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Michael Smith, MD, and Jayshil Patel, MD, discuss the factors associated with managing malnutrition in the critical ill utilizing enteral nutrition and the stages of critical care illness and how it effects nutrition assessment. Dr. Patel explains various considerations for nutrition in critically ill patients including the benefit of early nutrition within the first 24 to 48 hours of intensive care unit admission outlined in the joint American Society for Parenteral and Enteral Nutrition and SCCM nutrition guidelines published in Critical Care Medicine in 2016. Dr. Patel is the associate professor of medicine in the division of pulmonary and critical care medicine at the Medical College of Wisconsin. This podcast is sponsored by Nestlé Health Science.
Michael Smith, MD, and Sarah Vest Cogle, PharmD, BCCCP, review current methodologies for managing nutrition concerns for critically ill morbidly obese patients. Dr. Cogle discusses the role of nutrition risk assessment outlined in the joint American Society for Parenteral and Enteral Nutrition and SCCM nutrition guidelines published in Critical Care Medicine in 2016. Dr. Cogle is assistant clinical professor at Auburn University’s Harrison School of Pharmacy and a critical care and nutrition support clinical pharmacist at East Alabama Medical Center in Auburn, Alabama, USA. This podcast is sponsored by Nestlé Health Science.
Margaret M. Parker, MD, MCCM, and Craig M. Coopersmith, MD, FCCM, discuss Dr. Coopersmith's talk from the 48th Critical Care Congress titled “The Gut as a Motor of Multiorgan Dysfunction in Critical Illness.” They review current research and what treatments we might see in the future. Dr. Coopersmith is professor of surgery at Emory University in Atlanta, Georgia, USA.
Michael Weinstein, MD, FACS, speaks with Todd W. Rice, MD, MsC, about the article, “Feeding the Critically Ill Patient,” published in the December 2014 issue of Critical Care Medicine. Dr. Rice is an Assistant Professor of Medicine in the Division of Allergy, Pulmonary, and Critical Care Medicine at Vanderbilt University in Nashville, TN. In this article, Dr. Custer and coauthors discuss the most up-to-date nuances and controversies regarding nutritional support of critical care patients.
Ainsley Malone, RD, MS, LD, GNSD, discusses goal-directed nutrition with iCritical Care Podcast editor Jeffrey Guy, MD, MSc, MMHC. Malone, who presented on this topic during the 41st Critical Care Congress, is a nutrition support dietitian in the pharmacy department of Mount Carmel West Hospital in Columbus, Ohio, USA.
Ali Al-Khafaji, MD, MPH, is the lead author of an article published in the May 2011 Critical Care Medicine titled, “Critical Care Management of Patients with End-Stage Liver Disease.” The literature review showed that managing complications of end-stage liver disease requires awareness and expertise among physicians from a wide variety of fields. Authors present their recommendations for the neurologic, cardiovascular, pulmonary, gastrointestinal, renal, and infectious complications of end-stage liver disease. Al-Khafaji is an associate professor of critical care medicine at the University of Pittsburgh School of Medicine in Pittsburgh, Pennsylvania. He is also the Director of the Transplant Intensive Care Unit at the University of Pittsburgh.
Todd W. Rice, MD, MSc, is the lead author of an article published in the May 2011 Critical Care Medicine titled, “Randomized Trial of Initial Trophic Versus Full-Energy Enteral Nutrition in Mechanically Ventilated Patients with Acute Respiratory Failure.” Overall, the data found that a less aggressive feeding strategy during the initial stages of mechanical ventilation is not demonstrably worse than early advancement to full-energy enteral nutrition. Rice is an assistant professor of medicine at Vanderbilt University School of Medicine in Nashville, Tennessee.
Allan J. Walkey, MD, MSc, is the lead author of an article published in the June 2011 Critical Care Medicine titled “Utilization Patterns and Patient Outcomes Associated with Use of Rescue Therapies in Acute Lung Injury.” Walkey is an assistant professor of medicine and the director of pulmonary and critical care education at Boston University School of Medicine in Boston, Massachusetts.
Phillip S. Barie, MD, MBA, FCCM, discusses decontamination of the digestive tract and oropharynx in an attempt to prevent ventilator-associated pneumonia. He discusses a recent article published in The New England Journal of Medicine, “Decontamination of the Digestive Tract and Oropharynx in ICU Patients.” Barie is Immediate Past President of the Society of Critical Care Medicine (SCCM), as well as professor of surgery and public health at Weill Medical College of Cornell University in New York. He is also the director of surgical critical care and the surgical intensive care unit at New York Presbyterian Hospital. While Barie has not authored either of these articles, he is considered an expert in this field, which is very important to critical care practice.
Paul E. Wischmeyer, MD, discusses nutrition in the intensive care unit, specifically addressing what role total parenteral nutrition might have for the critically ill or injured patient. Dr. Wischmeyer is a professor of anesthesiology at the University of Colorado Health Sciences Center in Denver, Colorado.
