SCCM PodCast - iCritical Care

As advanced practice provider (APP) postgraduate programs expand, what lessons have we learned as program directors? In this second episode of the APP Fellowship series, Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, is joined by Melissa Ricker, DMSc, PA-C, and Sarah Peacock, DNP, APRN to discuss their experiences as program directors of APP fellowships in critical care. This episode will focus on the benefits and barriers of APP fellowship programs, focusing on the program director’s experience.

Host Elizabeth H. Mack, MD, MS, FCCM, is joined by John Lin, MD, to discuss the transformative impact of the ICU Liberation Bundle (ABCDEF) on caring for critically ill children. This episode delves into the Pediatric Critical Care Medicine article, "Caring for Critically Ill Children With the ICU Liberation Bundle (ABCDEF): Results of the Pediatric Collaborative," exploring the implementation, outcomes, and the potential for enhancing pediatric ICU care (Pedtr Crit Care Med. August 2023; 24(8):636-651). Dr. Lin is Associate Professor of Pediatrics, Critical Care Medicine, and Service Chief for Respiratory Failure and Sepsis in the PICU, as well as the Medical Director of Respiratory Care at St. Louis Children’s Hospital in St. Louis, Missouri.

Host Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, FAAN, is joined by Dr. Lakshmi Raman, MD, to explore critical insights into pediatric ECMO, addressing neurological complications and their potential mitigation strategies and other topics associate with the article "Early Changes in Arterial Partial Pressure of Carbon Dioxide and Blood Pressure After Starting Extracorporeal Membrane Oxygenation in Children: Extracorporeal Life Support Organization Database Study of Neurologic Complications" (Pedtr Crit Care Med. July 2023; 24(7):541-550). Dr. Raman is Professor of Pediatrics and Medical Director of ECMO at the University of Texas Southwestern Medical Center and Children's Medical Center in Dallas, Texas.

Host Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, FAAN, is joined by William Sveen, MD, MA, to discuss the article "Adverse Events During Apnea Testing for the Determination of Death by Neurologic Criteria" (Sveen, W.N., et al. Pedtr Crit Care Med. 2023 May;24(5):399-405). Explore the prevalence of adverse events in pediatric apnea testing and gain insights from this single-center retrospective cohort study. Dr. Sveen is an Assistant Professor in Pediatric Critical Care Medicine at the University of Minnesota.

Host Kyle B. Enfield, MD, FSHEA, FCCM is joined by Danielle K. Maue, MD, to discuss improving outcomes for bronchiolitis patients through a high-flow nasal cannula protocol, as discussed in the Pediatric Critical Care Medicine article, "Improving Outcomes for Bronchiolitis Patients After Implementing a High-Flow Nasal Cannula Holiday and Standardizing Discharge Criteria in a PICU." (Maue DK, et al. Pedtr Crit Care Med. 2023 Mar;24:233-244). Together, they explore groundbreaking initiatives that significantly improved outcomes for bronchiolitis patients using a high-flow nasal cannula protocol, the key interventions, and their impact. Dr. Maue is an Assistant Professor of Clinical Pediatrics for Riley Hospital for Children at Indiana University in Indianapolis, Indiana.

Host Marilyn N. Bulloch, PharmD, BCPS, FCCM, is joined by Joy Peterson, PharmD, BCPS, BCIDP, Neha Paranjape, MD, MPH, to discuss the article, "Outcomes and Adverse Effects of Baricitinib Versus Tocilizumab in the Management of Severe COVID-19," (Crit Care Med. March 2023 51(3):337-346) which delves into the comparative outcomes, mortality rates, and adverse effects of baricitinib and tocilizumab in severe COVID-19 cases. Dr. Peterson is a Clinical Pharmacy Specialist in infectious disease, and Dr. Paranjape is an Infectious Disease Specialist at Wellstar Health System in Marietta, Georgia.

This is the third episode of SCCM’s Current Concepts Series, in which authors unveil exclusive insights into the 2024 Current Concepts Course. Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, is joined by Aaron Goodwin, PA-C, MS, and Brett Hogan, ACNP, BSN, MS, RN, to discuss updates in toxidromes and illicit drug abuse in the ICU. The guests explain why this is an important topic and share their surprising discoveries while researching the topic.

