Critical Care Medicine Podcasts

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-423 Coagulopathy in COVID-19 Patients

COVID-19 is associated with a high prevalence of coagulopathy and venous thromboembolism. Host Kyle B. Enfield, MD, FCCM, talks with Jerrold H. Levy, MD, FAHA, FCCM, about what clinicians need to know about this serious problem and how it impacts care delivery (Iba et al. Crit Care Med. 2020;48:1358-1364). Dr. Levy is professor of anesthesiology, critical care professor of surgery (cardiothoracic), and codirector of the cardiothoracic ICU at Duke University Hospital in Durham, North Carolina, USA. This podcast is sponsored by BioFire.

Published: 9/30/2020

SCCM Pod-420 Nebulized Bacteriophages for Prophylaxis of Experimental MRSA VAP
Alternative strategies are needed to combat and prevent antibiotic-resistant bacterial infections. Host Ashish K. Khanna, MD, FCCP, FCCM, talks with David R. Cameron, PhD, about the potential for bacteriophage prophylaxis in the context of experimental ventilator-associated pneumonia due to methicillin-resistant Staphylococcus aureus in rats (Prazak J, et al. Crit Care Med. 2020;48:1042-1046). Dr. Cameron is research group leader in the department of intensive care medicine at Inselspital, Bern University Hospital in Bern, Switzerland. Published: 9/10/2020

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-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