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Review how to best utilize parameters provided by minimally invasive advanced hemodynamic monitors.
Host Michael Smith, MD, talks with Michael Scott, MBChB, about clinical thresholds that may warrant continuous advanced hemodynamic monitoring and the application of parameters such as stroke volume and stroke volume variation when administering fluid.
Dr. Scott is adjunct professor of anesthesiology and critical care at the University of Pennsylvania in Philadelphia, Pennsylvania, USA.
This podcast is sponsored by Edwards Lifesciences.
Ranjit Deshpande, MD, speaks with Laurence W. Busse, MD, MBA, about Dr. Busse’s talk on preserving end-organ perfusion presented at the 46th Critical Care Congress in Honolulu, Hawaii, USA.
Dr. Busse is an assistant professor in the Division of Pulmonary Critical Care, Sleep, and Allergy Medicine at Emory University in Atlanta, Georgia, USA.
This podcast is supported by an unrestricted educational grant provided by La Jolla Pharmaceutical Company.
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
Jeffrey Guy, MD, MSc, MMHC, speaks with David R. Janz, MD, lead author on an article published in the December issue of Critical Care Medicine, “Hyperoxia is Associated with Increased Mortality in Patients Treated with Mild Therapeutic Hypothermia after Sudden Cardiac Arrest.” Investigators found that sudden cardiac arrest is associated with high hospital mortality and poor neurologic outcomes. Janz is a clinical fellow at Vanderbilt University School of Medicine in Nashville, Tennessee.
Raina M. Merchant, MD, a resident in emergency medicine at the University of Chicago, and Benjamin S. Abella, MD, an assistant professor of medicine in the section of emergency medicine at the University of Chicago, discuss their article published in the July 2006 issue of Critical Care Medicine. The article, "Therapeutic Hypothermia Utilization Among Physicians After Resuscitation From Cardiac Arrest," addresses whether physicians are cooling patients after cardiac arrest.
Levy et al (J Am Coll Cardiol. 2018;72:173-182) conducted a prospective, double-blind, multicenter RCT comparing epinephrine to norepinephrine in the setting of CS in patients who underwent AMI treated with percutaneous coronary intervention.
Moskowitz et al (Resuscitation. 2019. Epub ahead of print) set out to investigate the preventability of ICU-CAs and identify targets for future intervention.
Can arginine supplements improve the hemodynamics of children with severe pain or acute chest syndrome (ACS) related to sickle cell anemia? Although mortality rates in children with sickle cell disease (SCD) have improved over the past decade, ACS and vasoocclusive episodes (VOE) remain relatively common diagnoses in pediatric ICUs. This Concise Critical Appraisal explores an article in which Onalo et al completed the second phase of their work determining the role that L-arginine treatment may play in the cardiopulmonary status of children with SCD and VOE, with or without ACS. In the first phase of their work, the authors demonstrated decreased hospitalization time, decreased opioid use, and the absence of serious adverse events in children with SCD after receiving L-arginine therapy.
Sudden cardiac arrest remains a leading cause of premature death worldwide. The reported likelihood of survival with favorable neurologic function is less than 10% in most communities, despite widespread CPR training and increased advanced care EMS systems. Host Margaret M. Parker, MD, MCCM, is joined by Paul E. Pepe, MD, MPH, MACP, FAEMS, MCCM, to review a practical, attainable roadmap for enhancing the likelihood of neurologically intact survival following sudden cardiac arrest (Pepe P, et al. Crit Care Explor. 2020;2:e0214). Dr. Pepe is professor of management policy and community health at the University of Texas Health Science Center in Houston, Texas, USA, and global coordinator of the Metropolitan EMS Medical Directors Alliance and medical director of the Dallas County emergency medical services in Dallas, Texas, USA. This podcast is sponsored by ZOLL.
