World-Renowned Experts at the 2024 Critical Care Congress

 

Crisis and Chaos: Pandemic Perspectives From the 20th U.S. Surgeon General

Sunday, January 21, 2024 | 9:00 a.m. – 9:30 a.m.

Jerome Adams, MD, MPH, FASA Ake Grenvik Honorary Lecture 20th U.S. Surgeon General Executive Director of Health Equity Initiatives Purdue University West Lafayette, Indiana, USA

Dr. Adams was the 20th U.S. Surgeon General when the COVID-19 pandemic began. He had a front-row seat to the government’s response to COVID-19. Dr. Adams provided his perspective on that response in his book Crisis and Chaos: Lessons from the Front Lines of the War Against COVID-19, which was published in October 2023. The book examines the past three years since the pandemic began, but Dr. Adams said that it also applies to America’s future unless changes are made.
 
“The title is meant to highlight our often-chaotic response to a once-in-a-century pandemic,” he said. “It’s unfortunately a response that continues to be chaotic even across administrations and despite multiple opportunities to change course. The book explores why we keep making the same mistakes and how we can do better in the future.”
 
Dr. Adams served as U.S. Surgeon General from 2017 to 2021. He led the 6000-person U.S. Public Health Service through responses to three category 5 hurricanes and an opioid epidemic in addition to the COVID-19 pandemic. Before being Surgeon General, he was commissioner of the Indiana Department of Health, where he addressed Ebola, Zika, and HIV crises. Today he is the executive director of health equity initiatives at Purdue University in West Lafayette, Indiana, USA, where he is also a distinguished professor of practice in the public health and pharmacy practice departments.
 
Dr. Adams said there are a number of key lessons to learn about the pandemic and the nation’s response to it. “The lack of public health data and infrastructure significantly hindered our ability to make and implement evidence-based policy decisions,” he said. “Politics was, and is, perhaps our biggest challenge in regard to doing better moving forward.” Dr. Adams is looking forward to connecting with SCCM members at Congress and talking about how the pandemic served as a magnifying glass for societal health inequities.
 
“It didn’t create new problems so much as it highlighted long-existing issues,” he said. “Those issues include poor baseline health, vaccine hesitancy, slow-to-respond government agencies, and politicization of health issues, plus our own political bias.” Dr. Adams will showcase that bias and politicization as he gives SCCM members “a peek behind the policy-making curtain” and explains how conflicting variables and priorities led to complex decisions that were often oversimplified in media coverage.
 
What is not complex, at least in Dr. Adams’ eyes, is the role SCCM members can play in the country’s health—both now and in future pandemics. “All health is local, and most people say the person they trust the most when it comes to health is their own doctor or healthcare professional,” he said. “Therefore, it is imperative that doctors are informed and recognize where bias and politics may be clouding their own judgment or the judgment of someone they are advising. I hope the audience understands the role they themselves can play in protecting themselves and their communities. I also hope people better understand that if health inequities continue unaddressed, we will continue to see crises like COVID impacting our health and our economy to a greater degree than they should.”
 
The Ake Grenvik Honorary Lecture is named in honor of Ake Grenvik, MD, PhD, MCCM, the first SCCM membership committee chair and the seventh SCCM president.
 

 

Fluids: From Theory to Bedside Practice in Hemodynamic Management of the Critically Ill

Monday, January 22, 2024 | 8:00 a.m. – 8:45 a.m.

Maurizio Cecconi, MD, FRCA, FFICM MD(Res) Max Harry Weil Honorary Lecture Head of Department Anaesthesia and Intensive Care IRCCS Istituto Clinico Humanitas Professor of Anaesthesia and Intensive Care Vice President MEDTEC School Humanitas University Milan, Italy

Dr. Cecconi likes to think of hemodynamic management in critically ill patients as orchestrating a complex symphony. Blood pressure, cardiac output, fluid balance, and every other cardiovascular variable must be in tune for vital organs to receive adequate oxygen delivery and perfusion. “It’s about interpreting a holistic picture to guide lifesaving interventions,” said Dr. Cecconi, head of the Department of Anaesthesia and Intensive Care and professor of anaesthesia and intensive care at Humanitas University in Milan, Italy. “No single variable can provide all the information needed, and no single intervention can be a magic bullet.”
 
