Critical Connections Blog

Concise Critical Appraisal: Hydrocortisone and Fludrocortisone Versus Hydrocortisone Only
Is hydrocortisone for septic shock best used alone or in combination with fludrocortisone? This Concise Critical Appraisal explores a retrospective cohort study that found that treatment with hydrocortisone plus fludrocortisone led to lower rates of mortality or discharge to hospice, hospital deaths, and fewer days on vasopressors than treatment with hydrocortisone alone.
Posted: 5/12/2023 | 0 comments | Concise Critical Appraisal, Shock

SCCM Trains Ukrainian Clinicians on Critical Care Ultrasound
Members of the Society of Critical Care Medicine (SCCM) traveled from the United States to Lviv, Ukraine in March to train more than 140 clinicians on lifesaving critical care ultrasound. Learning and using point-of-care ultrasound (POCUS) skills allows Ukrainian medical professionals to quickly diagnose and care for critically ill and injured patients—all the more important as injuries continue to mount in the ongoing Ukrainian humanitarian crisis.
Posted: 4/27/2023 | 0 comments | Global Health, Ukraine, Ultrasound

Remembering Norma Shoemaker: A Nurse Pioneer and SCCM’s First Executive Director
Norma J. Shoemaker, RN, MN, FCCM, one of the Society of Critical Care Medicine’s (SCCM) earliest nurse members and its first executive director, died March 8, 2023. She was 90.
Posted: 4/26/2023 | 0 comments |

Trip to West Africa Kicks Off SCCM AIRS Project
Oxygen is essential for human life and has no substitute. Its importance was highlighted during the COVID-19 pandemic by the many patients who had difficulty breathing. Medical oxygen is used in many different settings, such as intensive care units, operating rooms, delivery rooms, and during emergency transport.
Posted: 4/24/2023 | 0 comments | AIRS Project, Global Health, Medical Education, Resource Allocation

Concise Critical Appraisal: Endothelial Glycocalyx Integrity and Fluid Bolus Types
Is there an association between balanced versus unbalanced fluids and endothelial glycocalyx integrity in children with sepsis? This Concise Critical Appraisal offers insight into the vascular dysfunction that occurs in pediatric patients with sepsis or septic shock after receiving either balanced or unbalanced fluids.
Posted: 4/13/2023 | 0 comments | Concise Critical Appraisal, Fluid Administration

Concise Critical Appraisal: Artificial Intelligence and the ICU Patient
With the advancement and increasing popularity of artificial intelligence (AI) systems, researchers have begun studying how to apply the technical capabilities of AI to the intensive care unit (ICU). This Concise Critical Appraisal explores how ICU AI systems could replace traditional monitoring systems and clinical risk assessment tools with computers that use multidimensional and multidomain data patterns to enhance patient care, predict outcomes, and seamlessly extract and interpret clinical information.
Posted: 3/14/2023 | 0 comments | Artificial Intelligence, Concise Critical Appraisal

An Update on SCCM Relief Efforts in Türkiye and Syria
SCCM President Vinay M. Nadkarni, MD, MS, FCCM, provides an update on the SCCM emergency response efforts for the Türkiye-Syria Earthquake.
Posted: 2/15/2023 | 0 comments | Disaster Response, Global Health, Message from the President

Concise Critical Appraisal: Timing of Prone Positioning During Venovenous ECMO for ARDS
This Concise Critical Appraisal explores a meta-analysis showing that prone positioning is beneficial for patients meeting criteria for venovenous extracorporeal membrane oxygenation (ECMO), especially when initiated within five days after ECMO initiation. When initiated within five days, patients had lower intensive care unit (ICU) mortality rates, higher likelihood of being discharged alive, shorter ECMO duration, and cumulative 90-day probability of being discharged from the ICU.
Posted: 2/15/2023 | 0 comments | ARDS, Concise Critical Appraisal, ECMO

SCCM Africa Infrastructure Relief and Support Project Will Improve Access to Oxygen in West Africa
The Society of Critical Care Medicine’s (SCCM) new global health initiative, Africa Infrastructure Relief and Support (AIRS), will ensure the availability of medical oxygen to patients in the Gambia, Liberia, and Sierra Leone, made possible by a $5.5 million grant from Direct Relief and in collaboration with the Johns Hopkins Global Alliance of Perioperative Professionals (GAPP) and the Institute of Global Perioperative Care. Officials in the Gambia, Liberia, and Sierra Leone will identify specific medical oxygen-related needs, including hospital-based infrastructure, oxygen-generating plants, and solar energy. SCCM plans to eventually expand the initiative to additional countries.
Posted: 2/14/2023 | 0 comments | AIRS Project, Global Health, oxygen, respiratory

SCCM to Lead Ultrasound Training in Ukraine
José L. Díaz-Gómez, MD, FASE, FCCM, rides his bicycle to work every day in Houston, Texas. He passes the Texas Medical Center, where he sees a large Ukrainian flag on one of the hospital buildings. The flag symbolizes support for Ukraine in its ongoing war with Russia, and now when Dr. Díaz-Gómez passes it, he sees something more. He sees courage, responsibility, and hope.
Posted: 2/14/2023 | 0 comments | Emergency Response, Global Health, Ukraine, Ultrasound

