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Ranjit Deshpande, MD, speaks with Rajit Basu, MD, MS, FCCM, about treating volume overload in the intensive care unit with renal replacement therapy. Dr. Basu presented his talk at the 47th Critical Care Congress in San Antonio, Texas.
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.
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.
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" (Tumlin JA, et al. Crit Care Med. 2018;46:949-957).
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” (Santamaria J, et al. Crit Care Med. 2018;46:1063-1069).
Kyle B. Enfield, MD, speaks with John W. Devlin, PharmD, FCCM, about the article "Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU" (Devlin JW, et al. Crit Care Med. 2018;46:e825-e873).
Ludwig H. Lin, MD, and Philipp Schuetz, MD, discuss procalcitonin and how it impacts treatment of sepsis. This podcast originated from the article "Efficacy and Safety of Procalcitonin Guidance in Patients With Suspected or Confirmed Sepsis: A Systematic Review and Meta-Analysis" (Iankova I, et al. Crit Care Med. 2018;46:691-698).
Ranjit Deshpande, MD, and Simon W. Lam, PharmD, MS, BCPS, BCCCP, FCCM, discuss procalcitonin guidance during different phases of antibiotics management in patients admitted to intensive care units.
Ludwig H. Lin, MD, and Ashish K. Khanna, MD, FCCP, FCCM, discuss Dr. Khanna’s top-rated abstract, Derivation and Validation of a Novel Opioid-Induced Respiratory Depression Risk Prediction Tool (Khanna A, et al. Crit Care Med. 2019;47:18), from the Society of Critical Care Medicine’s 48th Critical Care Congress.
Margaret M. Parker, MD, MCCM, speaks with SCCM President Heatherlee Bailey, MD, FCCM, about Dr. Bailey's path to becoming SCCM’s 2019 president and about her goals for SCCM during her term as president.
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.
Ludwig H. Lin, MD, and Benjamin Moses, MD, MS, discuss Dr. Moses' talk from the 48th Critical Care Congress titled "Drug-Seeking Behavior in the ICU." They review the opioid crisis and managing addiction in the ICU.
Ranjit Deshpande, MD, and Mark D. Cipolle, MD, PhD, FCCM, discuss Dr. Cipolle's talk from the 48th Critical Care Congress on what's new in anticoagulant reversal. Tune in to hear about the hottest topics and current research.
Margaret M. Parker, MD, MCCM, and Patrick M. Kochanek, MD, MCCM, discuss the updated pediatric severe traumatic brain injury guidelines (Kochanek P, et al. Pediatr Crit Care Med. 2019;20:S1-S82).
Kyle B. Enfield, MD, and Paula Ferrada, MD, discuss Dr. Ferrada's talk from the 48th Critical Care Congress titled "Clostridium difficile: Sparring With Spores." Current treatment recommendations and surgical options are discussed.
Kyle B. Enfield, MD, and Craig M. Lilly, MD, FCCM, examine tele-ICUs. Dr. Lilly presented on this topic at the Society's 48th Critical Care Congress and here he continues the discussion of tele-ICUs’ function, development, and necessity.
Kyle B. Enfield, MD, and Sheila A. Alexander, BSN, PhD, RN, FCCM, review targeted temperature management, especially its use in treating intracerebral hemorrhage.
Ranjit Deshpande, MD, and Ruth M. Kleinpell, PhD, RN, ACNP, FCCM, discuss the results of the Choosing Wisely national survey from the Critical Care Societies Collaborative (Kleinpell R, et al. Crit Care Med. 2019;47:331-336).
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).
Ranjit Deshpande, MD, and Donna Lee Armaignac, PhD, APRN, CCNS, CCRN, discuss maximizing positive patient care outcomes through telemedicine.
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.
Kyle B. Enfield, MD, and Michael J. Connor Jr, MD, discuss when to start renal replacement therapy (RRT) in critically ill patients. Background studies, indicators for early RRT, and other factors that influence RRT decisions are discussed.
Margaret M. Parker, MD, MCCM, and Lorry R. Frankel, MD, FCCM, discuss the updated pediatric critical care admission, discharge, and triage criteria and levels of care guidance published in the September issue of Pediatric Critical Care Medicine (Frankel L, et al. Pediatr Crit Care Med. 2019;20:847-887).
Margaret M. Parker, MD, MCCM, speaks with Rakesh Lodha, MD, on his article titled Polyneuropathy in Critically Ill Mechanically Ventilated Children: Experience from Tertiary Care Hospital in North India, published the September issue of Pediatric Critical Care Medicine (Shubham S, et al. Pediatr Crit Care Med. 2019;20:826-831).
Ranjit Deshpande, MD, and Pratik P. Pandharipande, MD, FCCM, discuss the impact of critical illness on neurocognitive and physical functions.
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.
Ludwig H. Lin, MD, and John A. Kellum, MD, MCCM, review factors associated with renal recovery, therapies and techniques used to enhance recovery, and long-term consequences of nonrecovery in critical illness.