This is the second episode of SCCM’s Current Concepts Series, in which authors unveil exclusive insights into the 2024 Current Concepts Course. Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, is joined by Nasim Motayar, MD, to discuss updates in hemostatic resuscitation for traumatic and nontraumatic hemorrhage. Dr. Motayar offers a concise overview of this Current Concepts chapter, providing valuable takeaways for healthcare professionals looking to enhance their clinical practice.

Mentorship has been used within critical care for the transfer of specialized knowledge and expertise. Critical care practitioners have leaned on mentorship to acquire not only technical skills but also clinical decision-making abilities that come with experience. But is mentorship a thing of the past or a necessity for the future of healthcare? Host Kyle B. Enfield, MD, is joined by Lewis J. Kaplan, MD, FACS, FCCP, FCCM and Kenneth E. Remy, MD, MHSc, MSCI, FCCM, to discuss whether mentorship is obsolete in our modern healthcare environment. The information discussed in this podcast was provided by the Society of Critical Care Medicine’s Leadership, Empowerment, and Development (LEAD) Committee.

Dive into the inaugural episode of SCCM’s Current Concepts Series, where we unveil exclusive insights into the 2024 Current Concepts Course, directly from the authors themselves. Samantha Gambles Farr, MSN, NP-C, CCRN, RNFA is joined by Diane C. McLaughlin, DNP, AGACNP-BC, CCRN as they discuss the latest developments in the realm of coma, delving into essential aspects vital for the intricacies of critical care management. Don't miss this riveting exploration of cutting-edge knowledge in the field.

Discover how our evolving healthcare landscape is shaped by the interplay between experienced veterans and emerging talents, and how these generational shifts influence decision-making, communication, and the development of future critical care professionals. In this follow-up to the intriguing session held at the 2023 Critical Care Congress LEAD pre-course, titled "Generational Differences in Practice and Learning,” host Ludwig Lin, MD, is joined by Sergio L. Zanotti-Cavazzoni, MD, FCCM, to explore the dynamics of generational differences in critical care. Dr. Zanotti-Cavazzoni is Chief Medical Officer for Sound Physicians in Tacoma, Washington.

Millions of people have long COVID and may experience cognitive, mental health, and physical side effects. Elizabeth H. Mack, MD, MS, FCCM, is joined by James C. Jackson, PhD, PsyD, to discuss practical strategies to move patients from merely surviving to thriving. Drawing on research and vast clinical experience with ICU survivors with long COVID, Dr. Jackson highlights the value of acceptance, self-care, boundary setting, social support, and posttraumatic growth - coping strategies that can help patients foster meaningful lives, even in the face of chronic conditions.

Join host Pamela M. Peeke, MD, MPH, FACP, FACSM, as she delves into the critical topic of acute kidney injury (AKI) and its significant impact on critically ill patients. Guest Javier Neyra, MD, MSCS, offers a comprehensive overview of renal replacement therapy (RRT) in AKI, exploring the preferred modalities and technical considerations. With a focus on the benefits of continuous therapy versus hemodialysis, the discussion sheds light on indications for continuous RRT (CRRT), emphasizing the importance of early intervention and nephrology consultation. This podcast is sponsored by Baxter Healthcare Corporation.

Pamela M. Peeke MD, MPH, FACP, FACSM, is joined by Rajesh Speer, PharmD, MSHA, MS, to delve into continuous renal replacement therapy (CRRT) and anticoagulation. Unravel the intricacies of anticoagulation options, with an emphasis on citrate variations. Understand low- versus high-concentrate citrate and the nuances between compounding and commercially available products. Gain invaluable insights from a pharmacist’s standpoint about the ideal anticoagulation strategies for CRRT. This podcast is sponsored by Baxter Healthcare Corporation.

The Society of Critical Care Medicine's (SCCM) ICU Liberation Bundle (A-F) is unique because it can be applied to every patient, every day, by the full team. By fostering a holistic approach to treating patients and improving ICU team communication, the ICU Liberation Bundle has been proven in multiple studies to reduce: the likelihood of hospital death, delirium and coma days, physical restraint use, ICU readmissions, and discharges to rehabilitation facilities. Ludwig H. Lin, MD, was joined by Kristina A. Betters, MD, and Christopher Adams, PharmD, BCCCP, BCPS, FCCM, during the 2023 Critical Care Congress to discuss the future of ICU Liberation, including large-scale implementation, culture change, translation of existing tools, and implementation in resource-limited settings. This podcast is sponsored by Etiometry.

