings regarding when, why, and the mode in which children with sepsis die, and how understanding these factors is important in setting appropriate clinical and research priorities. Dr. Weiss is an Assistant Professor in the Division of Critical Care Medicine in the Department of Anesthesiology and Critical Care at The Children’s Hospital of Philadelphia and the University of Pennsylvania Perelman School of Medicine in Philadelphia, Pennsylvania. Pediatr Crit Care Med. 2017; 18(9):823-830. Released: 12/7/17
SCCM Pod-VCCR11 Workup, Management, and Critical Sequelae of Burn Injuries
Richard Iuorio, MD speaks with Laura Johnson, MD, and Jim Reilly, MD, about the workup, management, and critical sequelae of burn injuries. Using a fictional burn case as an example, Dr. Johnson talks about airway considerations, resuscitation protocols, and fluid properties. The team then speaks about the use of antibiotics, and weighs the respective merits of colloids vs. crystalloids before ending the podcast with a discussion on ventilation strategies and indications for emergent escharotomy. Dr. Johnson is a trauma surgeon and burn specialist at MedStar Washington Hospital Center in Washington, District of Columbia. Dr. Reilly is an Emergency Medicine resident at Lincoln Medical Center in the South Bronx.
SCCM Pod-354 The Septic Shock 3.0 Definition and Trials
Ranjit Deshpande, MD, speaks with James A. Russell, MD, about the article, “The Septic Shock 3.0 Definition and Trials: A Vasopressin and Septic Shock Trial Experience,” published in the June 2017 issue of Critical Care Medicine. Dr. Russell discusses findings from his retrospective analysis of the Vasopressin and Septic Shock Trial (VASST) using the Septic Shock 3.0 definition, and implications for trial design in septic shock. Dr. Russell is a professor of medicine at the University of British Columbia, and principal investigator at the Centre for Heart Lung Innovation at St. Paul’s Hospital in Vancouver, BC, Canada. Crit Care Med. 2017; 45(6):940-948. Released: 11/16/17
SCCM Pod-VCCR10 Pathophysiology and Management of AKI
Richard Iuorio, MD, speaks with Kianoush Kashani, MD and Jim Reilly, MD about the pathophysiology and management of acute kidney injury. Dr. Kashani delves into novel biomarkers and resuscitation of the sepsis-associated AKI, and he gives his expert opinion on the administration of radiographic contrast in the setting of acute nephropathy. Dr. Kashani is an intensivist, renowned nephrologist, and hypertension specialist at the Mayo Clinic in Rochester, Minnesota. Dr. Reilly is an Emergency Medicine resident at Lincoln Medical Center in the South Bronx. He completed his undergraduate degree in Biochemistry at the University of California, Davis, and then attended Boston University School of Medicine. His academic interests lie mainly in critical care, and he hopes to continue his training as a critical care fellow in New York City.
SCCM Pod-353 Are Biomarkers Ready for Prime Time?
Kyle Enfield, MD, speaks with John A. Kellum, MD, MCCM, about his talk presented at the 46th Critical Care Congress in Honolulu, Hawaii entitled, “Are Biomarkers Ready for Prime Time?” Dr. Kellum works as an Intensivist in the Cardiothoracic ICU at the University of Pittsburgh Medical Center (UPMC) in Pittsburgh, Pennsylvania. He is also the Vice Chair for Research and Director of the Center for Critical Care Nephrology in the Department of Critical Care Medicine at UPMC. He discusses how the understanding of acute kidney injury (AKI) has evolved and which biomarkers are most effective in identifying risk of AKI. Released: 11/9/17
SCCM Pod-352 New-Onset Atrial Fibrillation in the Critically Ill
Kyle Enfield, MD, speaks with Travis J. Moss, MD, MSc, and J. Randall Moorman, MD, about the article, “New-Onset Atrial Fibrillation in the Critically Ill,” published in the May 2017 issue of Critical Care Medicine. Drs. Moss & Moorman discuss their study which set out to determine the association of new-onset atrial fibrillation with outcomes, including ICU length of stay and survival. Dr. Moss is a Fellow in the Division of Cardiovascular Medicine and Dr. Moorman is a Professor in the Division Cardiovascular Medicine at the University of Virginia Health System, in Charlottesville, Virginia. Crit Care Med. 2017; 45(5):790-797. Released: 10/24/17
SCCM Pod-351 2016 Orlando Pulse Nightclub Shooting: Lessons Learned
Ludwig Lin, MD, speaks with Charles Hunley, MD, about his talk presented at the 46th Critical Care Congress in Honolulu, Hawaii entitled, “Rapidly Distributing Critical Care Services in Response to a Surge Event with Multiple Casualties.” Dr. Hunley is Medical Critical Care Director at the Orlando Regional Medical Center in Orlando, Florida, and and was one of the chief triage physicians on duty the early morning of the 2016 mass shooting at Pulse nightclub in Orlando.
He discusses lessons learned in preparing for a mass casualty event, such as maintaining medical storage supplies, facilitating regular tabletop and coordinated drills, and encouraging collaboration between different disciplines to facilitate coordination and flexibility during a disaster. Dr. Hunley also describes the importance of establishing a command center and systems for rapid triage, communication with family members and press, and support services to address the emotional burden on patients, families, and providers. Dr. Hunley has no relevant disclosures. Released: 8/31/17
SCCM Pod-350 Emergency Preparedness in Healthcare
Ludwig Lin, MD, speaks with Grete Porteous, MD, about emergency preparedness in healthcare and the role of critical care personnel in catastrophic situations. Dr. Porteous advises on how to prepare institutions for disaster including evaluation of disaster plans, development of standard work processes and cognitive aids, and staff education and training. Dr. Porteous is an anesthesiologist and Associate Program Director of the anesthesiology residency at Virginia Mason Medical Center in Seattle, Washington. She is also an instructor in emergency preparedness at Homeland Security’s Center for Domestic Preparedness in Aniston, Alabama. Dr. Porteous has no relevant disclosures. Released: 8/31/17