Michael Smith, MD, and Sarah Vest Cogle, PharmD, BCCCP, review current methodologies for managing nutrition concerns for critically ill morbidly obese patients.
Margaret M. Parker, MD, MCCM, speaks with Danny Hames, MD, on his article titled "Risk Factors for Mortality in Critically Ill Children Requiring Renal Replacement Therapy ," published in the November 2019 issue of Pediatric Critical Care Medicine (Hames D, et al. Pediatr Crit Care Med. 2019;20;1069-1077).
Kyle B. Enfield, MD, FCCM, and Azra Bihorac, MD, MS, FCCM, discuss best practices and complexities of implementing biomarkers for kidney stress and acute kidney injury (AKI) and what the future holds for AKI biomarker literature.
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.
Kyle B. Enfield, MD, and Marin H. Kollef, MD, discuss the findings and design of the cluster randomized crossover trial on early palliative care consultation in the medical intensive care unit (ICU) published in the December 2019 issue of Critical Care Medicine.
Margaret M. Parker, MD, MCCM, and Mitchell M. Levy, MD, MCCM discuss the Hour-1 Bundle, the controversies of the Surviving Sepsis Campaign, and the future of sepsis.
Margaret M. Parker, MD, MCCM, speaks with Rashid Alobaidi, MD, on his article titled "Population-Based Epidemiology and Outcomes of Acute Kidney Injury in Critically Ill Children,"
Ludwig H. Lin, MD, and Michael G.S. Shashaty, MD, MS, discuss acute kidney injury (AKI) biomarkers and whether they are ready for clinical use.
Margaret M. Parker, MD, MCCM, and Scott L. Weiss, MD, FCCM, discuss the release of "Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children," published in the February 2020 issue of Pediatric Critical Care Medicine (Weiss S, et al. Pediatr Crit Care Med. 2020;21(2);e52-e106).
Margaret M. Parker, MD, MCCM, and Jerry J. Zimmerman, MD, PhD, FCCM, talk about the trajectory of long-term mortality and significant health-related quality of life disability among children encountering septic shock.
Kyle B. Enfield, MD, and Craig M. Lilly, MD, discuss the newly released guidance for vaping-associated respiratory distress syndrome, published in Critical Care Explorations (Lilly C, et al. Crit Care Explor. 2020;2(2): e0081).
Explore the Surviving Sepsis Campaign's guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19) (Alhazzani W, et al. Crit Care Med. 2020;46:854-887) with host Kyle B. Enfield, MD, and authors Mitchell M. Levy, MD, MCCM, and Waleed Alhazzani, MD, MSc, FRCPC.
Review neurologic manifestations of COVID-19 and other severe respiratory viral contagions (Robinson C, et al. Crit Care Explor. 2020;2:e0107) with host Ludwig H. Lin, MD, and author Christopher P. Robinson, DO, MS.
Margaret M. Parker, MD, MCCM, and Christopher S. Parshuram, MBChB, PhD, discuss clinician moral distress in Canadian pediatric and neonatal intensive care units (Dryden-Palmer,K, et al. Pediatri Crit Care Med. 2020;21(4): 314-323).
Gain valuable insight on the clinical management of COVID-19 and its relevance to the pediatric critical care provider (Ong J, et al. Pediatr Crit Care Med. 2020;21:662-666) with host Elizabeth H. Mack, MD, MS, FCCM, and Jacqueline Ong, MB BChir, MMed (Paeds), MRCPCH.
Explore the need for randomized COVID-19 clinical trials and the difficulties and potential consequences of misinformation (Ingraham N, et al. Crit Care Explor. 2020;2:e0108) with host Ashish K. Khanna, MD, FCCP, FCCM, and Nicholas E. Ingraham, MD.
Discovery, the Critical Care Research Network's Viral Infection and Respiratory Illness Universal Study creates a real-time COVID-19 registry of current ICU and hospital care patterns.
The National Institutes of Health has released Coronavirus Disease 2019 (COVID-19) Treatment Guidelines.
In a situation where ventilators are in short supply, multiple patients on a single ventilator could be a strategy of last resort. In this podcast, Arthur S. Slutsky, MD, discusses his article "Personalized Ventilation to Multiple Patients Using a Single Ventilator: Description and Proof of Concept" (Han J, et al. Crit Care Explor. 2020;2:e0118).
Clinicians are working to understand and formulate an effective treatment for COVID-19-associated acute respiratory distress syndrome (Marini J. Crit Care Med. 2020 May 13; Epub ahead of print).
Montefiore Medical Center in the Bronx, New York, USA, quickly converted a children's hospital to an adult COVID-19 hospital.
Review how to best utilize parameters provided by minimally invasive advanced hemodynamic monitors.
Alternative strategies are needed to combat and prevent antibiotic-resistant bacterial infections. Host Ashish K. Khanna, MD, FCCP, FCCM, talks about this issue with David R. Cameron, PhD.
