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iCritical Care offers a wide selection of in-depth interviews on adult and pediatric topics. Gain unique perspectives as hosts chat with authors of the latest Critical Care Medicine and Pediatric Critical Care Medicine articles, well-known speakers and prominent SCCM members.
When should clinicians intubate preterm infants? The answer is not always straightforward, according to podcast guest Deepak Jain, MD, FAAP. He and host Pamela M. Peeke, MD, MPH, FACP, FACSM, discuss strategies that optimize noninvasive ventilation and when such strategies are appropriate, referring to a 2015 JAMA article (Stoll BJ et al. JAMA. 2015;314:1039-1051). Dr. Jain is interim chief in the Division of Neonatology at Rutgers Robert Wood Johnson Medical School. This podcast is supported by an unrestricted education grant from Medtronic.
The increasing use of electronic health records (EHRs) has inspired the need for a more dynamic checklist. Geva et al conducted a before-after quality improvement study by replacing a static checklist with an updated dynamic checklist. Host Margaret M. Parker, MD, MCCM is joined by Alon Geva, MD, MPH, to discuss how the implementation of eSIMPLER provided clinical decision support prompts with display of relevant data automatically pulled from the electronic health record and improved certain care processes (Geva A, et al. Pedtr Crit Care Med. 2021 October;22:898-905). Dr. Geva is an Associate in Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine and an Assistant Professor of Anesthesia at Harvard Medical School in Boston, Massachusetts. This podcast is sponsored by Mölnlycke.
This webcast will be a comparative analysis of conventional heparin- versus bivalirudin-based systemic anticoagulation in adult and pediatric patients supported on extracorporeal membrane oxygenation (ECMO). Host Ashish K. Khanna, MD, FCCP, FCCM, is joined by Troy Seelhammer, MD, to discuss a retrospective study of adult and pediatric patients receiving ECMO from January 1, 2014, to October 1, 2019 (Seelhammer T, et al. Crit Care Med. 2021 Sept;49:1481-1492). Dr. Seelhammer is an anesthesiologist in the Department of Anesthesiology and Perioperative Medicine at the Mayo Clinic in Rochester, Minnesota, USA.
Healthcare workload has emerged as an important metric associated with poor outcomes. To measure workload, studies have used bed occupancy as a surrogate. However, few studies have examined frontline clinician workload and outcomes. Host Elizabeth Mack, MD, MS, FCCM, is joined by Michael Fundora, MD, FAAP, to discuss if the hypothesized frontline clinician workload, measured by bed occupancy and staffing, is associated with poor outcomes and unnecessary testing (Fundora M.P., et al. Pedtr Crit Care Med. 2021 August; 22:683-691). Michael Fundora is a physician in the Division of Cardiology, Department of Pediatrics, Children’s Healthcare of Atlanta at Emory University School of Medicine in Atlanta, Georgia. This podcast is sponsored by Mölnlycke.
This podcast discusses patients who develop acute kidney injury (AKI) and how AKI is independently associated with mortality in critically ill infants, neonates, and larger children. Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Stuart Goldstein, MD, to discuss the HF20 study, including its end points and the clinical gaps the study addresses. (Munshi R, et al. Pediatr Nephrol 2020 Dec;35:2345-2352)
Dr. Goldstein is a professor of pediatrics and director of the Center for Acute Care Nephrology at Cincinnati Children's Hospital Medical Center in Cincinnati, Ohio, USA. This podcast is sponsored by Baxter Healthcare.
BioFire® FilmArray® is the latest in technologies for rapidly identifying pathogens that cause Lower Respiratory Tract Infections (LRTI). Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Tufik Assad M.D., M.S.C.I. to discuss how this technology can be integrated into clinical care to improve patient outcomes, describe the benefits in diagnosing bacterial secondary infections in patients with COVID-19 and summarize the benefits of Pneumonia (PN) Panel in the fight against Antimicrobial Resistance. Dr. Assad is the Medical Director of the Lung Nodule Clinic at Williamson Medical Center. This podcast is sponsored by BioFire.
Tufik Assad M.D., M.S.C.I., is the Medical Director of the Lung Nodule Clinic at Williamson Medical Center. Dr. Assad is board certified in Pulmonary Medicine, Critical Care Medicine and Internal Medicine. He practices with Williamson Medical Group in Franklin and is a credentialed physician with Williamson Medical Center.
As a proof of concept, a recurrent neural network (RNN) model was developed using electronic medical record (EMR) data capable of continuously assessing a child’s risk of mortality throughout an ICU stay as a proxy measure of illness severity. Host Margaret M. Parker, MD, MCCM, is joined by Melissa D. Aczon, PhD, to discuss how the RNN model can process hundreds of input variables contained in a patient’s EMR and integrate them dynamically as measurements become available. The RNN’s high discrimination suggests its potential to provide an accurate, continuous, and real-time assessment of a child in the PICU. (Aczon M, et al. Ped Crit Care Med. 2021;22:519-529) Dr. Aczon is a principal data scientist at Children’s Hospital Los Angeles. Melissa D. Aczon, PhD is a Principal Data Scientist at Children’s Hospital Los Angeles.
Learn about the importance of utilizing dynamic assessments of fluid responsiveness to guide treatment in patients with viral sepsis, including COVID-19, and understand how they can be used to help improve patient outcomes in sepsis patients. Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Patrick Troy, MD, to discuss how only 50% of hemodynamically unstable patients are fluid responsive and that the same treatment paradigm in fluid management applies to both viral sepsis and COVID-19 patients (Douglas IS, et al. Chest. 2020;158:1431-1445; Latham H, et al. J Crit Care. 2017;42:42-46). This podcast is sponsored by Baxter.
Patrick Troy M.D., is the Division Director Pulmonary Critical Care and Sleep Medicine Physician at Hartford Hospital, Assistant Professor of Clinical Medicine at the University of Connecticut School of Medicine.
Two previously published trials (ARDS et Curarisation Systematique [ACURASYS] and Reevaluation of Systemic Early Neuromuscular Blockade [ROSE]) presented equivocal evidence on the effect of neuromuscular blocking agent infusions in patients with acute respiratory distress syndrome. Host Kyle B. Enfield, MD, FCCM, is joined by Matthias Eikermann, MD, to discuss the different sedation regimens between these two trials as well as the different regimens within the ROSE trial between treatment and control groups. They will also discuss the hypothesis that the proportion of deeper sedation is a mediator of the effect of neuromuscular blocking agent infusions on mortality (Wongtangman K, et al. Crit Care Med. 2021;49:1137-1148; Jabaley C, Crit Care Med. 2021;49:1211-1213).
Dr. Eikermann is a professor of anesthesia at Harvard Medical School and an attending anesthesiologist and vice chair of faculty affairs in the Department of Anesthesia, Critical Care and Pain Medicine at Beth Israel Deaconess Medical Center. This podcast is sponsored by Sound Physicians.
Rapid delivery of antibiotics is a cornerstone of sepsis therapy, although time targets for specific components of antibiotic delivery are unknown. Host Ludwig H. Lin, MD, is joined by Stephanie Parks Taylor, MD, to discuss the significance of time lead for suspected sepsis patients, how to use a generous time window wisely, and new and reconfigured technologies opportunities (Taylor SP, et al. Crit Care Med. 2021 May;49:741-747).
Dr. Taylor is an associate professor in the Department of Internal Medicine at Atrium Health’s Carolinas Medical Center in Charlotte, North Carolina, USA. This podcast is sponsored by Biofire.