Icritical Care: All Audio

Guidelines recommend against red blood cell (RBC) transfusion in hemodynamically stable children without cardiac disease who meet certain criteria. Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, is joined by Katherine Steffen, MD, MHS, to discuss the clinical and economic impacts of compliance with RBC transfusion guidelines, as discussed in "The Impact of Restrictive Transfusion Practices on Hemodynamically Stable Critically Ill Children Without Heart Disease: A Secondary Analysis of the Age of Blood in Children in the PICU Trial" published in the February issue of Pediatric Critical Care Medicine (Steffen K et al. Pediatr Crit Care Med. 2023;24:84-92). Dr. Steffen is a clinical associate professor of pediatrics at Stanford University School of Medicine in Palo Alto, California, USA.

For more than 10 years, the Society of Critical Care Medicine has offered an in-person critical care ultrasound course that spanned two days, interspersing lectures with interactive training. This format has now been replaced by a hybrid format, allowing more countries to host the course, virtually or in person, to ensure that healthcare professionals continue to receive optimized ultrasound training and education. Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, was joined by Sarah E. Bain, MD, at the 2023 Critical Care Congress to discuss the critical care ultrasound course, how it has evolved, and how it is expanding around the world. Sarah E. Bain, MD, is division head of cardiovascular thoracic and structural heart anesthesiology at Virginia Mason Hospital in Seattle Washington, USA.

Marilyn N. Bulloch, PharmD, BCPS, FCCM, and Daleen Penoyer, PhD, RN, CCRP, FCNS, FAAN, FCCM, discuss how to develop and operationalize performance improvement teams to implement the Surviving Sepsis Campaign’s (SSC) Hour-1 Bundle, which was developed in 2021 to minimize time to treatment for patients with sepsis and septic shock. Explore how to overcome barriers teams encounter in implementing the bundle, including inflexibility, lack of awareness about the bundle, competing priorities, and insufficient staffing. This podcast is funded by the Gordon and Betty Moore Foundation through a grant program administered by the Council of Medical Specialty Societies.

During the COVID-19 pandemic, hospitals implemented tele-critical care medicine to help patients while keeping staff safe from exposure. Now that patient care has gone back to normal, what is the role of tele-critical care medicine? Donald S. Prough, MD, FCCM, was joined by Krzysztof Laudanski, MD, PhD, FCCM, and Sonia S. Everhart, PharmD, BCPS, BCCCP, FCCM, during the 2023 Critical Care Congress to discuss how tele-critical care medicine was implemented during the COVID-19 pandemic and its continued benefits after the pandemic. Sonia S. Everhart, PharmD, BCPS, BCCCP, FCCM, is a clinical pharmacy specialist in critical care at Atrium Health in Charlotte, North Carolina, USA. Krzysztof Laudanski, MD, PhD, FCCM, is a senior associate consultant at the Mayo Clinic in Rochester, Minnesota, USA. This podcast is sponsored by Equum Medical and CLEW Medical.

Although the variety of noninvasive interfaces for pediatric patients has grown in the past 10 years, they are still limited. Pediatric interfaces are typically scaled down from adult to child sizes, which does not consider the contours of a growing child’s face, causing poor fit in patients of certain ages. Donald S. Prough, MD, FCCM, was joined by Natalie Napolitano, MPH, RRT-NPS, during the 2023 Critical Care Congress to discuss how clinicians’ need to have the right equipment for their patients led to a device development project using 3D imaging that obtained sample sizes from various age groups to bridge the fit gap and lessen pressure point injury among pediatric patients. Natalie Napolitano, MPH, RRT-NPS, is a respiratory therapist and research clinical specialist at the Children's Hospital of Philadelphia in Philadelphia, Pennsylvania, USA.

The Viral Infection and Respiratory Illness Universal Study (VIRUS) is a prospective, cross-sectional, observational study and registry of all eligible adult and pediatric patients who are admitted to a hospital. Marilyn N. Bulloch, PharmD, BCPS, FCCM, was joined by Rahul Kashyap, MD, MBA, at the 2023 Critical Care Congress to discuss the Discovery VIRUS COVID-19 Registry. Dr. Kashyap is an assistant professor and clinical research scientist at Mayo Clinic in Rochester, Minnesota, USA.

From the earliest days of critical care medicine, the importance of measuring cardiac output and hemodynamic monitoring were recognized in understanding the physiology of critically ill patients, especially those in shock. However, methods for measuring cardiac output were cumbersome or not widely available. Ashish K. Khanna, MD, FCCP, FCCM, is joined by Margaret M. Parker, MD, MCCM, to discuss the evolution of the pulmonary artery catheter in critically ill patients, as discussed in "The Story of the Pulmonary Artery Catheter: Five Decades in Critical Care Medicine," published in the February issue of Critical Care Medicine (Parker M et al. Crit Care Med. 2023;51:159-163). Dr. Parker is professor emeritus of pediatrics at Stony Brook University School of Medicine in Stony Brook, New York, USA.

