SCCM Pod-418 COVID-19 Learning: Conversion of a Children’s Hospital to an Adult Hospital

SCCM Pod-419 Hemodynamic Monitoring in the ICU
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. Published: 7/22/2020

SCCM Pod-418 COVID-19 Learning: Conversion of a Children's Hospital to an Adult Hospital
Montefiore Medical Center in the Bronx, New York, USA, quickly converted a children's hospital to an adult COVID-19 hospital.

Hear Margaret M. Parker, MD, MCCM, talk with H. Michael Ushay, MD, PhD, FAAP, FCCM, about the process, challenges with staffing and personal protective equipment, and more.

Dr. Ushay is professor of pediatrics, interim chief of the division of pediatric critical care medicine, and medical director of the pediatric critical care unit at the Children's Hospital at Montefiore and the Pediatric Hospital for Albert Einstein College of Medicine in the Bronx, New York, USA. Published: 7/7/2020

SCCM Pod-417 COVID-19-Associated Acute Respiratory Distress Syndrome
Clinicians are working to understand and formulate an effective treatment for COVID-19-associated acute respiratory distress syndrome (Marini J. Crit Care Med. 2020 May 13; Epub ahead of print). Host Kyle B. Enfield, MD, FCCM, discusses specifics with John J. Marini, MD.

They also discuss the need to continue sharing clinical data, experience, and ideas. Dr. Marini is director of physiological and translational research at Regions Hospital in Saint Paul, Minnesota, USA. Published: 6/24/2020

SCCM Pod-416 COVID-19 Learning: Multiple Patients on a Single Ventilator
In a situation where ventilators are in short supply, multiple patients on a single ventilator could be a strategy of last resort. In this podcast, Arthur S. Slutsky, MD, discusses his article "Personalized Ventilation to Multiple Patients Using a Single Ventilator: Description and Proof of Concept" (Han J, et al. Crit Care Explor. 2020;2:e0118). A figure included in the article will provide a valuable visual aid to listeners.

Dr. Slutsky will discuss publishing information he hopes no one will ever have to use, but he encourages institutions to practice and test the proof of concept as an exercise in emergency preparedness.

The concept may also have benefit for resource-limited areas. Beyond the complexity of building the circuits, challenges related to alarms, infection control, and other complexities must also be considered.

"In a time of crisis where resources are limited, we introduce a system of multiple secondary breathing circuits driven by a ventilator in preference to that of simply splitting the breathing circuits, which has been shown to raise multiple risks for patients," he writes.

Dr. Slutsky is vice president or research at St. Michael's Hospital and professor of medicine, surgery, and biomedical engineering at University of Toronto in Ontario, Canada. Published: 5/28/2020

SCCM Pod-415 NIH COVID-19 Treatment Guidelines
The National Institutes of Health has released Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. SCCM members Craig M. Coopersmith, MD, FACS, MCCM; Amy L. Dzierba, PharmD, FCCP, BCCCP; and Greg S. Martin, MD, MS, FCCM, served on the guidelines development panel after being invited by Anthony S. Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases.

They talk with host Margaret M. Parker, MD, MCCM, about the major critical care recommendations, how these guidelines differ from the Surviving Sepsis COVID-19 guidelines, future updates, and more. Published: 5/11/2020

SCCM Pod-414 COVID-19 VIRUS Registry Aims to Identify Effective Treatment Strategies
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. Published: 5/7/2020

SCCM Pod-413 COVID-19 Fact Versus Science Fiction
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. Published: 5/1/2020

SCCM Pod-412 COVID-19 in Critically Ill Children
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 Apr 7; Epub ahead of print) 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. Published: 4/29/2020

SCCM Pod-411 Clinician Moral Distress
Margaret M. Parker, MD, MCCM, and Christopher S. Parshuram, MBChB, PhD, discuss clinician moral distress in Canadian pediatric and neonatal intensive care units (Dryden-Palmer,K, et al. Pediatri Crit Care Med. 2020;21(4): 314-323). They dive into a discussion on depersonalization, potentially mitigating factors, and more.

Dr. Parshuram is a pediatric critical care medicine physician at The Hospital for Sick Children and professor of pediatrics at the University of Toronto in Toronto, Ontario, Canada. Published: 4/8/2020

SCCM Pod-410 COVID-19 Neurologic Manifestations
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. Published: 4/8/2020