Dr. Cecconi, who is a past president of the European Society of Intensive Care Medicine, will discuss the journey of hemodynamic management of critically ill patients, which he calls both humbling and enriching. “It has taken years of collective scientific inquiry, clinical trials, and bedside observations to fine-tune our approach,” he said. “Technology advancements have accelerated our ability to monitor and adapt treatments in real time, but it’s crucial to remember that technology is an adjunct to, rather than a replacement for, sound clinical judgment.”
 
During his session, Dr. Cecconi will share how he became interested in the physiology of fluid administration and his focus on standardizing bedside testing. He will address various research methodologies and the value each brings to understanding hemodynamic management as well as the limitations of fluid responsiveness. “While it’s common to look for a binary yes-or-no increase in cardiac output,” he said, “this overlooks many nuances, such as how the fluid challenge was administered, initial changes in cardiac output, and whether the effect was short lived or sustained.”
 
Dr. Cecconi will examine how technology such as machine learning and artificial intelligence will impact critical care in the future. He believes these tools will make it possible for critical care professionals to customize fluid management strategies that improve clinical outcomes. Despite this positive outlook, he will caution attendees against thinking technology will replace clinicians. “We must approach this frontier with nuance,” he said. “The heterogeneity of our patient populations defies a one-size-fits-all approach. Technology and research are invaluable, but they can never fully replace the discerning judgment of a skilled clinician.”
 
The Max Harry Weil Honorary Lecture is named in honor of Max Harry Weil, MD, PhD, MCCM, the founder and first president of SCCM.
 

 

Implementation Science Applied to Critical Care

Monday, January 22, 2024 | 1:30 p.m. – 2:15 p.m.

Anne E. Sales, PhD, RN Norma J. Shoemaker Honorary Lecture Professor Sinclair School of Nursing University of Missouri Associate Dean for Implementation Research and Health Delivery Effectiveness Department of Family and Community Medicine University of Missouri School of Medicine Columbia, Missouri, USA

Implementation science is the study of how to safeguard research-based evidence that is used quickly in routine practice. While the definition is simple, its implementation is complex, according to Dr. Sales. “There are many issues related to evidence and what constitutes sufficient evidence for routine practice,” said Dr. Sales, professor at the University of Missouri’s Sinclair School of Nursing and associate dean for implementation research and health delivery effectiveness at the University of Missouri School of Medicine in Columbia, Missouri, USA. “In implementation science, we focus on a range of issues, from evidence to understanding how to ensure that it’s used routinely as appropriate and how to ensure that evidence-based care is sustained in practice.”
 
Dr. Sales said critical care is a perfect field to focus on implementation science because of its complex interventions and events. During her session, she will address these complexities, as well as lessons learned about research-based evidence during the COVID-19 pandemic. “Despite the complexities and challenges, changing practice to incorporate appropriate new evidence is feasible,” she said. “Although implementation science is in its infancy, there are tools that can be used routinely that would help accelerate change toward greater use of evidence-based practices.”
 
Dr. Sales said she enjoys working with critical care professionals and is excited to be a part of Congress. “I’m really looking forward to the dialogue with participants,” she said. “Working with clinicians in critical care is something I enjoy a great deal. People are highly motivated to provide exceptional care.”
 
The Norma J. Shoemaker Honorary Lecture is named in honor of Norma J. Shoemaker, RN, MN, FCCM, one of SCCM’s first nurse members and its first executive director.
 

 

ARDS: From Treating a Syndrome to Identifying Modifiable Traits

Tuesday, January 23, 2024 | 8:00 a.m. – 8:45 a.m.

Daniel McAuley, MD William C. Shoemaker Honorary Lecture Professor Queen’s University of Belfast and Royal Victoria Hospital Belfast, Northern Ireland, UK

Dr. McAuley is a professor at Queen’s University of Belfast and Royal Victoria Hospital in Belfast, Northern Ireland, where his major interest is acute respiratory distress syndrome (ARDS). He is the director of the National Institute for Health and Care Research (NIHR) Efficacy and Mechanism Evaluation Program and serves on the NIHR Board as scientific director for NIHR programs.
 
