Critical Connections Blog

Early Mobilization During Mechanical Ventilation: Pain With No Gain
Early active mobilization has been shown to mitigate ICU-acquired weakness, reduce disability and, most importantly, reduce mortality. This Concise Critical Appraisal describes a recent article published in the New England Journal of Medicine about mobilization during mechanical ventilation that reevaluates the effects of sedation minimization and daily physiotherapy on serious adverse events and mortality at 180 days.
Posted: 12/15/2022 | 0 comments | Concise Critical Appraisal, Early Mobility, Mechanical Ventilation

NIH Funds SCCM Discovery Study on the Use of Sepsis Bundles in the Emergency Department
In funding a five-year prospective multicenter study to determine the safest and most effective approach to sepsis intervention, the National Heart, Lung, and Blood Institute (NHLBI) is recognizing the significant accomplishments of the Surviving Sepsis Campaign (SSC) and the Society of Critical Care Medicine (SCCM) to improve outcomes in patients with sepsis.
Posted: 12/9/2022 | 0 comments | Discovery, Sepsis

Improving Post-ICU Stay Outcomes: How SCCM’s Discovery Grant Helped Establish an NIH-Funded Study
Paul E. Wischmeyer, MD, EDIC, FASPEN, FCCM, has a highly personal understanding of the challenges of recovering from an intensive care unit (ICU) stay. Diagnosed at age 15 with ulcerative colitis, his colon was removed when it perforated and caused septic peritonitis. Throughout his life, he has had 27 major surgeries and multiple ICU stays for bowel resections after bowel obstructions or to address complications from recurrent intestinal obstructions. These experiences have motivated his research to test a personalized, remotely monitored, coached exercise program to help patients recover after ICU discharge.
Posted: 12/2/2022 | 0 comments | Discovery, PICS, Quality

SCCM Member Creates Telehealth Nonprofit to Help Ukrainians
When Russia invaded Ukraine, Jarone Lee, MD, MPH, FCCM, like so many others, wanted to help the Ukrainian people. But beyond donating money or supplies, Dr. Lee realized his unique combination of skills could help in a different way.
Posted: 11/22/2022 | 0 comments | Disaster Response, Telemedicine, Ukraine

SCCM Member Efforts in Ukraine
Rom A. Stevens, MD, FCCM, and Robert Kerr, MD, were planning to spend this past April sailing off the west coast of Alaska. The two retired Navy captains were looking forward to a relaxing escape, ready to soak in the breathtaking scenery of the last frontier. Instead, they found themselves in war-torn Ukraine, trying desperately to aid a country being decimated by ongoing Russian invasions.
Posted: 11/21/2022 | 0 comments | Disaster Response, Ukraine

Concise Critical Appraisal: Impact of a Machine Learning Early Warning Score on Hospital Mortality
Common causes of death in hospitals, such as sepsis and respiratory failure, are treatable and benefit from early intervention. Machine learning algorithms or early warning scores can be used for early identification and recognition to potentially help accelerate interventions and limit morbidity and mortality. This Concise Critical Appraisal explores an article published in Critical Care Medicine that looked at the impact of one of these early warning scores—electronic cardiac arrest risk triage (eCART)—on mortality for elevated-risk adult inpatients.
Posted: 11/16/2022 | 0 comments | Cardiac Arrest, Concise Critical Appraisal, Hospital Mortality, Machine Learning

Discovery and SARI-PREP Have Roles in Preparing for Next Pathogen Outbreak
The COVID-19 pandemic exposed major gaps in the U.S. healthcare system, prompting the National Emerging Special Pathogens Training and Education Center (NETEC) to form the National Special Pathogen System of Care (NSPS) to prepare the country for the next large-scale outbreak. Discovery, the Critical Care Research Network, and its Severe Acute Respiratory Infection – Preparedness (SARI-PREP) program are helping lead the way in this new vision. SARI-PREP is a key player in the effort to establish a coordinated and standardized healthcare network that provides high-quality care to parents with a special pathogen, while also protecting healthcare workers.
Posted: 10/14/2022 | 0 comments | COVID-19, Discovery Research Network, SARI-PREP

Concise Critical Appraisal: Professional Development Despite ICU Burnout and Staff Shortages
This Concise Critical Appraisal describes two articles that illuminate the associations among the COVID-19 pandemic, clinician well-being, and burnout—an article on the perceptions of critical care shortages, resource use, and clinician well-being and an article comparing the effects of the pandemic among critical care professions.
Posted: 9/14/2022 | 0 comments | Burnout, Concise Critical Appraisal, Professional Development, Staff Shortages

Concise Critical Appraisal: Arginine Therapy in Hospitalized Children With Sickle Cell Anemia
Can arginine supplements improve the hemodynamics of children with severe pain or acute chest syndrome (ACS) related to sickle cell anemia? Although mortality rates in children with sickle cell disease (SCD) have improved over the past decade, ACS and vasoocclusive episodes (VOE) remain relatively common diagnoses in pediatric ICUs. This Concise Critical Appraisal explores an article in which Onalo et al completed the second phase of their work determining the role that L-arginine treatment may play in the cardiopulmonary status of children with SCD and VOE, with or without ACS. In the first phase of their work, the authors demonstrated decreased hospitalization time, decreased opioid use, and the absence of serious adverse events in children with SCD after receiving L-arginine therapy.
Posted: 8/17/2022 | 0 comments | cardiopulmonary, Concise Critical Appraisal, Hemodynamic Support

