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Category: Cardiovascular

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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.

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.

SCCM Pod-419 Hemodynamic Monitoring in the ICU

Review how to best utilize parameters provided by minimally invasive advanced hemodynamic monitors.

Host Michael Smith, MD, talks with Michael Scott, MBChB, about clinical thresholds that may warrant continuous advanced hemodynamic monitoring and the application of parameters such as stroke volume and stroke volume variation when administering fluid.

Dr. Scott is adjunct professor of anesthesiology and critical care at the University of Pennsylvania in Philadelphia, Pennsylvania, USA.

This podcast is sponsored by Edwards Lifesciences.

SCCM Pod-373 Preserving End-Organ Perfusion

Ranjit Deshpande, MD, speaks with Laurence W. Busse, MD, MBA, about Dr. Busse’s talk on preserving end-organ perfusion presented at the 46th Critical Care Congress in Honolulu, Hawaii, USA.

Dr. Busse is an assistant professor in the Division of Pulmonary Critical Care, Sleep, and Allergy Medicine at Emory University in Atlanta, Georgia, USA.

This podcast is supported by an unrestricted educational grant provided by La Jolla Pharmaceutical Company.

SCCM Pod-352 New-Onset Atrial Fibrillation in the Critically Ill

Kyle Enfield, MD, speaks with Travis J. Moss, MD, MSc, and J. Randall Moorman, MD, about the article, “New-Onset Atrial Fibrillation in the Critically Ill,” published in the May 2017 issue of Critical Care Medicine. Drs. Moss & Moorman discuss their study which set out to determine the association of new-onset atrial fibrillation with outcomes, including ICU length of stay and survival. Dr. Moss is a Fellow in the Division of Cardiovascular Medicine and Dr. Moorman is a Professor in the Division Cardiovascular Medicine at the University of Virginia Health System, in Charlottesville, Virginia. Crit Care Med. 2017; 45(5):790-797. Released: 10/24/17

SCCM Pod-212 CCM: Therapeutic Hypothermia Following Sudden Cardiac Arrest

Jeffrey Guy, MD, MSc, MMHC, speaks with David R. Janz, MD, lead author on an article published in the December issue of Critical Care Medicine, “Hyperoxia is Associated with Increased Mortality in Patients Treated with Mild Therapeutic Hypothermia after Sudden Cardiac Arrest.” Investigators found that sudden cardiac arrest is associated with high hospital mortality and poor neurologic outcomes. Janz is a clinical fellow at Vanderbilt University School of Medicine in Nashville, Tennessee.

SCCM Pod-35 CCM: Cooling After Cardiac Arrest

Raina M. Merchant, MD, a resident in emergency medicine at the University of Chicago, and Benjamin S. Abella, MD, an assistant professor of medicine in the section of emergency medicine at the University of Chicago, discuss their article published in the July 2006 issue of Critical Care Medicine. The article, "Therapeutic Hypothermia Utilization Among Physicians After Resuscitation From Cardiac Arrest," addresses whether physicians are cooling patients after cardiac arrest.

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.

Concise Critical Appraisal: Ultra-Low Tidal Volume Ventilation During CPR

Ruemmler et al (Resuscitation. 2018;132:56-62) set out to compare intermittent positive pressure ventilation to passive oxygenation (continuous positive airway pressure) and a novel ultra-low tidal volume ventilation (ULTVV) regimen.

Concise Critical Appraisal: Epinephrine in Out-of-Hospital Cardiac Arrest

Perkins et al (N Engl J Med. 2018;379:711-721) set out to examine the effects of epinephrine during OHCA.

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.

Concise Critical Appraisal: ARREST Trial: ECMO Versus Advanced Cardiac Life Support

The ARREST Trial compared extracorporeal membrane oxygenation (ECMO)-facilitated resuscitation to advanced cardiac life support (ACLS) treatment in patients with out-of-hospital cardiac arrest (OHCA). This month’s Concise Critical Appraisal takes a deep dive into the trial, published in The Lancet.