Discovery, the Critical Care Research Network, is an SCCM program that aims to expand research and improve outcomes. Discovery has launched the Data Science Campaign to leverage large-scale (big) data for research, seeking to apply these data in a clinical environment through standardized models and shared resources. Kyle B. Enfield, MD, FSHEA, FCCM, was joined by J. Perren Cobb, MD, FACS, FCCM, and Karin Reuter-Rice, PhD, NP, FAAN, FCCM, at SCCM's 2023 Critical Care Congress to discuss the future of data science and critical care research.

Intensive care unit (ICU) clinicians pride themselves on their ability to care for others, even at the expense of caring for themselves. Kyle B. Enfield, MD, FSHEA, FCCM, was joined by Emily K. Valcin, DNP, RN, FCCM, during SCCM’s 2023 Critical Care Congress to discuss ICU clinician well-being and the importance of self-care.

Healthcare professionals who want to make a job change often do not know how to go about it. Impending job searches seem daunting. Ludwig Lin, MD, was joined by Mojdeh Heavner, PharmD, BCCCP, BCPS, FCCM, during SCCM's 2023 Critical Care Congress to discuss the dos and don'ts of changing jobs mid-career.

Confident, well-rounded leaders can increase the efficiency of their critical care unit, improve the performance of their teams, and ultimately achieve better patient outcomes. Marilyn Bulloch, PharmD, BCPS, FCCM, was joined by Judith Jacobi, PharmD, BCCCP, MCCM, during SCCM’s 2023 Critical Care Congress to discuss how the new Leadership, Empowerment, and Development (LEAD) Committee will engage participants in a variety of didactic and small-group sessions to facilitate their progress as mentors, managers, leaders of trainees, coworkers, critical care teams, volunteers, and future leaders within SCCM.

Diagnostic delays and errors are significant contributors to patient illness, injury, and death in the United States. According to the Society to Improve Diagnosis in Medicine, diagnostic errors impact nearly 12 million Americans every year, leading to prolonged hospital stays, increased nonreimbursed healthcare costs, and even more harm when combined with other medical errors. Maureen Madden, DNP, RN, CPNP-AC, CCRN, FCCM, is joined by Mary Jo C. Grant, ACNP, PhD, FAAN, to discuss how to reduce diagnostic delays and errors, with an emphasis on sepsis. This podcast is funded by the Gordon and Betty Moore Foundation through a grant program administered by the Council of Medical Specialty Societies. 0.5 hours of accredited continuing education credit is available for this podcast through March 31, 2024. Visit sccm.org/store and search the podcast name to find details.

The contribution of adverse events to the deaths of patients in the pediatric ICU (PICU) who die despite a low predicted mortality risk is unknown. Elizabeth H. Mack, MD, MS, FCCM, is joined by Carin W. Verlaat, MD, to discuss adverse events in low-risk nonsurvivors compared with low-risk survivors and high-risk PICU survivors and nonsurvivors and the contribution of adverse events to mortality. The podcast centers around the article, Adverse Events in Pediatric Critical Care Nonsurvivors With a Low Predicted Mortality Risk: A Multicenter Case Control Study (Verlaat C, et al. Pediatr Crit Care Med. 2023;24:4-16). Dr. Verlaat is a pediatric intensivist at Radboud University Medical Center in Nijmegen, Netherlands.

Bloodstream infections (BSIs) acquired in the ICU are potentially preventable. Kyle B. Enfield, MD, FSHEA, FCCM, is joined by Sameer S. Kadri-Rodriguez, MD, MS, to discuss the article, Epidemiology of ICU-Onset Bloodstream Infection: Prevalence, Pathogens, and Risk Factors Among 150,948 ICU Patients at 85 U.S. Hospitals, (Gouel-Cheron A, et al. Crit Care Med. 2022;50:1725-1736). Dr. Kadri-Rodriguez is a critical care and infectious diseases physician at the National Institutes of Health Clinical Center in Bethesda, Maryland. This podcast is sponsored by Sound Physicians.

Although only a small number of patients hospitalized with COVID-19 present with a secondary bacterial pneumonia, a large percentage are unnecessarily treated with antibiotics. Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by George Sakoulas, MD, to discuss how physicians and hospitalists can identify when antibiotics are unnecessary for hospitalized patients with moderate to severe respiratory infections. Dr. Sakoulas is chief of infectious disease at Sharp Rees-Stealy Medical Group in San Diego, California, and an adjunct professor in the Division of Host-Microbe Systems and Therapeutics Center for Immunity, Infection, and Inflammation at the University of California San Diego School of Medicine in La Jolla, California. This podcast is sponsored by bioMérieux.

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

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

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.

As a proof of concept, a recurrent neural network (RNN) model was developed using electronic medical record (EMR) data capable of continuously assessing a child's risk of mortality throughout an ICU stay as a proxy measure of illness severity.

This webcast will be a comparative analysis of conventional heparin-versus bivalirudin-based systemic anticoagulation in adult and pediatric patients supported on extracorporeal membrane oxygenation (ECMO).