COVID-19 survivors who experience severe critical illness are at risk even when they leave the ICU. Long COVID is becoming recognized as a widespread problem, resulting in lower quality of life and productivity. Ludwig H. Lin, MD, is joined by E. Wesley Ely, MD, MHP, MCCM, to discuss the range of symptoms encompassing long COVID, as well as the latest research and treatment. Dr. Ely is a subspecialist in pulmonary and critical care medicine who conducts patient-oriented health services research as a professor of medicine in the Division of Allergy, Pulmonary, and Critical Care Medicine at Vanderbilt University Medical Center in Nashville, Tennessee, USA. He is a practicing intensivist and the author of Every Deep-Drawn Breath: A Critical Care Doctor on Healing, Recovery, and Transforming Medicine in the ICU. As associate director for research for the VA Tennessee Valley Geriatric Research Education and Clinical Center, his focus is on geriatric ICU care.

COVID-19 transformed healthcare and presented specific long-term challenges for the nursing profession. Samantha Gambles Farr, MSN, NP-C, CCRN, RNFA, was joined by Norma J. Shoemaker Honorary Lecturer Ernest J. Grant, PhD, RN, FAAN, at the 2023 Critical Care Congress to discuss the shortage of critical care nurses. Survey results reveal that nurses continue to experience burnout and frustration. They discuss how to leverage data to best support nurses now and in the future.

Can healthcare professionals use social media to enhance delivery of medical education and deliver the same educational content to a larger, more diverse, and more engaged audience? Ludwig H. Lin, MD, was joined by Nicolas M. Mark, MD, at the 2023 Critical Care Congress to discuss the role of social media in medical education. Dr. Mark is a board-certified intensivist at Swedish Medical Center First Hill in Seattle, Washington, USA.

The Assessment of Implementation of Methods in Sepsis and Respiratory Failure (AIMS) Study seeks to determine the safest and most effective approach to sepsis intervention using the evidence-based Surviving Sepsis Campaign guidelines. Marylin N. Bulloch, PharmD, BCPS, FCCM, was joined by Mitchell M. Levy, MD, MCCM, at the 2023 Critical Care Congress to discuss the goal of the AIMS Study and the elements of both the Hour-1 and 3-Hour bundles. Dr. Levy is chief of the Division of Critical Care, Pulmonary, and Sleep Medicine and professor of medicine at the Warren Alpert Medical School of Brown University. He is also the medical director of the medical ICU at Rhode Island Hospital in Providence, Rhode Island, USA.

The National Board of Echocardiography has developed an examination to assess echocardiography and ultrasound skills, which are required by many medical programs. Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, was joined by Sara Nikravan, MD, FASE, FCCM, at the 2023 Critical Care Congress to discuss advanced echocardiography and the National Board of Echocardiography examination. Sara Nikravan, MD, FASE, FCCM, is director of point-of-care ultrasound and associate program director of residency at the University of Washington in Seattle, Washington, USA. This podcast is sponsored by Echonous.

According to the United Nations, climate change is the defining crisis of our time and is happening more quickly than anticipated. Can critical care professionals be the spark that lights the fire of change? Kyle B. Enfield, MD, FSHEA, FCCM, was joined by Srinivas Murthy, MD, MDCM, MHSc, at the 2023 Critical Care Congress to discuss the intersection of climate change and critical care. Dr. Murthy is a pediatric infectious diseases and intensive care physician at the University of British Columbia in Vancouver British Columbia, Canada. His academic and clinical interests are in emerging and severe infections, innovative clinical trials, and global public health.

Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, is joined by Craig M. Coopersmith, MD, FACS, MCCM, to discuss optimal strategies for preventing sepsis and septic shock in the hospital setting. Explore the challenges faced in integrating these strategies into hospital workflows and gain insights into the significant contributions made by multiple team members. This podcast is funded by the Gordon and Betty Moore Foundation through a grant program administered by the Council of Medical Specialty Societies.

The power of scientific collaboration has a broad reach. During the COVID-19 pandemic, more than 7000 clinical trials were registered, with more than 100 different countries represented. Samantha Gambles Farr, MSN, NP-C, CCRN, RNFA, was joined by SCCM Lifetime Achievement Award Recipient John C. Marshall, MD, FRCSC, FACS, at the 2023 Critical Care Congress to discuss the importance of research and scientific collaboration. Dr. Marshall has been involved in research programs with researchers around the globe and is a well-known speaker with nearly 600 published manuscripts. This podcast is sponsored by Dompe Pharmaceutical.

