Critical Connections Blog

Assessment of Inflammation Phenotypes in Pediatric Sepsis-Induced Multiple Organ Failure
This Concise Critical Appraisal discusses how Carcillo et al (Pediatr Crit Care Med. 2019. Epub ahead of print) compared mortality in children with severe sepsis and MOF who present with one of four phenotypes: 1) immunoparalysis-associated MOF (IPMOF), 2) thrombocytopenia-associated MOF (TAMOF), 3) sequential liver failure-associated MOF (SMOF), and 4) MOF without any immunologic phenotype. The study investigated the association between these phenotypes and macrophage activation syndrome, a potential common pathway of uncontrolled inflammation (Carcillo et al. Pediatr Crit Care Med. 2017;18:S32-S45).
 
Posted: 12/9/2019 | 0 comments

How ICU Liberation Brought Value to Our Patients, Team Members, and Administrators
An interview with an ICU Liberation Collaborative Leader and Participant.
Posted: 11/25/2019 | 0 comments

Donor-Funded Training Supports Fundamentals Courses in Rwanda

Learn how Society of Critical Care Medicine (SCCM) members turned a passion for improving care into action by holding donor-funded training in resource-limited areas.

Posted: 11/18/2019 | 0 comments

Strategies for Reducing and Eliminating CLABSI And CAUTI in the Intensive Care Unit
The Society of Critical Care Medicine (SCCM) held a session at the 48^th Critical Care Congress that offered best practices for reducing CLABSI and CAUTI infections. Subject matter experts discussed quality improvement strategies as well as overcoming challenges and resistance to change.  We’ve outlined the questions from the session and curated responses.
 
Posted: 11/13/2019 | 0 comments

Concise Critical Appraisal: Moderate Therapeutic Hypothermia in Patients with Nonshockable Rhythms
Lascarrou et al (N Engl J Med. 2019. Epub ahead of print) set out to test the effectiveness of moderate therapeutic hypothermia (MTH) in patients with nonshockable rhythms.
 
Posted: 11/12/2019 | 0 comments

Call for 2021 Strategic Planning Proposals
Members of the Society of Critical Care Medicine (SCCM) play a crucial role in cultivating new ideas and initiatives. Submitting a strategic planning proposal is one way to engage with SCCM and be a part of its mission to improve critical care and are under way. Proposals are due by March 6, 2020.
Posted: 11/8/2019 | 0 comments

Help Shape the Future of Sepsis Research on the National Level
The National Institute of General Medical Sciences (NIGMS) is changing its priorities to invest in sepsis research in a more targeted and strategic way. In an important opportunity to help shape the future of sepsis research, NIGMS has issued a request for information related to its new priorities. The request for information is found here and is due by November 15, 2019.
Posted: 10/22/2019 | 0 comments

My First Congress: What to Know
Caitlin Cundiff, ACNP-BC, presented her Critical Care Congress abstract case report during a Research Snapshot Theater at the 49th Critical Care Congress. She shares her tips for attending Congress.
Posted: 10/15/2019 | 0 comments

Concise Critical Appraisal: Cardiac Arrest in the ICU: An Assessment of Preventability
Moskowitz et al (Resuscitation. 2019. Epub ahead of print) set out to investigate the preventability of ICU-CAs and identify targets for future intervention.
Posted: 10/9/2019 | 0 comments

Texas In-Hospital Do-Not-Resuscitate Orders: New Law, New Changes
In-hospital do-not-resuscitate (DNR) orders in the State of Texas have faced much tighter regulation since April 2018. With Senate Bill 11, both the meaning of a DNR order and the circumstances in which it can be entered are now more tightly defined.
Posted: 10/7/2019 | 0 comments

Anti-Factor Xa-Based Monitoring of Unfractionated Heparin
Saini et al (J Pediatr. 2019;209:212-219.e1) sought to evaluate the clinical outcomes in pediatric patients receiving UFH while being monitored using anti-factor Xa and to determine the correlation between anti-factor Xa heparin and aPTT.
Posted: 9/4/2019 | 0 comments

Concise Critical Appraisal: Early Sedation Using Dexmedetomidine in Critically Ill Patients
Shehabi et al (N Engl J Med. 2019;380:2506-2517) set out to examine the effects of using dexmedetomidine as the primary agent for early sedation among patients receiving ventilatory support and found that the dexmedetomidine group had a higher risk of adverse events and needed additional sedatives to achieve sedation goals.
Posted: 8/12/2019 | 0 comments

Concise Critical Appraisal: Mentorship in Academic Medicine
Disch (Crit Care Med. 2018;46:437-441) set out to highlight the benefits of mentorship and its lack in underrepresented groups. Although women and minorities make up an increasing percentage of physicians and medical school faculty, they are underrepresented at higher ranks. She cites a study surveying over 1,100 women faculty members that found that only 54% felt they had a mentor.
Posted: 7/1/2019 | 0 comments

Concise Critical Appraisal: Effect of Community-Acquired Pediatric Sepsis on Survivors
Killien et al (Pediatr Crit Care Med. 2019;Epub ahead of print) set out to evaluate the prevalence of health-related quality of life (HRQL) decline in pediatric survivors of community-acquired sepsis, severe sepsis, and septic shock and to determine which factors are associated with a failure to return to baseline HRQL.
Posted: 6/13/2019 | 0 comments

Working Together to Advance Diversity and Inclusion
Read about the Society of Critical Care Medicine's (SCCM) efforts to seek diversity and inclusion within the critical care profession and SCCM organization.
Posted: 6/3/2019 | 0 comments

Concise Critical Appraisal: Impact of Mentoring in Academic Medicine
Efstathiou et al (PLoS One. 2018;13:e0207634) developed a standardized mentorship program and a series of surveys to evaluate the program’s impact, specifically measuring faculty satisfaction and productivity.
Posted: 5/9/2019 | 0 comments

Concise Critical Appraisal: Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status Versus Serum Lactate
Hernández et al (JAMA. 2019;321:654-664) set out to address that question with a multicenter randomized trial in which they compared two resuscitative targets: the normalization of blood lactate and the normalization of peripheral perfusion as quantified by capillary refill time.
Posted: 4/11/2019 | 0 comments

Concise Critical Appraisal: Epinephrine Versus Norepinephrine for Cardiogenic Shock
Levy et al (J Am Coll Cardiol. 2018;72:173-182) conducted a prospective, double-blind, multicenter RCT comparing epinephrine to norepinephrine in the setting of CS in patients who underwent AMI treated with percutaneous coronary intervention.
Posted: 3/12/2019 | 0 comments

Concise Critical Appraisal: Effect of Low Versus Intermediate Tidal Volume Strategy
Simonis et al (JAMA. 2018;320;1872-1880) set out to evaluate the effect of an LTVV strategy versus an intermediate tidal volume ventilation strategy in intensive care unit patients without ARDS.
Posted: 2/12/2019 | 0 comments

Concise Critical Appraisal: Antipsychotic Medications for Delirium in the ICU
Girard et al (N Engl J Med. 2018;379:2506-2516) and Page et al (Lancet Respir Med. 2013;1:515-523) evaluated the treatment of acute delirium with antipsychotics.
Posted: 1/8/2019 | 0 comments