The increase in acute kidney injury in COVID-19 patients is resulting in more utilization of renal replacement therapy (RRT) and continuous renal replacement therapy. Host Pamela M. Peeke, MD, MPH, FACP, FACSM , is joined by Michael J. Connor Jr, MD, to review RRT utilization.
Procalcitonin testing on admission seems to be a valuable piece of information for early risk assessment and ruling out bacterial co-infection in COVID-19 patients. Host Pamela M. Peeke, MD, MPH, is joined by Michael Broyles, PharmD, and Eric H. Gluck, MD, to explore this topic.
COVID-19 is associated with a high prevalence of coagulopathy and venous thromboembolism. Explore what clinicians need to know about this serious problem and how it impacts care delivery.
Continuous monitoring on hospital wards can prevent adverse events and unnecessary ICU admissions. Michael Smith, MD, is joined by Ashish K. Khanna, MD, FCCP, FCCM, to review the demographics of respiratory depression.
Cystic fibrosis patient care has advanced greatly in recent years and the mortality rate has improved. Explore PICU mortality and the factors associated with death among critically ill children with cystic fibrosis in this iCritical Care podcast.
Continuous renal replacement therapy (CRRT) requires considerable involvement from the bedside nurse. Explore when to start CRRT, the nursing role, and other considerations and challenges in this podcast.
Severe COVID-19 infection can be a form of viral sepsis with occasionally concomitant bacterial infection. Explore the definition of sepsis and overlap with case descriptions of patients with severe COVID-19, treatment, and more.
Each year, approximately 790,000 patients in the United States develop acute respiratory failure that requires intubation and mechanical ventilation. This podcast explores the association between endotracheal tube size and aspiration in acute respiratory failure survivors.
Continuous renal replacement therapy (CRRT) is complex, and dosing varies among institutions. Review dosing regimens, utilization in COVID-19 patients, and more in this podcast.
Sudden cardiac arrest remains a leading cause of premature death worldwide and survival with favorable neurologic function is less than 10%. Review a practical, attainable roadmap for enhancing the likelihood of neurologically intact survival in this podcast.
Mannitol is a commonly used osmotherapy agent in raised intracranial pressure (ICP) but the side effects are significant. An alternative therapy, hypertonic saline, has shown varied results.
With widespread utilization of continuous renal replacement therapy, its critical to know about how citrate may have a role. Review its role in the anticoagulation process and how it can decrease the likelihood of adverse events and ease clinician workload in this podcast.
Five new recommendations to reduce waste and enhance value in the practice of critical care address invasive devices, proactive liberation from mechanical ventilation, antibiotic stewardship, early mobilization, and providing goal-concordant care.
This infographic highlights key points from the SCCM Free webcast Caring for pregnant patients with COVID-19.
This infographic reviews strategies to develop a multiprofessional team approach to COVID-19 ventilator management with highlights from the SCCM Free webcast Interdisciplinary COVID-19 Ventilator Management.
This infographic highlights key points from the Free SCCM webcast revisiting precautions, engineering and hazard controls.
During this webcast, subject matter experts addressed questions on how to manage patients with COVID-19 in a rural location with limited resources, how to treat patients with limited equipment, and how to manage resources when there are bed shortages.
Family nurse practitioners (FNP) who do not have acute care certification may be recruited to work in ICUs. But when the FNP moves to another institution, ICU experience may not be considered an adequate qualification. This podcast discusses the difficulties of FNPs who need acute care certification to work in ICUs.
COVID-19 complicated critical care clinicians’ decision-making with regard to tracheostomy. ICU resource constraints and risk of staff exposure during an aerosol-generating procedure necessitated rapid adaption of clinical practice in the setting of many unknowns.
Targets for treatment of raised intracranial pressure or decreased cerebral perfusion pressure in pediatric neurocritical care are not well defined. Host Margaret Parker, MD, MCCM, is joined by Alicia K. Au, MD, MS, to discuss this topic.
Extubation is a high-risk endeavor in some COVID-19 patients. Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Joshua H. Atkins, MD, PhD; Christopher Rassekh, MD; and Ara Chalian, MD, to discuss this topic.
Enteral feed intolerance occurs frequently during enteral nutrition delivery in the critically ill and is associated with lower enteral nutrition delivery and worse clinical outcomes. Host Ludwig H. Lin, MD, is joined by Daren K. Heyland, MD, MSc, FRCPC,to explore this topic.
Explore the different mechanisms of the various patient-ventilator dyssynchronies and how to detect these dyssynchronies and evaluate their possible impact on patient-centered outcomes in this podcast.
Explore the correlation between antibiotic delay and hospital mortality in patients with sepsis in this podcast.
Two previously published trials presented equivocal evidence on the effect of neuromuscular blocking agent infusions in patients with acute respiratory distress syndrome. Host Kyle B. Enfield, MD, FCCM, is joined by Matthias Eikermann, MD, to discuss the different sedation regimens between these two trials, different regimens within the ROSE trial between treatment and control groups, and the hypothesis that the proportion of deeper sedation is a mediator of the effect of neuromuscular blocking agent infusions on mortality.