The ICU Liberation Campaign aims to liberate patients from the harmful effects of an intensive care unit (ICU) stay. The campaign is expanding to include more resources for children and infants. Host Ludwig Lin, MD, was joined by Jerry Zimmerman, MD, PhD, FCCM, at the 2023 Critical Care Congress to discuss ICU Liberation and how it is being adapted to improve care in the pediatric ICU. Dr. Zimmerman is an attending physician in the pediatric ICU at Seattle Children’s Hospital and professor of pediatrics and anesthesiology at the University of Washington School of Medicine in Seattle, Washington, USA. This podcast is sponsored by Etiometry.

Implicit bias is a form of automatic and unintentional bias that affects judgments, decisions, and behaviors. Implicit bias can pose a barrier to the diagnosis and treatment of critical illness. Ludwig H. Lin, MD, is joined by Varun U. Shetty, MD, to discuss ways that critical care professionals can mitigate diagnostic delays and errors by being aware of their own implicit biases. Dr. Shetty is an adult intensivist who focuses on caring for critically ill patients in global health settings. He has worked both in the United States and abroad in resource-limited settings and has presented several lectures on healthcare disparities with a specific focus on the care of critically ill patients. This podcast is funded by the Gordon and Betty Moore Foundation through a grant program administered by the Council of Medical Specialties.

Guidelines recommend against red blood cell (RBC) transfusion in hemodynamically stable children without cardiac disease who meet certain criteria. Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, is joined by Katherine Steffen, MD, MHS, to discuss the clinical and economic impacts of compliance with RBC transfusion guidelines, as discussed in "The Impact of Restrictive Transfusion Practices on Hemodynamically Stable Critically Ill Children Without Heart Disease: A Secondary Analysis of the Age of Blood in Children in the PICU Trial" published in the February issue of Pediatric Critical Care Medicine (Steffen K et al. Pediatr Crit Care Med. 2023;24:84-92). Dr. Steffen is a clinical associate professor of pediatrics at Stanford University School of Medicine in Palo Alto, California, USA.

For more than 10 years, the Society of Critical Care Medicine has offered an in-person critical care ultrasound course that spanned two days, interspersing lectures with interactive training. This format has now been replaced by a hybrid format, allowing more countries to host the course, virtually or in person, to ensure that healthcare professionals continue to receive optimized ultrasound training and education. Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, was joined by Sarah E. Bain, MD, at the 2023 Critical Care Congress to discuss the critical care ultrasound course, how it has evolved, and how it is expanding around the world. Sarah E. Bain, MD, is division head of cardiovascular thoracic and structural heart anesthesiology at Virginia Mason Hospital in Seattle Washington, USA.

Marilyn N. Bulloch, PharmD, BCPS, FCCM, and Daleen Penoyer, PhD, RN, CCRP, FCNS, FAAN, FCCM, discuss how to develop and operationalize performance improvement teams to implement the Surviving Sepsis Campaign’s (SSC) Hour-1 Bundle, which was developed in 2021 to minimize time to treatment for patients with sepsis and septic shock. Explore how to overcome barriers teams encounter in implementing the bundle, including inflexibility, lack of awareness about the bundle, competing priorities, and insufficient staffing. This podcast is funded by the Gordon and Betty Moore Foundation through a grant program administered by the Council of Medical Specialty Societies.

During the COVID-19 pandemic, hospitals implemented tele-critical care medicine to help patients while keeping staff safe from exposure. Now that patient care has gone back to normal, what is the role of tele-critical care medicine? Donald S. Prough, MD, FCCM, was joined by Krzysztof Laudanski, MD, PhD, FCCM, and Sonia S. Everhart, PharmD, BCPS, BCCCP, FCCM, during the 2023 Critical Care Congress to discuss how tele-critical care medicine was implemented during the COVID-19 pandemic and its continued benefits after the pandemic. Sonia S. Everhart, PharmD, BCPS, BCCCP, FCCM, is a clinical pharmacy specialist in critical care at Atrium Health in Charlotte, North Carolina, USA. Krzysztof Laudanski, MD, PhD, FCCM, is a senior associate consultant at the Mayo Clinic in Rochester, Minnesota, USA. This podcast is sponsored by Equum Medical and CLEW Medical.