“There is a new paradigm that de-emphasizes the syndromic definition of ARDS and focuses on phenotypes more closely linked to the host biological response,” he said. “This may be the key to identifying effective therapeutics.” Dr. McAuley’s session will cover his research strategy for his investigation into potential novel therapeutic agents for ARDS using a precision medicine approach. His session will center on the journey to find new treatments for patients with ARDS.
 
The key difference is an emphasis on personalization. “There is a lot of heterogeneity within the overall population,” he said. “This heterogeneity is likely the reason why drugs have not worked—there may be some responders and some nonresponders, but when you look at the overall population, it appears there is no benefit. We need to be able to identify patients who will and will not respond to a treatment to make sure each patient is getting the right treatment.” His clinical trials started by treating ARDS as a homogenous disease and moved through the development of novel diagnostic solutions to identify modifiable traits, which could then be targeted with both novel and conventional therapies.
 
Dr. McAuley is currently setting up the PANTHER trial with the hope of developing potential therapeutic agents for ARDS. “ARDS phenotypes are more closely linked to specific mechanisms causing ARDS, and these mechanisms drive the phenotypes,” he said. “These mechanisms represent treatable traits that might be targeted with a drug. This represents the personalized approach.”
 
The William C. Shoemaker Honorary Lecture is named in honor of William C. Shoemaker, MD, FACS, MCCM, a founding member of SCCM and its third president. Dr. Shoemaker was also the founding editor of Critical Care Medicine.
 

 

New Heart, New Life

Tuesday, January 23, 2024 | 1:30 p.m. – 2:15 p.m.

Alin Gragossian, DO, MPH Peter Safar Honorary Lecture Associate Medical Director, Donor Network West Intensivist, Equum Medical Los Angeles, California, USA

As a 30-year-old medical resident, Dr. Gragossian was more interested in caring for patients than seeking care for herself. She rarely visited her own physician. But in December 2018, she found herself on the other side of the clinician-patient relationship after she had heart failure and was diagnosed with dilated cardiomyopathy. She was intubated, started on mechanical ventilation, and put in a medically induced coma. In January 2019, she received a heart transplant and since then has become a champion for organ donation.
 
Dr. Gragossian’s Congress session will focus on her story, her diagnosis, her recovery, and how she has used her story to educate others about organ donation, disabilities, and seeing the silver lining in any situation. One silver lining for Dr. Gragossian is that she developed a new understanding and appreciation for the realities of life as a patient, particularly in critical care. “It made me empathize with patients differently, as I felt closer to some of their problems in so many ways,” she said. “This was especially interesting as an ICU physician. I had a new view of what some procedures felt like and what it was like for someone to give you a critical diagnosis.”
 
Soon after her transplant, Dr. Gragossian began writing about her experience on her personal blog, A Change of Heart (achangeofhe.art). In her first post, published a week after receiving the transplant, Dr. Gragossian described herself before her heart failure as “happily getting ready for a big move to New York City to specialize in critical care medicine. I wanted to become a ‘lifesaver on steroids.’ I was the definition of a patient advocate. Passionate about my career, I was ready for my next challenging chapter in training. I was stubborn but enthusiastic and whole-hearted about everything I did.”
 
She now is enthusiastic and wholeheartedly committed to raising awareness about organ donation. On her blog she shares transplant resources and continues to write about the journey. She speaks at public events. She also subsequently co-launched a podcast titled Both Sides of the Stethoscope, in which she and cardiologist Colby Salerno, DO, a fellow heart transplant recipient, share their perspectives on life as both physician and patient.
 
“My story has not only helped me express myself, whether through writing or speaking events, but it’s helped me connect with so many other people who are going through similar issues,” Dr. Gragossian said. “Most interestingly, I met so many other physicians with transplants and chronic illnesses. Being a physician with a disability is stigmatized at times, so sharing my story and talking about these things helps me advocate for all of us as a community.”
 
The Peter Safar Honorary Lecture is named in honor of Peter Safar, MD, MCCM, the second SCCM president.

Register for the 2024 Critical Care Congress to attend these sessions and more!