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SCCM Pod-410 COVID-19 Neurologic ManifestationsSCCM Pod-410 COVID-19 Neurologic Manifestations

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SCCM Pod-436 Interventions to Reduce Patient and Clinician COVID-19 Risk
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. Published: 5/3/2021

SCCM Pod-435 Intracranial and Cerebral Perfusion Pressure Thresholds Associated with In-Hospital Mortality Across Pediatric Neurocritical Care

Targets for treatment of raised intracranial pressure or decreased cerebral perfusion pressure in pediatric neurocritical care are not well defined. Host Margaret Parker, MD, MCCM, is joined by Alicia K. Au, MD, MS, to discuss the process of defining intracranial pressure and cerebral perfusion pressure thresholds associated with in-hospital mortality across a large single-center pediatric neurocritical care cohort (Au A, et al. Pediatr Crit Care Med. 2021 Feb;22:135-146). Dr. Au is assistant professor of critical care medicine and associate medical director of the pediatric intensive care unit at the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania.

Published: 4/28/2021

SCCM Pod-434 Tracheostomy Adaptation for COVID-19 Patients

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.

Published: 4/12/2021

SCCM Pod-433 Choosing Wisely for Critical Care: The Next Five
Five new recommendations to reduce waste and enhance value in the practice of critical care address invasive devices, proactive liberation from mechanical ventilation, antibiotic stewardship, early mobilization, and providing goal-concordant care. Host Elizabeth H. Mack, MD, MS, FCCM, is joined by Jerry J. Zimmerman, MD, PhD, FCCM and Pamela L. Smithburger, PharmD, MS, BCPS, BCCCP, FCCP, FCCM, to formulate new “Choosing Wisely” for Critical Care recommendations that identify best practices to avoid waste and promote value while providing critical care (Zimmerman J, et al. Crit Care Med. 2021;49:472-481). Dr. Zimmerman is professor of pediatrics and anesthesiology and a faculty member and emeritus division chief of pediatric critical care medicine at Seattle Children's Hospital, Harborview Medical Center, and University of Washington School of Medicine in Seattle, WA. Dr. Smithburger is associate professor at University of Pittsburgh School of Pharmacy and pharmacist at University of Pittsburgh Medical Center, in Presbyterian in Pittsburgh, PA. This podcast is sponsored by Biofire. Published: 4/7/2021

SCCM Pod-432 Citrate and Continuous Renal Replacement Therapy
With widespread utilization of continuous renal replacement therapy, its critical to know about how citrate may have a role. Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Ashita Tolwani, MD, to review citrate and its role in the anticoagulation process and how it can decrease the likelihood of adverse events and ease clinician workload. Dr. Tolwani is a nephrologist at the University of Alabama in Tuscaloosa, Alabama, USA. This podcast is sponsored by Baxter Healthcare. Published: 3/10/2021

SCCM Pod-431 Hypertonic Saline in Children with Raised Intracranial Pressure

Mannitol is a commonly used osmotherapy agent in raised intracranial pressure (ICP) but the side effects are significant. An alternative therapy, hypertonic saline, has shown varied results. Host Margaret M. Parker, MD, MCCM, is joined by Arun Bansal, MD, to review a study that compared the effect of hypertonic saline versus mannitol on raised ICP in pediatric acute central nervous system infections (Rameshkumar R, et al. Pediatr Crit Care Med. 2020 Dec;21:1071-1080). Dr. Bansal is a professor in the department of pediatrics at the Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research in Chandigarh, India.

Published: 1/22/2021

SCCM Pod-430 Optimal Bundle of Management for Cardiac Arrest
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. Published: 12/10/2020

SCCM Pod-429 Drug Dosing Considerations in AKI and RRT
Continuous renal replacement therapy (CRRT) is complex, and dosing varies among institutions. Host Michael Smith, MD, is joined by Melissa L. Thompson Bastin, PharmD, BS, BCPS, to review dosing regimens for CRRT, studies of CRRT antibiotic dosing, and CRRT utilization in COVID-19 patients. Dr. Thompson Bastin is a medical ICU and pulmonary critical care pharmacist and assistant adjunct professor at the University of Kentucky in Lexington, Kentucky, USA. This podcast is sponsored by Baxter Healthcare. Published: 12/2/2020

SCCM Pod-428 Endotracheal Tube Size and Aspiration
Each year, approximately 790,000 patients in the United States develop acute respiratory failure that requires intubation and mechanical ventilation. Host Ludwig H. Lin, MD, is joined by Gintas P. Krisciunas, MPH, MA, to explore whether a modifiable risk factor, endotracheal tube size, is associated with the diagnosis of postextubation aspiration in survivors of acute respiratory failure (Krisciunas G et al. Crit Care Med. 2020;48:1604-1611). Gintas P. Krisciunas is a research assistant professor of otolaryngology at Boston University School of Medicine and Boston Medical Center in Boston, Massachusetts, USA. Published: 11/19/2020

SCCM Pod-427 Severe COVID-19 and Sepsis

Severe COVID-19 infection can be a form of viral sepsis with occasionally concomitant bacterial infection. Pamela M. Peeke MD, MPH, FACP, FACSM, is joined by Russell Miller, MD, MPH, FCCM, to discuss the definition of sepsis and overlap with case descriptions of patients with severe COVID-19, how experience with viral sepsis can be leveraged to diagnose and treat COVID-19 patients being admitted to ICU, and the need to be able to differentiate viral from bacterial sepsis to avoid over or under treatment. Dr. Miller is medical director of critical care at FirstHealth of the Carolinas in Pinehurst, North Carolina, USA. This podcast is sponsored by Immunexpress.

Published: 11/10/2020

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