Critical Care Medicine Podcasts

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-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-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

SCCM Pod-409 SSC COVID-19 Guidelines
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 Mar 27; Epub ahead of print) 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). Published: 4/3/2020

SCCM Pod-408 Vaping-Associated Respiratory Distress Syndrome
Kyle B. Enfield, MD, and Craig M. Lilly, MD, discuss the newly released guidance for vaping-associated respiratory distress syndrome, published in Critical Care Explorations (Lilly C, et al. Crit Care Explor. 2020;2(2): e0081). They explore screening and risk stratification, vaping exposure criteria, patient evaluation and monitoring, and more. Dr. Lilly is professor of medicine, anesthesiology, and surgery at UMass Memorial Medical Center in Worcester, Massachusetts, USA. Published: 3/13/2020

SCCM Pod-407 Life Following Pediatric Septic Shock
Margaret M. Parker, MD, MCCM, and Jerry J. Zimmerman, MD, PhD, FCCM, talk about the trajectory of long-term mortality and significant health-related quality of life disability among children encountering septic shock. This discussion is based on two articles Dr. Zimmerman recently published in Critical Care Medicine, Critical Illness Factors Associated With Long-Term Mortality and Health-Related Quality of Life Morbidity Following Community-Acquired Pediatric Septic Shock (Zimmerman J, et al. Crit Care Med. 2020;48(3):319-328) and Trajectory of Mortality and Health-Related Quality of Life Morbidity Following Community-Acquired Pediatric Septic Shock (Zimmerman J, et al. Crit Care Med. 2020;48(3):329-337). 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, Washington, USA. He has received research funding from National Institutes of Health, Immunexpress, and Seattle Children’s Research Institute, royalties from Elsevier Publishing as co-editor for Pediatric Critical Care, and travel reimbursement from SCCM. Published: 3/2/2020

SCCM Pod-402 Early Palliative Care Consultations in the ICU
Kyle B. Enfield, MD, and Marin H. Kollef, MD, discuss the findings and design of the cluster randomized crossover trial on early palliative care consultation in the medical intensive care unit (ICU) published in the December 2019 issue of Critical Care Medicine (Ma J, et al. Crit Care Med. 2019;47;1707-1715). Dr. Kollef outlines the automatic triggers for palliative care consultations that were chosen for the study, the reactions of the transplant physicians and the nursing staff to the study, and the importance of communication in palliative care between the ICU staff, palliative care experts, patients, and families. Dr. Kollef is a professor of medicine at Washington University of Medicine in St. Louis Missouri, USA. This podcast is sponsored by Sound Critical Care. Published: 12/4/2019

SCCM Pod-396 Post-ICU Clinics and Peer Support Groups to Reduce Post-Intensive Care Syndrome (PICS)
Kyle B. Enfield, MD, and Kimberley J. Haines, PhD, BHSc, discuss implementing post-ICU clinics and peer support groups following critical illness to help reduce the burden of post-intensive care syndrome. Dr. Haines participated in the Society of Critical Care Medicine’s (SCCM) THRIVE Collaborative which is an ongoing initiative to provide resources and education for ICU patient survivors and families following their ICU stay. Drs. Enfield and Haines clarify qualitative methods used in the study published in the September 2019 issue of Critical Care Medicine (Haines K, et al. Crit Care Med. 2019;47:1194-1200), and navigate ways to overcome some of the barriers in implementing post-ICU clinics. Dr. Haines is a senior ICU physiotherapist and physiotherapy researcher lead at Western Health in Melbourne, Australia. Dr. Haines discloses that her research team was funded by SCCM and that she was the recipient of an SCCM THRIVE Research Grant. This podcast is sponsored by Sound Critical Care. Published: 10/7/2019

SCCM Pod-388 Choosing Wisely in Critical Care
Ranjit Deshpande, MD, and Ruth M. Kleinpell, PhD, RN, ACNP, FCCM, discuss the results of the Choosing Wisely national survey from the Critical Care Societies Collaborative (Kleinpell R, et al. Crit Care Med. 2019;47:331-336). They review the Choosing Wisely recommendations and the implementation and impact on ICUs. Dr. Kleinpell is assistant dean for clinical scholarship at the Vanderbilt University School of Nursing in Nashville, Tennessee, USA. Published: 6/18/2019