ICU Liberation Bundle Implementation: Nurses Champion Change as Early Adopters
How can nurses champion change and improve outcomes by implementing the ICU Liberation Bundle (A-F)? Laura S. Maples, MSN, RN, CCRN-K, summarizes how nurses become early adopters of the bundle, focusing on advocacy for their patients’ best outcomes, and advocating for multiprofessional collaboration to successfully implement the elements of the bundle.
Posted: 8/17/2022 | 0 comments | ICU Liberation, ICU Liberation Bundle (A-F), Nurses

SCCM Humanitarian Efforts in Ukraine
The ongoing humanitarian crisis in Ukraine has quickly become historic for its magnitude. The conflict has also led to crisis within the Ukrainian healthcare system. Here is how the Society of Critical Care Medicine (SCCM) has been helping.
Posted: 7/27/2022 | 0 comments | Disaster, Disaster Response, Ukraine

Concise Critical Appraisal: COVID-19 Pandemic Impacts Burnout Critical Care Professions Differently
The COVID-19 pandemic created a new challenging environment in which healthcare workers must survive. Before the pandemic, healthcare workers experienced burnout due to resource allocation and shortages, mental anguish, and long work hours. The pandemic further exacerbated this situation, creating a new crisis within our already frayed healthcare system. This Concise Critical Appraisal dives into an article published in Critical Care Medicine that reviewed the causes of burnout and the correlation between the COVID-19 pandemic and workplace burnout.
Posted: 7/22/2022 | 0 comments | Burnout, Concise Critical Appraisal, COVID-19

Concise Critical Appraisal: Continued Rise of Venous Thromboembolism Across US Children’s Hospitals
Has the rate of venous thromboembolism (VTE) in children changed over time? A 2009 study reported a 70% increase in VTE in acutely and chronically ill children. The reasons for this increase were not clear but were postulated to be related to improved survival of critically ill children, increased use of central venous catheters, and increased prevalence of adolescent obesity. This Concise Critical Appraisal dives into a 2022 article that sought to determine whether the rate of VTE continued to increase between 2008 and 2019.
Posted: 6/8/2022 | 0 comments | Concise Critical Appraisal, Venous Thromboembolism

Mpox Outbreak: Frequently Asked Questions
The Society of Critical Care Medicine (SCCM) has compiled and developed resources on what clinicians need to know about mpox (formerly monkeypox). While mpox is usually a self-limited disease with symptoms lasting two to four weeks, severe cases and death have occurred during the current outbreak, so it is important for critical care clinicians to recognize potential mpox infections. Visit SCCM’s mpox web page for additional details.
Posted: 5/31/2022 | 0 comments | Emergency Response, Monkeypox, Mpox

Concise Critical Appraisal: Temperature Management After Cardiac Arrest
Recently published guidelines have replaced the recommendations on temperature management after cardiac arrest included in the 2021 post-resuscitation care guidelines co-issued by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). This Concise Critical Appraisal examines the previously reported recommendations and evidence, reviews the ERC-ESICM updated recommendations, and highlights the areas that still lack investigation and clarity.
Posted: 5/10/2022 | 0 comments | Cardiology, Concise Critical Appraisal, Targeted Temperature Management

Best Practices for Mentorship and Burnout Mitigation
More than 75% of healthcare professionals have self-reported burnout as well as increased frustration and feeling overwhelmed at work. Andrea Sikora, PharmD, BCCCP, MSCR, FCCM, discusses what can be done and highlights three recent articles offering recommendations on how to prevent burnout and establish effective mentorship opportunities.
Posted: 4/19/2022 | 0 comments | 2022 Congress, Burnout, Mentorship, Well-Being

AHRQ Releases New Experience-Based Toolkit for Intensive Care Units
The new Agency for Healthcare Research and Quality (AHRQ) Toolkit for Preventing CLABSI and CAUTI in ICUs offers customizable tools and training resources to help your facility prevent dangerous infections. Its unique design gives users resources to assess current clinical and safety practices, implement a reduction plan, and overcome common cultural and technical challenges in reduction efforts. 
Posted: 4/18/2022 | 0 comments | 2022 Congress, Infection Control

SCCM ICU Heroes: The Love Army
The ICU Heroes Award recognizes that patients and families are an integral part of intensive care unit (ICU) care. The award is given to an ICU patient and family and to the multiprofessional team that delivered the care.
Posted: 4/15/2022 | 0 comments | Awards, COVID-19, Patient and Family

Concise Critical Appraisal: Quality Improvement Intervention on Sleep and Delirium
Does your hospital use a checklist or bundle to minimize risk factors for delirium? Delirium is common in surgical and medical intensive care units (ICUs) and has shown to be associated with longer mechanical ventilation duration and longer ICU and hospital lengths of stay. This Concise Critical Appraisal explores a study that evaluated a multicomponent nonpharmacologic quality improvement intervention aimed at the sleep-wake cycle for reducing delirium in critically ill patients in the surgical critical care setting.
Posted: 4/13/2022 | 0 comments | Concise Critical Appraisal, Delirium

SCCM Demonstrates Commitment to Diversity, Equity, and Inclusion at 2022 Critical Care Congress
The Society of Critical Care Medicine’s (SCCM) dedication to diversity, equity, and inclusion (DEI) will be on full display at the 2022 Critical Care Congress. Congress will feature a number of sessions that delve deep into DEI topics, offering attendees suggestions for providing equitable care for all patients, as well as advocating for themselves and others in the intensive care unit (ICU).
Posted: 4/7/2022 | 0 comments | 2022 Congress, Diversity