Learn about the importance of utilizing dynamic assessments of fluid responsiveness to guide treatment in patients with viral sepsis, including COVID-19, and understand how they can be used to help improve patient outcomes in sepsis patients. Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Patrick Troy, MD, to discuss how only 50% of hemodynamically unstable patients are fluid responsive and that the same treatment paradigm in fluid management applies to both viral sepsis and COVID-19 patients.
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. Host Margaret M. Parker, MD, MCCM, is joined by Melissa D. Aczon, PhD, to discuss how the RNN model can process hundreds of input variables contained in a patient’s EMR and integrate them dynamically as measurements become available.
BioFire® FilmArray® is the latest in technologies for rapidly identifying pathogens that cause Lower Respiratory Tract Infections (LRTI). Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Tufik Assad M.D., M.S.C.I. to discuss how this technology can be integrated into clinical care to improve patient outcomes, describe the benefits in diagnosing bacterial secondary infections in patients with COVID-19 and summarize the benefits of Pneumonia (PN) Panel in the fight against Antimicrobial Resistance.
This podcast discusses patients who develop acute kidney injury (AKI) and how AKI is independently associated with mortality in critically ill infants, neonates, and larger children. Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Stuart Goldstein, MD, to discuss the HF20 study, including its end points and the clinical gaps the study addresses.
Host Elizabeth Mack, MD, MS, FCCM, is joined by Michael Fundora, MD, FAAP, to discuss if the hypothesized frontline clinician workload, measured by bed occupancy and staffing, is associated with poor outcomes and unnecessary testing.
This podcast will be a comparative analysis of conventional heparin- versus bivalirudin-based systemic anticoagulation in adult and pediatric patients supported on ECMO.
Host Margaret M. Parker, MD, MCCM is joined by Alon Geva, MD, MPH, to discuss how the implementation of eSIMPLER provided clinical decision support prompts with display of relevant data automatically pulled from the electronic health record and improved certain care processes.
When should clinicians intubate preterm infants? This podcast discusses strategies that optimize noninvasive ventilation and when such strategies are appropriate.
The PANDEM guidelines evaluate current practices and provide recommendations for management of pain, agitation, iatrogenic withdrawal, neuromuscular blockade, delirium, ICU environment, and early mobility in critically ill infants and children. Host Margaret M. Parker, MD, MCCM, is joined by Heidi A. B. Smith, MD, MSCI, FAAP, to discuss the guidelines.
Deep Dive courses offer a nuanced look at a specific topic.
View a summary of activities from the past fiscal year.
Because COVID-19 can create a status of systemic inflammation, which can affect multiple organs, including the kidneys, the adjuvant therapy of blood purification has gained some recognition.
Discuss strategies for personal and professional well-being.
During the COVID-19 pandemic, healthcare providers have received many requests for media appearances and interviews to help inform the public. This infographic provides strategies and techniques to increase confidence of providers participating in media communications.
Review strategies to develop a multiprofessional team approach to COVID-19 ventilator management in this FREE SCCM webcast. A multiprofessional panel of experts will discuss how each clinician’s role contributes to optimal ventilator management.
Review the three part approach to management of Vaccination Status Conflicts.
Discuss coping skills and strategies to assist health care providers or colleagues experiencing burnout.
Review the risk factors for AKI in COVID-19 patients and mechanism for renal injury in COVID-19 patients.
Review the incidence of acute kidney injury (AKI) and renal replacement therapy (RRT) in COVID-19 versus other diseases, mortality and long-term prognosis.
Host an FCCS: Surgical course and prepare nonsurgical healthcare professionals to manage critically ill surgical patients.
Matthew Churpek, MD, MPH, PhD, will share the top 10 things he wished someone had told him about clinical predictive modeling as part of the thought leader session Data Science and Critical Care at the 2022 Critical Care Congress.
From Critical Care Explorations The authors report three cases of healthy young adults diagnosed with severe acute respiratory syndrome-CoV-2 related (MIS-A).
From Critical Care Explorations The authors describe hospital variation in use of “guideline-based care” for acute respiratory distress syndrome (ARDS) due to COVID-19.
From Critical Care Explorations The authors studied impact of paralysis on prone-induced gas exchange improvements and provider attitudes regarding paralytics.
From Critical Care Explorations The authors aim to increase clinician awareness of, and risk factors for ARC in patients with COVID-19, especially in comparison to other critical illnesses.
From Critical Care Explorations The authors investigate microvascular function in patients with critical coronavirus disease 2019.
From Critical Care Explorations The authors describe outcomes after cardiopulmonary resuscitation for in-hospital cardiac arrest in two COVID-19 patient cohorts.
From Critical Care Explorations In this Letter to the Editor the authors investigated the effect of prone ventilation on right ventricular (RV) function of intubated patients with COVID-19–associated acute respiratory distress syndrome.