Although the variety of noninvasive interfaces for pediatric patients has grown in the past 10 years, they are still limited. Pediatric interfaces are typically scaled down from adult to child sizes, which does not consider the contours of a growing child’s face, causing poor fit in patients of certain ages. Donald S. Prough, MD, FCCM, was joined by Natalie Napolitano, MPH, RRT-NPS, during the 2023 Critical Care Congress to discuss how clinicians’ need to have the right equipment for their patients led to a device development project using 3D imaging that obtained sample sizes from various age groups to bridge the fit gap and lessen pressure point injury among pediatric patients. Natalie Napolitano, MPH, RRT-NPS, is a respiratory therapist and research clinical specialist at the Children's Hospital of Philadelphia in Philadelphia, Pennsylvania, USA.

The Viral Infection and Respiratory Illness Universal Study (VIRUS) is a prospective, cross-sectional, observational study and registry of all eligible adult and pediatric patients who are admitted to a hospital. Marilyn N. Bulloch, PharmD, BCPS, FCCM, was joined by Rahul Kashyap, MD, MBA, at the 2023 Critical Care Congress to discuss the Discovery VIRUS COVID-19 Registry. Dr. Kashyap is an assistant professor and clinical research scientist at Mayo Clinic in Rochester, Minnesota, USA.

From the earliest days of critical care medicine, the importance of measuring cardiac output and hemodynamic monitoring were recognized in understanding the physiology of critically ill patients, especially those in shock. However, methods for measuring cardiac output were cumbersome or not widely available. Ashish K. Khanna, MD, FCCP, FCCM, is joined by Margaret M. Parker, MD, MCCM, to discuss the evolution of the pulmonary artery catheter in critically ill patients, as discussed in "The Story of the Pulmonary Artery Catheter: Five Decades in Critical Care Medicine," published in the February issue of Critical Care Medicine (Parker M et al. Crit Care Med. 2023;51:159-163). Dr. Parker is professor emeritus of pediatrics at Stony Brook University School of Medicine in Stony Brook, New York, USA.

Discovery, the Critical Care Research Network, is an SCCM program that aims to expand research and improve outcomes. Discovery has launched the Data Science Campaign to leverage large-scale (big) data for research, seeking to apply these data in a clinical environment through standardized models and shared resources. Kyle B. Enfield, MD, FSHEA, FCCM, was joined by J. Perren Cobb, MD, FACS, FCCM, and Karin Reuter-Rice, PhD, NP, FAAN, FCCM, at SCCM's 2023 Critical Care Congress to discuss the future of data science and critical care research.

Confident, well-rounded leaders can increase the efficiency of their critical care unit, improve the performance of their teams, and ultimately achieve better patient outcomes. Marilyn Bulloch, PharmD, BCPS, FCCM, was joined by Judith Jacobi, PharmD, BCCCP, MCCM, during SCCM’s 2023 Critical Care Congress to discuss how the new Leadership, Empowerment, and Development (LEAD) Committee will engage participants in a variety of didactic and small-group sessions to facilitate their progress as mentors, managers, leaders of trainees, coworkers, critical care teams, volunteers, and future leaders within SCCM.

Diagnostic delays and errors are significant contributors to patient illness, injury, and death in the United States. According to the Society to Improve Diagnosis in Medicine, diagnostic errors impact nearly 12 million Americans every year, leading to prolonged hospital stays, increased nonreimbursed healthcare costs, and even more harm when combined with other medical errors. Maureen Madden, DNP, RN, CPNP-AC, CCRN, FCCM, is joined by Mary Jo C. Grant, ACNP, PhD, FAAN, to discuss how to reduce diagnostic delays and errors, with an emphasis on sepsis. This podcast is funded by the Gordon and Betty Moore Foundation through a grant program administered by the Council of Medical Specialty Societies. 0.5 hours of accredited continuing education credit is available for this podcast through March 31, 2024. Visit sccm.org/store and search the podcast name to find details.

