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Discovery, the Critical Care Research Network's Viral Infection and Respiratory Illness Universal Study creates a real-time COVID-19 registry of current ICU and hospital care patterns. Explore the pressing need for this study, its current status and future goals, how it differs from other large registry datasets, and more (Walkey A, et al. Crit Care Explor. 2020;2:e0113) with host Ashish K. Khanna, MD, FCCP, FCCM, and co-principal investigator Allan J. Walkey, MD, MSc. Learn more about the registry. Dr. Walkey is an associate professor at Boston University School of Medicine in the section of pulmonary, allergy, sleep, and critical care medicine in Boston, Massachusetts, USA.
Explore the need for randomized COVID-19 clinical trials and the difficulties and potential consequences of misinformation (Ingraham N, et al. Crit Care Explor. 2020;2:e0108) with host Ashish K. Khanna, MD, FCCP, FCCM, and Nicholas E. Ingraham, MD. Dr. Ingraham is a fellow and a part of the University of Minnesota's Department of Medicine in the Division of Pulmonary and Critical Care in Minneapolis, Minnesota, USA.
Gain valuable insight on the clinical management of COVID-19 and its relevance to the pediatric critical care provider (Ong J, et al. Pediatr Crit Care Med. 2020;21:662-666) with host Elizabeth H. Mack, MD, MS, FCCM, and Jacqueline Ong, MB BChir, MMed (Paeds), MRCPCH. Preparedness activities that every pediatric ICU should perform are also explored. Dr. Ong is head of the paediatric ICU at National University Hospital in Singapore.
Review neurologic manifestations of COVID-19 and other severe respiratory viral contagions (Robinson C, et al. Crit Care Explor. 2020;2:e0107) with host Ludwig H. Lin, MD, and author Christopher P. Robinson, DO, MS. In their discussion, they touch on identifying primary and secondary neurological manifestations associated with COVID-19, the main mechanisms of neurological injury, diagnostics, and possible treatments. Dr. Robinson is assistant professor of neurology and neurosurgery at the University of Florida in Gainesville, Florida, USA.
Explore the Surviving Sepsis Campaign's Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19) (Alhazzani W, et al. Crit Care Med. 2020;46:854-887) with host Kyle B. Enfield, MD, and authors Mitchell M. Levy, MD, MCCM, and Waleed Alhazzani, MD, MSc, FRCPC. The guidelines discussed were created by the Surviving Sepsis Campaign (SSC), a joint collaboration of the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM).
Ludwig Lin, MD, speaks with Jean-Louis Vincent, MD, PhD, FCCM, about the article, “The Impact of Hospital and ICU Organizational Factors on Outcome in Critically Ill Patients: Results from the Extended Prevalence of Infection in Intensive Care Study,” published in Critical Care Medicine. Dr. Vincent is a Professor of Intensive Care Medicine at the French-speaking University of Brussels in Brussels, Belgium, and President of the World Federation of Societies of Intensive and Critical Care Medicine. In this article, Dr. Vincent and coauthors investigate the impact of various facets of intensive care unit organization on outcome in a large cohort of ICU patients from different geographical regions.
Margaret Parker, MD, MCCM, speaks with the Society of Critical Care Medicine President-Elect, Craig Coopersmith, MD, FCCM, and Jay Varkey, MD, about the Ebola epidemic and how clinicians should be preparing for emerging infections. Dr. Coopersmith is Professor of Surgery at Emory in Atlanta, Georgia. Dr. Varkey was on a team of clinicians at Emory who successfully treated an American missionary and doctor with Ebola. He is Assistant Professor of Medicine in Infectious Disease and serves as the Director of the Antimicrobial Management Program and Associate Hospital Epidemiologist at Emory University Hospital.
Margaret Parker, MD, FCCM, speaks with Carl O. Eriksson, MD, MPH, lead author on an article published in the November Pediatric Critical Care Medicine. Researchers found that prevention and early use of antiviral medications may reduce the risk of influenza-related acute respiratory failure requiring mechanical ventilator support. Eriksson is an attending physician in the pediatric intensive care unit at Oregon Health & Science University in Portland, Oregon, USA.
Carol E. Nicholson, MD, MS, FAAP, is the Project Scientist for the Collaborative Pediatric Critical Care Research Network (CPCCRN) and Program Director for Pediatric Care and Rehabilitation Research (PCCR). Nicholson discusses the results of the CPCCRNs critical pertussis study, which sought to characterize the condition, its change over time and the level of support required for pediatric patients.