SCCM Pod-379 Opioid-Induced Respiratory Depression Risk Prediction Tool
Ludwig H. Lin, MD, and Ashish K. Khanna, MD, FCCP, FCCM, discuss Dr. Khanna’s top-rated abstract, Derivation and Validation of a Novel Opioid-Induced Respiratory Depression Risk Prediction Tool (Khanna A, et al. Crit Care Med. 2019;47:18), from the Society of Critical Care Medicine’s 48th Critical Care Congress. Nearly half of all in-hospital cardiorespiratory arrests occur on general care floors; opioid-induced respiratory depression (OIRD) is one potential cause of these events. Dr. Khanna investigated the incidence of OIRD as part of the PRODIGY trial. Dr. Khanna is an associate professor of anesthesiology and associate chief of research at Wake Forest University School of Medicine in Winston-Salem, North Carolina, USA. Dr. Khanna discloses that he served on the executive advisory board for the respiratory monitoring division of Medtronic and received consulting fees from Medtronic for being part of the steering committee of the PRODIGY trial. This podcast is supported by an unrestricted educational grant provided by Medtronic.        View podcast summary. Published: 3/8/2019

SCCM Pod-378 Procalcitonin Guidance during Antibiotics Management
Ranjit Deshpande, MD, and Simon W. Lam, PharmD, MS, BCPS, BCCCP, FCCM, discuss procalcitonin guidance during different phases of antibiotics management in patients admitted to intensive care units. This podcast originated from the article “Systematic Review and Meta-Analysis of Procalcitonin-Guidance Versus Usual Care for Antimicrobial Management in Critically Ill Patients: Focus on Subgroups Based on Antibiotic Initiation, Cessation, or Mixed Strategies” (Lam S, et al. Crit Care Med. 2018;46:684-690). Dr. Lam is a clinical specialist in pharmacoeconomics, outcomes research, and critical care at the Cleveland Clinic in Cleveland, Ohio, USA. He has no disclosures to report. This podcast is sponsored by Thermo Fisher Scientific.  Published: 2/11/2019

SCCM Pod-377 Procalcitonin Guidance in Patients with Sepsis
Ludwig H. Lin, MD, and Philipp Schuetz, MD, discuss procalcitonin and how it impacts treatment of sepsis. This podcast originated from the article “Efficacy and Safety of Procalcitonin Guidance in Patients With Suspected or Confirmed Sepsis: A Systematic Review and Meta-Analysis” (Iankova I, et al. Crit Care Med. 2018;46:691-698). Dr. Schuetz is a professor of internal medicine, endocrinology, diabetes, and metabolism at the University of Basel in Basel, Switzerland. This podcast is sponsored by Thermo Fisher Scientific.  Published: 1/30/2019

SCCM Pod-376 2018 PADIS Guidelines
Kyle B. Enfield, MD, speaks with John W. Devlin, PharmD, FCCM, about the article “Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU” (Devlin JW, et al. Crit Care Med. 2018;46:e825-e873). Dr. Devlin discusses what’s new in the 2018 guidelines, including the added topics of rehabilitation/mobilization and sleep, the guideline development process, and implementation strategies. Dr. Devlin is an associate professor at Northeastern University in Boston, Massachusetts, USA, and has been involved in the ICU Liberation committees and collaboratives. Published: 1/16/2019

SCCM Pod-375 Medical Emergency Calls and Hospital Mortality
Todd Fraser, MD, speaks with John D. Santamaria, MBBS, MD, FRACP, FCICM, FCCP, about the article “Increasing the Number of Medical Emergency Calls Does Not Improve Hospital Mortality” (Santamaria J, et al. Crit Care Med. 2018;46:1063-1069). The podcast explores Dr. Santamaria’s recent study on the relationship between emergency calling rates and adjusted in-hospital mortality and the effect of increasing call rates on the workload of the teams. Dr. Santamaria is the director of intensive care at St. Vincent’s Hospital in Melbourne, Australia. Published: 12/17/2018

SCCM Pod-374 Angiotensin II Treatment in Patients with Vasodilatory Shock and Renal Replacement Therapy
Todd Fraser, MD, speaks with Rinaldo Bellomo, MD, MBBS, FRACP, FCICM, FAAHMS, about the article “Outcomes in Patients with Vasodilatory Shock and Renal Replacement Therapy Treated with Intravenous Angiotensin II” (Tumlin JA, et al. Crit Care Med. 2018;46:949-957). Dr. Bellomo discusses his post-talk analysis of the Angiotensin II for the Treatment of High-Output Shock 3 (ATHOS-3) trial and potential benefits of angiotensin II in patients with shock requiring renal replacement therapy. Dr. Bellomo is the director of intensive care research at Austin Hospital in Melbourne, Australia. Published: 12/10/2018