The contribution of adverse events to the deaths of patients in the pediatric ICU (PICU) who die despite a low predicted mortality risk is unknown. Elizabeth H. Mack, MD, MS, FCCM, is joined by Carin W. Verlaat, MD, to discuss adverse events in low-risk nonsurvivors compared with low-risk survivors and high-risk PICU survivors and nonsurvivors and the contribution of adverse events to mortality. The podcast centers around the article, Adverse Events in Pediatric Critical Care Nonsurvivors With a Low Predicted Mortality Risk: A Multicenter Case Control Study (Verlaat C, et al. Pediatr Crit Care Med. 2023;24:4-16). Dr. Verlaat is a pediatric intensivist at Radboud University Medical Center in Nijmegen, Netherlands.

Bloodstream infections (BSIs) acquired in the ICU are potentially preventable. Kyle B. Enfield, MD, FSHEA, FCCM, is joined by Sameer S. Kadri-Rodriguez, MD, MS, to discuss the article, Epidemiology of ICU-Onset Bloodstream Infection: Prevalence, Pathogens, and Risk Factors Among 150,948 ICU Patients at 85 U.S. Hospitals, (Gouel-Cheron A, et al. Crit Care Med. 2022;50:1725-1736). Dr. Kadri-Rodriguez is a critical care and infectious diseases physician at the National Institutes of Health Clinical Center in Bethesda, Maryland. This podcast is sponsored by Sound Physicians.

Although only a small number of patients hospitalized with COVID-19 present with a secondary bacterial pneumonia, a large percentage are unnecessarily treated with antibiotics. Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by George Sakoulas, MD, to discuss how physicians and hospitalists can identify when antibiotics are unnecessary for hospitalized patients with moderate to severe respiratory infections. Dr. Sakoulas is chief of infectious disease at Sharp Rees-Stealy Medical Group in San Diego, California, and an adjunct professor in the Division of Host-Microbe Systems and Therapeutics Center for Immunity, Infection, and Inflammation at the University of California San Diego School of Medicine in La Jolla, California. This podcast is sponsored by bioMérieux.

The American Heart Association's (AHA) cardiopulmonary resuscitation guidelines recommend against the routine administration of IV calcium during pediatric cardiopulmonary arrest because of its association with worse outcomes. However, IV calcium is routinely used in children with heart disease who have cardiopulmonary arrest. Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, is joined by Gurpreet S. Dhillon, MD, to discuss the article, Calcium Administration During Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest in Children With Heart Disease is Associated With Worse Survival - A Report From the American Heart Association's Get With the Guidelines-Resuscitation (GWTG-R) Registry, published in the November issue of Pediatric Critical Care Medicine (Dhillon G, et al. Pediatr Crit Care Med. 2022;23:860-871). Dr. Dhillon is a pediatric cardiac intensivist at Lucile Packard Children's Hospital at Stanford in Palo Alto, California.

Untreated hyperammonemia can cause irreversible neurologic damage, coma, or death. A high level of clinical suspicion is necessary to quickly recognize and implement emergency interventions for hyperammonemia in the acute presentation of urea cycle disorders (UCDs). Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Anna-Kaisa Niemi, MD, PhD, and a patient who was hospitalized for hyperammonemia at age 8 years to discuss the importance of improved recognition of hyperammonemia and awareness of the underlying causes, such as UCDs. Dr. Niemi is a neonatologist and associate professor at Rady Children’s Hospital in San Diego, California, USA. This podcast is sponsored by Horizon Therapeutics.

Pediatric advanced life support (PALS) guidelines include weight-based epinephrine dosing recommendations of 0.01 mg/kg with a maximum of 1 mg, which corresponds to a weight of 100 kg. But what are the actual practice patterns? Elizabeth H. Mack, MD, MS, FCCM, is joined by Martha Kienzle, MD, to discuss the article: Weight-Based Versus Flat Dosing of Epinephrine During Cardiac Arrest in the PICU: A Multicenter Survey, published in the October 2022 issue of Pediatric Critical Care Medicine. Dr. Kienzle is an attending physician in the Department of Anesthesiology and Critical Care Medicine at Children's Hospital of Philadelphia.

Clinicians aim to communicate with surrogates of ICU patients in ways that both inform them of the patient’s medical condition and support their emotional needs. Written communication, as a supplement to traditional verbal communication, may overcome some of the challenges that clinicians face when engaging with families in the ICU. Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, is joined by Jared Greenberg, MD, MSc, to discuss the article "Daily Written Care Summaries for Families of Critically Ill Patients: A Randomized Controlled Trial," published in the September 2022 issue of Critical Care Medicine. Dr. Greenberg is assistant professor of internal medicine in the Division of Pulmonary, Critical Care and Sleep Medicine at Rush University Medical Center in Chicago, Illinois. This podcast is sponsored by Sound Physicians.