Spreading Point-of-Care Ultrasound Training With the SCCM Course
In 2014, Nibras F. Bughrara, MD, FASA, FCCM, joined Albany Medical Center (AMC) in Albany, New York, USA, after completing a critical care medicine fellowship and perioperative echocardiography training at Johns Hopkins School of Medicine. At the time, he was the only intensivist at AMC using point-of-care ultrasound (POCUS).
Posted: 2/13/2023 | 0 comments | ultrasound

COVID-19 Shutdown Expands Opportunity to Teach Critical Care Medicine
Before Michael J. Waxman, MBA, MD, FCCM, heads out to teach an FCCS course, he goes into his attic, where his simulation and teaching equipment is stored. He selects what he needs among the mannequins, defibrillators, ventilators, and other supplies, packs it all into his car, and hits the road.
Posted: 2/9/2023 | 0 comments | Fundamentals

Teaching Crisis Management in the United States and Around the World
Mary J. Reed, MD, FCCM, began teaching FCCS about 25 years ago. From there, her involvement expanded to teaching multiple SCCM courses, helping to develop courses, and teaching the courses overseas.
Posted: 2/7/2023 | 0 comments | Fundamentals

SCCM Supports FCCS Training in Tajikistan
Khorog, the regional capital of Gorno-Badakhshan Autonomous Oblast (GBAO), sits at an elevation of 2200 meters among the beautiful but rugged and isolated Pamir Mountains, where some people live at elevations of 4000 meters or more. In this resource-limited region, the Soviet-era healthcare system differs markedly from that of the United States.
Posted: 2/6/2023 | 0 comments | Fundamentals

The Critical Care Community Shares Why It’s “Better Together” at Congress 2023
The Society of Critical Care Medicine’s (SCCM) 2023 Critical Care Congress in San Francisco marked the in-person return of the largest multiprofessional critical care gathering, bringing together thousands of colleagues and experts from around the world. This year’s Congress theme of “Better Together” recognized the meaningful ways in which critical care professionals collaborate with each other and contribute to the communities in which they live and work.
Posted: 2/2/2023 | 0 comments | 2023 Congress

Dr. Glaucomflecken Shares Humor on Social Media and at 2023 Critical Care Congress
Social media star and comedian Dr. Glaucomflecken, aka ophthalmologist William E. Flanary, MD, along with his wife, Kristin Flanary, MA, shared social media insights as well as his experience as an ICU patient during his presentation of the Peter Safar Honorary Lecture, “Wife and Death: Featuring Dr. and Lady Glaucomflecken,” on January 22, 2023, at the Society of Critical Care Medicine’s (SCCM) 2023 Critical Care Congress in San Francisco, California.
Posted: 2/1/2023 | 0 comments | 2023 Congress

Fluid Accumulations and Adverse Outcomes in Critically Ill Pediatric Patients
Is there an association between fluid accumulation (FA) and adverse outcomes in critically ill pediatric patients, and is there a threshold FA associated with these outcomes? This Concise Critical Appraisal explores a retrospective cohort study of PICU patients over a 5-year period that found that FA was common among critically ill mechanically ventilated children within the first 7 days of admittance. Higher FA was associated with adverse outcomes; however; only greater than 20% FA was associated with worse outcomes.
Posted: 2/1/2023 | 0 comments | Concise Critical Appraisal, pediatrics

2023 ICU Heroes Award Winners: Perseverance and Compassion Amid the Chaos
Fifteen-year-old Rowen Cartmill played basketball for Westside Christian High School’s freshman team on January 8, 2022. Three days later, he was in the pediatric intensive care unit (ICU) at Randall Children’s Hospital in Portland, Oregon, intubated, sedated, and paralyzed, and on extracorporeal membrane oxygenation (ECMO).
Posted: 1/30/2023 | 0 comments | 2023 Congress, ICU Heroes

Early Mobilization During Mechanical Ventilation: Pain With No Gain
Early active mobilization has been shown to mitigate ICU-acquired weakness, reduce disability and, most importantly, reduce mortality. This Concise Critical Appraisal describes a recent article published in the New England Journal of Medicine about mobilization during mechanical ventilation that reevaluates the effects of sedation minimization and daily physiotherapy on serious adverse events and mortality at 180 days.
Posted: 12/15/2022 | 0 comments | Concise Critical Appraisal, Early Mobility, Mechanical Ventilation

NIH Funds SCCM Discovery Study on the Use of Sepsis Bundles in the Emergency Department
In funding a five-year prospective multicenter study to determine the safest and most effective approach to sepsis intervention, the National Heart, Lung, and Blood Institute (NHLBI) is recognizing the significant accomplishments of the Surviving Sepsis Campaign (SSC) and the Society of Critical Care Medicine (SCCM) to improve outcomes in patients with sepsis.
Posted: 12/9/2022 | 0 comments | Discovery, Sepsis