Amy Creel, MD, served as lead author on an article published in the May 2009 issue of Pediatric Critical Care Medicine, titled “Severe Invasive Community-Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA) Infections in Previously Healthy Children.” Creel is a pediatric critical care physician at Children’s Hospital in New Orleans, Louisiana. The study examined increases in CA-MRSA in healthy children, which raise concerns about the initial empirical antibiotic therapy being used.
Jeanine Wiener-Kronish, MD, discusses an article published in the September 2008 issue of Critical Care Medicine, titled "Increased Mortality of Ventilated Patients with Endotracheal Pseudomonas Aeruginosa Without Clinical Signs of Infection." Dr. Wiener-Kronish is a professor of research and teaching in anaesthetics and anaesthesia at Harvard Medical School, and Chief of Anesthesia, Massachusetts General Hospital in Boston.
Marin Kollef, MD, professor of medicine in the department of pulmonary and critical care medicine at the Washington University School of Medicine and director of medical critical care at Barnes-Jewish Hospital, discusses his article in the August issue of Critical Care Medicine, "Methicillin-Resistant Staphylococcus aureus Sterile-Site Infection: The Importance of Appropriate Initial Antimicrobial Treatment."
From SCCM's 50th Critical Care Congress. Critical care professionals from around the world shared their thoughts and perspectives on COVID-19.
This Concise Critical Appraisal explores an article in The Lancet Respiratory Medicine that evaluated the efficacy of awake prone positioning to prevent intubation or death in patients with severe COVID-19. This meta-trial used a new study design that allowed for the combination of six simultaneous national randomized, controlled, open-label trials.
Untreated hyperammonemia can cause irreversible neurologic damage, coma, or death. A high level of clinical suspicion is necessary to quickly recognize and implement emergency interventions for hyperammonemia in the acute presentation of urea cycle disorders (UCDs). Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Anna-Kaisa Niemi, MD, PhD, and a patient who was hospitalized for hyperammonemia at age 8 years to discuss the importance of improved recognition of hyperammonemia and awareness of the underlying causes, such as UCDs. Dr. Niemi is a neonatologist and associate professor at Rady Children’s Hospital in San Diego, California, USA. This podcast is sponsored by Horizon Therapeutics.
Little is known about the epidemiology of ventilator-acquired pneumonia among COVID-19 patients. Ashish K. Khanna, MD, FCCP, FCCM, is joined by Charles-Hervé Vacheron, MD, to discuss a cohort exposed/nonexposed study that found a higher incidence of ventilator-associated pneumonia among COVID-19 patients compared with the general population (Vacheron CH, et al. Crit Care Med. 2022;50:449-459). Dr. Vacheron is a physician in the Department of Anaesthesia and Intensive Care at Centre Hospitalier Lyon Sud in Pierre-Bénite, France.
Extubation is a high-risk endeavor in some COVID-19 patients. Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Joshua H. Atkins, MD, PhD; Christopher Rassekh, MD; and Ara Chalian, MD, to discuss recognizing risks surrounding extubation in ventilated COVID-19 patients, provide framework for rapid assessment and iterative change in complex care settings, and identify essential elements of integration of data and teams for implementation of new care pathways. This episode’s guests are from the University of Pennsylvania Medical Center in Philadelphia, Pennsylvania, USA. Dr. Atkins is an anesthesiologist and Drs. Rassekh and Chalian are ENT surgeons. This podcast is supported by an unrestricted education grant from Medtronic.
COVID-19 complicated critical care clinicians’ decision-making with regard to tracheostomy. ICU resource constraints and risk of staff exposure during an aerosol-generating procedure necessitated rapid adaption of clinical practice in the setting of many unknowns. Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Joshua H. Atkins, MD, PhD; Christopher Rassekh, MD; and Ara Chalian, MD, to discuss essential considerations for tracheostomy in the COVID-19 setting and identify challenges to coordinated development of tracheostomy best practices. This episode’s guests are from the University of Pennsylvania Medical Center in Philadelphia, Pennsylvania, USA. Dr. Atkins is an anesthesiologist and Drs. Rassekh and Chalian are ENT surgeons. This podcast is supported by an unrestricted education grant from Medtronic.
O’Grady NP, Alexander E, Alhazzani W, et al. Society of Critical Care Medicine and the Infectious Diseases Society of America guidelines for evaluating new fever in adult patients in the ICU. Crit Care Med. 2023 Nov;51(11):1570-1586.
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.