SCCM Pod-389 Infections on Extracorporeal Life Support

Margaret M. Parker, MD, MCCM, and Luregn Schlapbach, MD, FCICM, review a survey of international practice on prevention, diagnosis, and treatment of infections on extracorporeal life support in adults and children published in Pediatric Critical Care Medicine (Farrell, Deborah, et al. Pediatr Crit Care Med. 2019;20:667-671).

Dr. Schlapbach is a pediatric intensivist at Queensland Children's Hospital in South Brisbane, Australia.

SCCM Pod-309 Overall Hypothermia Update

Margaret Parker, MD, MCCM, speaks with Benjamin Abella, MD, about his upcoming talk, “Overall Hypothermia Update,“ which he will present at the 45th Critical Care Congress as part of the Society’s Current Concepts in Adult Critical Care Pre-Course. Dr. Abella is Associate Professor of Emergency Medicine and Vice Chair of Research in the Department of Emergency Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania. Dr. Abella discusses current hypothermia guidelines, the use of hypothermia as a treatment following cardiac arrest, and the benefits and challenges of implementing targeted temperature management protocols.

SCCM Pod-288 The Use of Pediatric Ventricular Assist Devices in Children's Hospitals

Margaret Parker, MD, MCCM, speaks with Robert T. Mansfield, MD, about the article, “The Use of Pediatric Ventricular Assist Devices in Children’s Hospitals from 2000 to 2010: Morbidity, Mortality, and Hospital Charges*,” published in the July 2015 issue of Pediatric Critical Care Medicine. Dr. Mansfield is a Cardiac Intensivist at the Children’s Hospital of Philadelphia in Philadelphia, Pennsylvania. In this article, Dr. Mansfield and coauthors examine the use of ventricular assist devices (VADs) in pediatric patients over time; specifically, the overall use, outcome, co-morbidities and resource utilization.

SCCM Pod-239 Hypertension and Health Outcomes in the PICU

Margaret Parker, MD, MCCM, speaks with Brett J. Ehrmann, MD, MS, about the article, “Hypertension and Health Outcomes in the PICU,” published in Pediatric Critical Care Medicine. Dr. Ehrmann is beginning his residency in Internal Medicine at the New York Presbyterian Hospital in New York City, New York. At the time of this project, he was a researcher in the Division of Pediatric Nephrology at the C.S. Mott Children’s Hospital in Ann Arbor, Michigan. This study represents the first detailed effort to characterize hypertension and its significance in critically ill children.

SCCM Pod-128 Patient Management After Cardiac Surgery

Anthony Carlese, MD, DO, discusses management of the patient after cardiac surgery, specifically his approach to caring for patients in the ICU who have just undergone coronary artery bypass surgery and the different situations and that he encounters. Carlese is the director of the open heart unit at Montefiore Medical Center in New York City, and he is also an American College of Critical Care Medicine member.

SCCM Pod-67 PCCM: Lower Limit of Systolic and Mean Arterial Pressure in Children

Arno Zaritsky, MD, discusses an article he and Dr. Ikram Haque published in the March 2007 issue of Pediatric Critical Care Medicine titled "Analysis of the Evidence for Lower Limit of Systolic and Mean Arterial Pressure in Children." Dr. Zaritsky is professor and chief of pediatric critical care at the University of Florida College of Medicine in Gainesville, Florida. 

SCCM Pod-58 CC: Cardiology Pharmacotherapies

Frederick P. Ognibene, MD, FCCM, discusses his goals as the Society's president for 2007 as well as his decades-long involvement in SCCM and the critical care community. Dr. Ognibene is director of the office of clinical research training and medical education at the National Institutes of Health (NIH) Clinical Center and the director of clinical research training program, OIR. He also is an attending in the medical intensive care unit at the NIH Clinical Center. 

Can antiplatelets be administered at the same time as anticoagulation in patients with COVID-19?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on February 24, 2021