From Critical Care Explorations The authors evaluated the characteristics and outcomes across the range of frailty in patients admitted to ICU with coronavirus disease 2019.
From Critical Care Explorations The authors conducted eleven team triage simulations from December 2020 through February 2021.
From Critical Care Explorations The authors test the hypothesis that relatively lower clot strength on thromboelastography maximum amplitude (MA) is associated with development of venous thromboembolism (VTE) in critically ill patients with COVID-19.
From Critical Care Explorations The authors report successful treatment in such a patient who is ineligible for phase 3 trials of Aviptadil.
From Critical Care Medicine The authors describe the impact of lockdown measures on the utilization of critical care services and patient outcomes compared with nonlockdown epochs in a large integrated health region.
From Critical Care Medicine In this Letter to the Editor, the authors read the study by Chotalia et al.
From Critical Care Medicine The authors determined the association between temperature trajectories and distinct manifestations of coronavirus disease 2019.
Top officials for the American Hospital Association and the Center to Advance Palliative Care (CAPC) convened virtually for a fireside chat to discuss the impact and importance of palliative care practices during the pandemic and share stories from experts in the field.
The U.S. Food and Drug Administration (FDA) has issued an Emergency Use Authorization (EUA) for the emergency use of bebtelovimab for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19) in adults and pediatric patients (12 years of age and older weighing at least 40 kg): with positive results of direct SARS-CoV-2 viral testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death, and for whom alternative COVID-19 treatment options approved or authorized by FDA are not accessible or clinically appropriate.
All specialties and disciplines can strengthen their care of patients living with a serious illness. For CAPC members, CAPC’s online training curriculum provides free continuing education credits for physicians, nurses, social workers, and case managers at member organizations. Free ABIM MOC (Maintenance of Certification) credits are also available for physicians.
Whether your organization is in the middle of a COVID-19 surge or planning forward, Center to Advance Palliative Care (CAPC) has tools, technical assistance, clinical training, and convening opportunities to help.
Drawn from best practices, CAPC toolkits are curated, proven resources for improving the care of people living with serious illness. Toolkits include technical assistance and tools for palliative care teams; serious illness strategies for health systems, health plans, and ACOs; resources for skill-building among clinicians from all specialties and disciplines; and much more.
In this "Breathe Easy Elevator Pitch" podcast, Dr. Siva Bhavani interviews Dr. David Furfaro, and they discuss the study "Latent Class Analysis Reveals COVID-19-related ARDS Subgroups", recently published in the Blue Journal.
This article describes the new Leapfrog quality metrics and their methodology, focusing on postoperative sepsis identification and the potential impact of dashboard performance tracking moving forward. Critical care professionals routinely encounter patients with sepsis and play an integral role in the formulation and implementation of management plans for postoperative sepsis, making them key participants in this effort.
This Concise Critical Appraisal highlights an article in Pediatric Critical Care Medicine that sought to determine the association between invasive mechanical ventilation—a known predictor of adverse outcomes in children—and subsequent new neurodevelopmental and psychiatric disorders after pediatric intensive care unit hospitalization by reviewing Texas Medicaid Analytic eXtract data.
In this podcast, host Kyle B. Enfield, MD, FSHEA, FCCM, is joined by Samuel K. McGowan, MD, to discuss a systematic review that found significant differences in care and outcomes, including mortality rates, among intensive care unit (ICU) patients of different races.
In the ICU, medical staff do all they can to assist patients and get them back to health as quickly as possible. In the process of saving lives, bedside manner and communication may suffer.
Since the publication of the Surviving Sepsis Campaign guidelines, the focus has been on sepsis management, early identification, and treatment.
SCCM stands with the people of Ukraine and is poised to offer as much support as possible.
SCCM President Sandra L. Kane-Gill, PharmD, MSc, FCCP, FCCM, provides an update on the SCCM emergency response efforts in Ukraine.
Peta M.A. Alexander, MBBS, FRACP, FCICM, will present the Max Harry Weil Memorial Lecture titled, “What Has COVID-19 Taught Us About ECMO?” during SCCM’s 2022 Critical Care Congress.
During this webinar, experts will address questions related to caring for mechanically ventilated pregnant patients with COVID-19. Review the safety of extracorporeal membrane oxygenation in pregnancy, drug safety for critically ill patients with COVID-19, vaccination strategies, and post-ICU care for unvaccinated pregnant patients. This webcast will also benefit non-ICU clinicians who may need to care for critically ill and injured patients.
Revisit isolation precautions, engineering controls, and aerosol-generating procedures, and review personal protective equipment updates, including the evolution of masking recommendations.
Understanding the frequency with which new symptoms and conditions emerge in the months following SARS-CoV-2 infection is important to inform patients’ expectations for recovery and allow health care professionals and health systems to address patients’ needs. Shortness of breath, fatigue or muscle weakness, and mild subjective cognitive dysfunction (ie, “brain fog”) are among the most commonly reported persistent symptoms in the months following SARS-CoV-2 infection.