The Society of Critical Care Medicine's president-elect Phil Barie, MD, MBA, FCCM, discusses a study published in Annals of Surgery, titled "Early Antibiotic Treatment for Severe Acute Necrotizing Pancreatitis." Dr. Barie is professor of surgery and public health at Weill Medical College of Cornell University in New York and was a co-author in this important study.
John Mazuski, MD, FCCM, and Beth Taylor, MS, RD, CNSD, FCCM, discuss their article published in the February 2007 issue of Critical Connections, titled "Gastric vs. Intestinal Feeding: Does it Make a Difference?" Dr. Mazuski is a professor of surgery at Washington University in St. Louis, Missouri, and Ms. Taylor is a nutrition support dietitian at Barnes Jewish Hospital in St. Louis.
This podcast will describe the principle of albumin dialysis of the molecular adsorbent recirculating system (MARS). Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Ram M. Subramanian, MD, MBA, FCCM, to discuss the logistics of starting a MARS program to outline indications for MARS. Dr. Subramanian is a hepatologist at Emory University in Atlanta, Georgia. This podcast is sponsored by Baxter.
What is the benefit of early versus late nutrition in critically ill children? In this Concise Critical Appraisal, Daniel E. Sloniewsky, MD, FCCM, offers a deep dive on this Pediatric Critical Care Medicine article by Srinivasan et al, which sought to answer this question using data from the Heart and Lung Failure-Pediatric Insulin Titration (HALF-PINT) study.
Margaret M. Parker, MD, MCCM, and Elizabeth Emrath, MD, discuss Dr. Emrath’s talk on the new pediatric nutritional guidelines (Mehta N, et al. Pediatr. Crit Care Med. 2017;18:675-715) from the 48th Critical Care Congress precourse Current Concepts in Pediatric Critical Care. They review the updated recommendations and what future research is needed. Dr. Emrath is an assistant professor at the Medical University of South Carolina in Charleston, South Carolina, USA. This podcast is sponsored by Nestle Health Science.
Margaret Parker, MD, MCCM, speaks with Nilesh M. Mehta, MD, about the article, “Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition,” published in the July 2017 issue of Pediatric Critical Care Medicine. Dr. Mehta discusses best practices in nutrition therapy in critically ill children. Dr. Mehta is the Director of Critical Care Nutrition in the division of critical care medicine in the department of anesthesiology, critical care, and pain medicine at Boston Children’s Hospital and an associate professor of anesthesia (critical care) at Harvard Medical School in Boston, Massachusetts. Mehta, Nilesh M. MD; Skillman, Heather E. MS, RD, CSP, CNSC; Irving, Sharon Y. PhD, CRNP, FCCM, FAAN; Coss-Bu, Jorge A. MD; Vermilyea, Sarah MS, RD, CSP, LD, CNSC; Farrington, Elizabeth Anne PharmD, FCCP, FCCM, FPPAG, BCPS; McKeever, Liam MS, RDN; Hall, Amber M. MS; Goday, Praveen S. MBBS, CNSC; Braunschweig, Carol PhD, RD. Ped Crit Care Med. 2017; 18(7):675-715. This podcast is supported by an educational grant provided from Abbott Nutrition.
Margaret Parker, MD, MCCM, speaks with Ann-Marie Brown, ACNP, PhD, RN, FCCM, Assistant Professor of Nursing at the University of Akron and Advanced Practice Nurse in the Pediatric Intensive Care Unit at Akron Children’s Hospital in Akron, Ohio. Dr. Brown shares her insights on the benefits of a protocolized feeding approach and discusses the issues related to feeding in critically ill children.
Todd Fraser, MD, speaks with Monty Mythen, MD, about the article, “Trial of the Route of Early Nutritional Support in Critically Ill Adults,” published in The New England Journal of Medicine in 2014. Dr. Mythen is the Smiths Medical Professor of Anaesthesia and Critical Care at the University College of London and an elected council member of the Royal College of Anaesthetists. Dr. Mythen and coauthors found no significant difference in 30-day mortality associated with the route of delivery of early nutritional support in critically ill adults.
Margaret Parker, MD, MCCM, speaks with Nilesh M. Mehta, MD, about the article, “A Stepwise Enteral Nutrition Algorithm for Critically Ill Children Helps Achieve Nutrient Delivery Goals,” published in Pediatric Critical Care Medicine. Dr. Mehta is an Associate Professor in Anesthesia at Harvard Medical School; Associate Medical Director of Critical Care in the Department of Anesthesiology, Pain, and Perioperative Medicine at Boston Children’s Hospital; and the Director of the Pediatric Critical Care Nutrition Program at Boston Children’s Hospital. In this article, Dr. Mehta and coauthors evaluate the impact of implementing an enteral nutrition algorithm on achieving optimal enteral nutrition delivery in the PICU.
Jeffrey Guy, MD, MSc, MMHC, speaks with Nilesh Mehta, MD, about his article published in the July 2012 Critical Care Medicine, “Nutritional Practices and Their Relationship to Clinical Outcomes in Critically Ill Children: An International Multicenter Cohort Study.” Mehta is an associate in critical care medicine at Children’s Hospital Boston in Boston, Massachusetts.