Critical Care Medicine Podcasts

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

SCCM Pod-366 Predictors of In-Hospital Mortality After Rapid Response Team Calls
Ranjit Deshpande, MD, speaks with Matthew M. Churpek, MD, MPH, PhD, about the article, “Predictors of In-Hospital Mortality After Rapid Response Team Calls in a 274 Hospital Nationwide Sample,” published in the July 2018 issue of Critical Care Medicine. Dr. Churpek discusses predictors for in-hospital mortality for patients who had already been identified as high-risk by the rapid response team. Dr. Churpek is an assistant professor in pulmonary and critical care medicine in the Department of Medicine at the University of Chicago in Chicago, Illinois, USA. Shappell C, Snyder A, Edelson DP, Churpek MM; American Heart Association’s Get With the Guidelines-Resuscitation Investigators. Crit Care Med. 2018 Jul;46(7):1041-1048.  Published: 7/19/2018

SCCM Pod-363 Hemodynamic Support of Pediatric and Neonatal Septic Shock
Margaret Parker, MD, MCCM, speaks with Joseph A. Carcillo, MD, about the article, "American College of Critical Care Medicine Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock," published in the June 2017 issue of Critical Care Medicine. Dr. Carcillo the revisions made to the 2014 guidelines and recommendations regarding use of 1) a “recognition bundle” containing a trigger tool for rapid identification of patients with septic shock, 2) a “resuscitation and stabilization bundle” to help adherence to best practice principles, and 3) a “performance bundle” to identify and overcome perceived barriers to the pursuit of best practice principles. Dr. Carcillo is a professor of Anesthesia, Critical Care Medicine, and Pediatrics at the University of Pittsburgh School of Medicine in Pittsburgh, Pennsylvania. Crit Care Med. 2017; 45(6):1061-1093. Published: 6/7/2018

SCCM Pod-361 Antibiotic Therapy in Comatose Mechanically Ventilated Patients Following Aspiration
Dr. Fraser, MD, speaks with Jean Baptiste Lascarrou, MD, about the article, “Antibiotic Therapy in Comatose Mechanically Ventilated Patients Following Aspiration: Differentiating Pneumonia from Pneumonitis,” published in Critical Care Medicine. He discusses results from his team’s prospective observational study to determine the proportion of patients with documented bacterial aspiration pneumonia among comatose ICU patients with symptoms suggesting either bacterial aspiration pneumonia or non-bacterial aspiration pneumonitis. Dr. Lascarrou is a physician in the Medical Intensive Care Unit at CHU Nantes in Nantes, France. Crit Care Med. 2017; 45(8):1268-1275. Published: 3/22/2018

SCCM Pod-358 Liberal Glycemic Control in Critically Ill Patients With Type 2 Diabetes
Ludwig Lin, MD, speaks with Palash Kar, MBBS, about the article, “Liberal Glycemic Control in Critically Ill Patients With Type 2 Diabetes: An Exploratory Study," published in Critical Care Medicine. In this article, Dr. Kar and coauthors found that in critically ill patients with type 2 diabetes and chronic hyperglycemia, liberal glycemic control appears to attenuate glycemic variability and may reduce the prevalence of moderate-severe hypoglycemia. Dr. Kar is a senior registrar in intensive care at Royal Adelaide Hospital in South Australia. Dr. Kar has no relevant disclosures. Crit Care Med. 2016; 44(9):1695-1703. 
  Published: 1/25/2018

SCCM Pod-357 Initial Crystalloid Resuscitation in Sepsis and Septic Shock
Ludwig Lin, MD, speaks with Daniel E. Leisman, BS, about the article, “Patterns and Outcomes Associated With Timeliness of Initial Crystalloid Resuscitation in a Prospective Sepsis and Septic Shock Cohort,” published in Critical Care Medicine. Mr. Leisman addresses the controversy of the role of fluids in management of sepsis. Study findings showed that earlier crystalloid initiation was associated with better patient outcomes, including decreased mortality, mechanical ventilation, ICU utilization, and length of stay. Comorbidities and severity did not modify this effect. Mr. Leisman is a clinical researcher in the Department of Emergency Medicine at Hofstra-Northwell School of Medicine, and MD/MSCR candidate at Mount Sinai School of Medicine in New York, New York. Crit Care Med. 2017; 45(10):1596-1606.  Published: 1/11/2018

SCCM Pod-356 Repeated Critical Illness and Unplanned Readmissions to PICUs
Margaret Parker, MD, MCCM, speaks with Jeffrey D. Edwards, MD, MA, MAS, about the article, “Repeated Critical Illness and Unplanned Readmissions Within 1 Year to PICUs,” published in the August 2017 issue of Critical Care Medicine. Dr. Edwards discusses how critical illness impacts children with complex chronic conditions and how these medically complex children impact critical care services. Dr. Edwards is an Assistant Professor in the Division of Pediatric Critical Care in the Department of Pediatrics at Columbia University College of Physician and Surgeons in New York. Crit Care Med. 2017; 45(8):1276-1284.  Published: 1/2/2018

SCCM Pod-354 The Septic Shock 3.0 Definition and Trials
Ranjit Deshpande, MD, speaks with James A. Russell, MD, about the article, “The Septic Shock 3.0 Definition and Trials: A Vasopressin and Septic Shock Trial Experience,” published in the June 2017 issue of Critical Care Medicine. Dr. Russell discusses findings from his retrospective analysis of the Vasopressin and Septic Shock Trial (VASST) using the Septic Shock 3.0 definition, and implications for trial design in septic shock. Dr. Russell is a professor of medicine at the University of British Columbia, and principal investigator at the Centre for Heart Lung Innovation at St. Paul’s Hospital in Vancouver, BC, Canada. Crit Care Med. 2017; 45(6):940-948. Published: 11/16/2017