The cardiovascular complications of acute coronavirus disease 2019 (COVID-19) are well described, but the post-acute cardiovascular manifestations of COVID-19 have not yet been comprehensively characterized. Here we used national healthcare databases from the US Department of Veterans Affairs to build a cohort of 153,760 individuals with COVID-19, as well as two sets of control cohorts with 5,637,647 (contemporary controls) and 5,859,411 (historical controls) individuals, to estimate risks and 1-year burdens of a set of pre-specified incident cardiovascular outcomes.
Prepare nonsurgical healthcare professionals to manage critically ill surgical patients.
Prepare nonintensivists to manage critically ill patients.
Myocarditis is inflammation of the heart muscle. This can happen after viral infections like COVID-19 and, very rarely, after receiving mRNA COVID-19 vaccines. Most people with myocarditis following vaccination recover completely with rest and simple treatment. However, myocarditis from COVID-19 can be very severe.
The American Academy of Physical Medicine and Rehabilitation (AAPM&R) has undertaken comprehensive efforts to support our call for a national plan to address Post-Acute Sequelae of SARS-CoV-2 infection (PASC or Long COVID) and the millions Americans it is affecting. The PASC Dashboard serves to estimate those affected including state and county level data and trends over time.
Tracheal intubation is a high-risk procedure that is frequently performed in the emergency department and intensive care unit. Failure of first-pass success (FPS) when intubating has been shown to be associated with major adverse events, so maximizing FPS is paramount for improving patient outcomes. This Concise Critical Appraisal explores a study published in JAMA that sought to determine the effect of using a bougie (tracheal tube introducer) versus an endotracheal tube with stylet when intubating.
Obtain a better understanding of billing and documentation procedures in a critical care setting.
This presentation discusses utilization of motivational interviewing techniques to discuss COVID-19 vaccines. This is SCCM curated COVID-19 microlearning content.
This is a podcast series accounting for the parallel pandemics of COVID-19 and clinician burnout, while introducing the story of one undocumented patient who helped to reveal the authentic feelings and values of his healthcare team. With historically high mortality rates in the ICU and pervasive emotional and physical fatigue, this ICU team in Marietta, Georgia had the courage to hope and the commitment to care.
WHO has recommended two new drugs for COVID-19, providing yet more options for treating the disease. The extent to which these medicines will save lives depends on how widely available and affordable they will be. The first drug, baricitinib, is strongly recommended for patients with severe or critical COVID-19. WHO has also conditionally recommended the use of a monoclonal antibody drug, sotrovimab, for treating mild or moderate COVID-19 in patients who are at high risk of hospitalization.
The national map below displays public locations that have received shipments of U.S. Government-procured COVID-19 therapeutics under U.S. Food and Drug Administration (FDA) Emergency Use Authorization (EUA) authority. The locations displayed in the locator have reported stock on hand within the last day.
Medicare & COVID-19 Monoclonal Antibody Products: Coverage, Coding, Payment and Billing. Monoclonal antibody products to treat Coronavirus disease 2019 (COVID-19) help the body fight the virus or slow the virus’s growth. Medicare beneficiaries have coverage without beneficiary cost sharing for these products when used as authorized or approved by the Food and Drug Administration (FDA).
SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Centers for Disease Control and Prevention (CDC). These resources are categorized as Procedures
Emphasize importance of continual assessment, nonpharmacologic interventions, and family involvement. The PANDEM guidelines for children and infants were published in the February 2022 issue of Pediatric Critical Care Medicine.
Improve outcomes for children and infants with the ICU Liberation Campaign.
Ped Crit Care Med. 2022;23:e74-e110.
During the COVID-19 pandemic, healthcare providers receive many requests for media appearances and interviews to help inform the public. This training will provide strategies and techniques to increase confidence of providers participating in media communications.
Although several trials have examined in-hospital cardiac arrest (IHCA), only two trials in the past decade have examined the use of vasopressin and glucocorticoids for IHCA. Both trials found improved survival and favorable neurologic outcome with a vasopressin-epinephrine-methylprednisolone combination. Because of a lack of additional supporting evidence, neither the American nor European international guidelines have recommended this combination for IHCA. This Concise Critical Appraisal examines an article by Andersen et al that attempted to validate the results of these trials.
The COVID-19 Treatment Guidelines Panel (the Panel) has recommended several therapeutic agents for the treatment and prevention of SARS-CoV-2 infection in individuals who are at high risk for progression to severe COVID-19. These anti-SARS-CoV-2 therapeutics are of greatest benefit for nonhospitalized patients who have risk factors for progression to severe COVID-19. With the increase in cases of COVID-19 and the emergence of the Omicron (B.1.1.529) variant of concern, there may be logistical or supply constraints that make it impossible to offer the available therapy to all eligible patients, making patient triage necessary.
SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Centers for Disease Control and Prevention (CDC). These resources are categorized as Epidemiology-Outcomes
John J. Gallagher, DNP, RN, CCNS, CCRN-K, TCRN, RRT, FCCM, will bring his experiences and teaching enjoyment to SCCM’s 2022 Critical Care Congress, where he will lead the thought leader session “Critical Care Nurses and COVID-19.”
Critical Care Explorations The authors found a similar percentage of positive test results in mini-bronchoalveolar lavage and bronchoalveolar lavage samples in patients with suspected coronavirus disease 2019–associated pulmonary aspergillosis, indicating that mini-bronchoalveolar lavage could be a useful tool for coronavirus disease 2019–associated pulmonary aspergillosis screening in ICU patients.
Critical Care Explorations In this study, the authors concluded that soluble CD14 subtype levels may have prognostic utility in coronavirus disease 2019.
From Critical Care Medicine The authors review the pathogenesis, clinical presentation, diagnosis, and treatment of vaccine-induced immune thrombotic thrombocytopenia, an unexpected consequence of the coronavirus disease 2019 pandemic era.
From Critical Care Explorations This international study suggests that in patients with coronavirus disease 2019 on invasive mechanical ventilation, older age and clinically relevant variables monitored at baseline or sequentially during the course of invasive mechanical ventilation are associated with 28-day invasive mechanical ventilation mortality hazard.
From Critical Care Explorations In this observational study, the authors successfully identified significant genetic factors in OAS1 and IL1B genes using a candidate gene approach study as valuable information for further mechanistic investigation and predictive model building.
From Critical Care Explorations In this essay, the authors propose a number of questions that recognize the existential frustrations critical care professionals experience when carting for unvaccinated patients in the ICU, while also uncovering the ethical obligations that remain.
From Critical Care Explorations In this paper, the authors aimed to characterize the kinetics of serum albumin in critically ill patients with coronavirus disease 2019 compared with critically ill patients with sepsis-induced acute respiratory distress syndrome.
From Critical Care Explorations This hypothesis-generating study suggests that the pathophysiology of immunothrombosis differs between coronavirus disease 2019 patients and noncoronavirus disease septic patients.
From Critical Care Explorations In this descriptive statistical study, heart rate variability measures were found to be statistically different across critically ill patients infected with severe acute respiratory syndrome coronavirus 2 and distinct from bacterial sepsis.
From Critical Care Explorations In this study, the authors found that Patients who suffered critical illness from coronavirus disease 2019 had a high frequency of postintensive care syndrome after 1 year.
The WHO Therapeutics and COVID-19: living guideline contains the Organization’s most up-to-date recommendations for the use of therapeutics in the treatment of COVID-19. The latest version of this living guideline is available in pdf format (via the ‘Download’ button) and via an online platform, and is updated regularly as new evidence emerges.
AHA published a new blog post from an LLN member hospital titled, The Pandemic. “How a Bold, New Strategy Took on Health Care Inequities During the Pandemic,” authored by Luminis Health Chief Diversity Officer Tamiko Stanley.
December 22, 2021, the FDA issued an emergency use authorization (EUA) for Pfizer’s Paxlovid (nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use) for the treatment of mild-to-moderate coronavirus disease (COVID-19) in adults and pediatric patients (12 years of age and older weighing at least 40 kilograms or about 88 pounds) with positive results of direct SARS-CoV-2 testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death. Paxlovid is available by prescription only and should be initiated as soon as possible after diagnosis of COVID-19 and within five days of symptom onset.
The FDA has granted molnupiravir emergency use authorization (EUA) to treat mild to moderate COVID-19 in adults at high risk of severe illness. High risk people include adults aged 65 and over and people with certain medical conditions. The FDA also states that molnupiravir should only be used when other COVID-19 treatments are unavailable.
In this “Breathe Easy Critical Perspective” podcast, Dr. Dominique Pepper interviews Dr. Richard Wunderink They discuss Dr. Wunderink's recent publication in the Blue Journal about bacterial superinfection in patients intubated and mechanically ventilated for COVID-19 pneumonia. Dr. Wunderink is a Professor of Medicine in Pulmonary and Critical Care at Northwestern University in Chicago, Illinois.
The fourth and current wave of the COVID-19 pandemic has created a worrisome landscape for the nursing profession. Nurses across the country report that they no longer feel celebrated as heroes as they did in the early days of the pandemic. This AHA Podcast covers nurse leaders discussing COVID-19 nursing challenges, and solutions.
Obtain the realistic training needed to perform and interpret pediatric and neonatal ultrasound imaging.
Obtain the realistic training needed to perform and interpret ultrasound imaging.
SCCM has announced the cancelation of the 2022 Critical Care Congress in-person event and the postponement of the virtual event to April 18 through 21, 2022.
During the COVID-19 pandemic, people have been exposed to an abundance of information from a large number of sources.