Margaret M. Parker, MD, MCCM, and Luregn Schlapbach, MD, FCICM, review a survey of international practice on prevention, diagnosis, and treatment of infections on extracorporeal life support in adults and children published in Pediatric Critical Care Medicine (Farrell, Deborah, et al. Pediatr Crit Care Med. 2019;20:667-671).
Dr. Schlapbach is a pediatric intensivist at Queensland Children's Hospital in South Brisbane, Australia.
Margaret Parker, MD, MCCM, speaks with Benjamin Abella, MD, about his upcoming talk, “Overall Hypothermia Update,“ which he will present at the 45th Critical Care Congress as part of the Society’s Current Concepts in Adult Critical Care Pre-Course. Dr. Abella is Associate Professor of Emergency Medicine and Vice Chair of Research in the Department of Emergency Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania. Dr. Abella discusses current hypothermia guidelines, the use of hypothermia as a treatment following cardiac arrest, and the benefits and challenges of implementing targeted temperature management protocols.
Margaret Parker, MD, MCCM, speaks with Robert T. Mansfield, MD, about the article, “The Use of Pediatric Ventricular Assist Devices in Children’s Hospitals from 2000 to 2010: Morbidity, Mortality, and Hospital Charges*,” published in the July 2015 issue of Pediatric Critical Care Medicine. Dr. Mansfield is a Cardiac Intensivist at the Children’s Hospital of Philadelphia in Philadelphia, Pennsylvania. In this article, Dr. Mansfield and coauthors examine the use of ventricular assist devices (VADs) in pediatric patients over time; specifically, the overall use, outcome, co-morbidities and resource utilization.
Margaret Parker, MD, MCCM, speaks with Brett J. Ehrmann, MD, MS, about the article, “Hypertension and Health Outcomes in the PICU,” published in Pediatric Critical Care Medicine. Dr. Ehrmann is beginning his residency in Internal Medicine at the New York Presbyterian Hospital in New York City, New York. At the time of this project, he was a researcher in the Division of Pediatric Nephrology at the C.S. Mott Children’s Hospital in Ann Arbor, Michigan. This study represents the first detailed effort to characterize hypertension and its significance in critically ill children.
Anthony Carlese, MD, DO, discusses management of the patient after cardiac surgery, specifically his approach to caring for patients in the ICU who have just undergone coronary artery bypass surgery and the different situations and that he encounters. Carlese is the director of the open heart unit at Montefiore Medical Center in New York City, and he is also an American College of Critical Care Medicine member.
Arno Zaritsky, MD, discusses an article he and Dr. Ikram Haque published in the March 2007 issue of Pediatric Critical Care Medicine titled "Analysis of the Evidence for Lower Limit of Systolic and Mean Arterial Pressure in Children." Dr. Zaritsky is professor and chief of pediatric critical care at the University of Florida College of Medicine in Gainesville, Florida.
Frederick P. Ognibene, MD, FCCM, discusses his goals as the Society's president for 2007 as well as his decades-long involvement in SCCM and the critical care community. Dr. Ognibene is director of the office of clinical research training and medical education at the National Institutes of Health (NIH) Clinical Center and the director of clinical research training program, OIR. He also is an attending in the medical intensive care unit at the NIH Clinical Center.
Ruemmler et al (Resuscitation. 2018;132:56-62) set out to compare intermittent positive pressure ventilation to passive oxygenation (continuous positive airway pressure) and a novel ultra-low tidal volume ventilation (ULTVV) regimen.
Perkins et al (N Engl J Med. 2018;379:711-721) set out to examine the effects of epinephrine during OHCA.
Lascarrou et al (N Engl J Med. 2019. Epub ahead of print) set out to test the effectiveness of moderate therapeutic hypothermia (MTH) in patients with nonshockable rhythms.
The ARREST Trial compared extracorporeal membrane oxygenation (ECMO)-facilitated resuscitation to advanced cardiac life support (ACLS) treatment in patients with out-of-hospital cardiac arrest (OHCA). This month’s Concise Critical Appraisal takes a deep dive into the trial, published in The Lancet.