Clazakizumab is a monoclonal antibody against human interleukin-6 that may benefit patients hospitalized with severe or critical COVID-19 accompanied by hyperinflammation. Although not yet FDA approved, clinical trials of clazakizumab for treatment of COVID-19 are under way worldwide. Samantha Gambles Farr, MSN, NP-C, CCRN, RNFA, is joined by Bonnie E. Lonze, MD, PhD, to discuss the article, A Randomized Double-Blinded Placebo Controlled Trial of Clazakizumab for the Treatment of COVID-19 Pneumonia With Hyperinflammation, published in the September 2022 issue of Critical Care Medicine. Dr. Lonze is a faculty transplant surgeon at NYU Langone in New York, New York, USA, focusing primarily on kidney transplants. As vice chair for research of the NYU Langone Transplant Institute, she leads the research group on clinical trials and regulatory oversight.

This podcast will educate clinicians on the unfamiliar parameters of processed EEG (pEEG). Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Meghan B. Lane-Fall, MD, MSHP, FCCM, to discuss the benefits of pEEG for monitoring sedated mechanically ventilated patients and patients undergoing neuromuscular blockade. Dr. Lane-Fall is an associate professor of anesthesiology, critical care, and epidemiology at the University of Pennsylvania. This podcast is sponsored by Medtronic.

Catecholamine is used in patients with septic shock to augment hemodynamics and achieve goal mean arterial pressure. Ludwig H. Lin, MD, is joined by Gretchen L. Sacha BCCCP, PharmD, to discuss this retrospective observational study to evaluate the associations of catecholamine dose, lactate concentration, and timing from shock onset at vasopressin initiation with in-hospital mortality. (Sacha G, et al. Crit Care Med. 2022;50:614-623). Dr. Sacha is a critical care clinical specialist at Cleveland Clinic in Cleveland, Ohio. This podcast is sponsored by Sound Physicians.

This podcast will examine a retrospective, observational cohort study that found an association between excessive oxygen supplementation in the first day of mechanical ventilation with multiple organ dysfunction syndrome on day 7 of admission and in-hospital mortality in critically ill children. Host Elizabeth H. Mack, MD, MS, FCCM, is joined by L. Nelson Sanchez-Pinto, MD, MBI, to discuss the study's findings.

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.

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 (McGowan S, et al. Crit Care Med. 2022 Jan;50:1-20). Dr. McGowan is a first-year fellow in pulmonary and critical care at University of California in San Francisco, California, USA. This podcast is sponsored by Sound Physicians.

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. Host Elizabeth H. Mack, MD, MS, FCCM, is joined by Lauren Rissman, MD, to discuss the eye-opening experience Dr. Rissman had when she was admitted to the ICU from the labor and delivery unit and the importance of having a patient advocate.

Since the publication of the Surviving Sepsis Campaign guidelines, the focus has been on sepsis management, early identification, and treatment. (Evans L, et al. Crit Care Med. 2021;49:e1063-e1143). As more patients are surviving sepsis, they may be left with short- and long-term problems that need to be addressed. Host Ludwig H. Lin, MD, is joined by Christa A. Schorr, DNP, MSN, RN, FCCM, to discuss the implementation of initiatives for preventing impairments due to sepsis. They will also discuss the challenges faced by survivors of sepsis and the difficulties of matching care to the patient's and family's goals of care.

Family nurse practitioners (FNPs) who do not have acute care certification may be recruited to work in ICUs that lack enough acute care nurses, which is a challenge for both the ICU and the FNP. When the FNP moves on to another institution, that institution may not consider the FNP's ICU experience to be an adequate qualification. Host Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, is joined by Christian Santos, MSN, FNP-BC, and Mariah Rose, ARNP, both nurse practitioners at Mayo Clinic in Jacksonville, Florida, to discuss the difficulties of FNPs who need acute care certification to work in ICUs. Christian Santos, MSN, FNP-BC, is a nurse practitioner at Mayo Clinic Hospital in Jacksonville, Florida, USA. Mariah Rose, ARNP, is a nurse practitioner at Mayo Clinic in Jacksonville, Florida, USA.