On December 3, 2021, the U.S. Food and Drug Administration revised the emergency use authorization (EUA) of bamlanivimab and etesevimab (previously authorized for pediatric patients 12 years of age and older weighing at least 40 kilograms, or about 88 pounds), to additionally authorize bamlanivimab and etesivimab administered together for the treatment of mild to moderate COVID-19 in all younger pediatric patients, including newborns, who have a positive COVID-19 test and are at high risk for progression to severe COVID-19, including hospitalization or death. This revision also authorizes bamlanivimab and etesevimab, to be administered together, for post-exposure prophylaxis for prevention of COVID-19 in all pediatric patients, including newborns, at high risk of progression to severe COVID-19, including hospitalization or death.
In this review, the epidemiologic and pathophysiologic features, diagnosis, and treatment of COVID-19 pulmonary thrombosis and thromboembolism are discussed.
Infographic: Symptoms, Risk Factors, Screening, Recovery Programs
Research Question: Does the rate of VTE among adults hospitalized with COVID-19 differ from matched hospitalized control participants without COVID-19?
COVID in Focus: Perspectives on the Literature. Brief summary and highlights specific studies in the COVID-19 literature is a curated review of key information and literature about this topic. It is not comprehensive of all data related to this subject.
During the 2022 Critical Care Congress, Karin Reuter-Rice, PhD, NP, FAAN, FCCM, will talk about precision health, and specifically the role omic technologies play in critical care in a thought leader session titled “Genetics and Genomics.”
SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Infectious Diseases Society of America (IDSA) COVID-19 Real-Time Learning Network. These resources are categorized as Neurology
From Pediatric Critical Care Medicine. In this Editorial, the authors discuss the article by Vacheron et al. on the epidemiology of ventilatory-associated pneumonia among patients with COVID-19.
From Critical Care Medicine In this Editorial, the authors discuss the article by Vacheron et al. on the epidemiology of ventilatory-associated pneumonia among patients with COVID-19.
From Critical Care Explorations While the overall safety profile of the BNT162b2 coronavirus disease 2019 vaccine remains excellent for the general population, rare serious events have been reported. In this case report, the authors describe a case of multisystem inflammation and organ dysfunction of unknown mechanism beginning shortly after administration of the first dose of BNT162b2 coronavirus disease 2019 vaccine in a previously healthy recipient.
From Critical Care Explorations. This international study suggests that in patients with coronavirus disease 2019 on invasive mechanical ventilation, older age and clinically relevant variables monitored at baseline or sequentially during the course of invasive mechanical ventilation are associated with 28-day invasive mechanical ventilation mortality hazard.
From Critical Care Explorations. In this study the authors found that hospital variation in the use of repurposed medications varied widely across hospitals early in the pandemic and later converged with the emergence of randomized clinical trials.
From Critical Care Explorations. In this study, the authors successfully identified significant genetic factors in OAS1 and IL1B genes using a candidate gene approach study as valuable information for further mechanistic investigation and predictive model building.
From Critical Care Explorations. Dorsal Push and Abdominal Binding Improve Respiratory Compliance and Driving Pressure in Proned Coronavirus Disease 2019 Acute Respiratory Distress Syndrome
This webinar covers highlights from the Critical Impact: Ethics and Supply Chain course.
Stay up to date on the mass vaccination efforts in the United States with this SCCM webcast. Thought leaders will address current COVID-19 variants and vaccine efficacy and review pediatric vaccination considerations. This webcast is the second in a series of updates that SCCM is producing to better educate clinicians as vaccination efforts continue. The webinar was held on December 8, 2021.
Learn how COVID-19 is becoming an endemic condition in intensive care units in this FREE SCCM webcast. Subject matter experts will also discuss COVID-19 myths and misconceptions and how COVID-19 has changed the continuum of care. The Society of Critical Care Medicine and the Infectious Diseases Society of America partnered to produce this webcast. The webinar was held on December 14, 2021.
To help understand what moral distress looks like and how to manage and prevent it, the Society of Critical Care Medicine recently hosted the webcast Managing Moral Distress During a Pandemic.
With the average rate of daily new cases of COVID-19 on the rise, and the delta and omicron variants causing concern, the Society of Critical Care Medicine (SCCM) asked members in states with high rates of infection to share their experience and advice. Here are some of their insights.
Beth A. Wathen, CCRN-K, MSN, RN, is the current president of the American Association of Critical-Care Nurses (AACN), the world’s largest specialty nursing organization. Ms. Wathen has had the unique opportunity to support critical care nurses personally and professionally in the midst of the ongoing COVID-19 pandemic. Since becoming president in July, she has balanced the need to continue moving the association forward with recognizing the realities of exhaustion among critical care clinicians.
In SCCM's webcast “Best Practices for Managing Staff Shortages,” a multiprofessional panel of experts discussed how staffing challenges arise in overwhelmed healthcare systems and how they have managed staff shortages.
With the rise in cases among children across the country, more healthcare professionals who typically work with adult patients are being tasked with treating pediatric patients. SCCM’s latest blog post summarizes two webcasts SCCM hosted to help smooth this transition.