SCCM Podcast

SCCM Pod-533 CCM: Updated Brain Death Guidance: What Critical Care Teams Need to Know

Host Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, welcomes Matthew Kirschen, MD, PhD, FAAN, FNCS, to discuss what critical care professionals need to know about determining brain death/death by neurologic criteria (BD/DNC).
In October 2023, a revised consensus practice guideline for the determination of brain death in both children and adults was published in Neurology (Greer DM, et al. Neurology. 2023;101;1112-1132). The guideline integrated guidance for adults and children to provide a comprehensive, practical way to evaluate patients with catastrophic brain injuries to determine whether they meet the criteria for brain death.
The Society of Critical Care Medicine (SCCM) offers several additional resources to support critical care clinicians’ understanding of the updated guidelines, including an article published in the March 2024 issue of Critical Care Medicine addressing what the critical care team needs to know about the guidelines (Kirschen MP, et al. Crit Care Med. 2024;52:376-386). Dr. Kirchen was the lead author of that article and shares key points in this podcast episode.
Other resources include:
Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Practice Guidelines 2024 Critical Care Congress presentation
Free AAN evaluation tool that walks clinicians through the process of brain death evaluation.
Special article in Neurology: Clinical Practice that provides a detailed narrative about what has changed in the 2023 guidelines compared to prior guidelines. The article also includes tables outlining comparisons, bolding new recommendations, and italicizing age-specific guidance to easily identify the differences between determining brain death in children versus adults.

SCCM Pod-532 PCCM: Understanding Quality-of-Life Risks in PARDS Survivors

Host Elizabeth H. Mack, MD, MS, FCCM, welcomes Elizabeth Y. Killien, MD, MPH, to discuss pediatric acute respiratory distress syndrome (PARDS). Dr. Killien explains the findings from her retrospective study on PARDS severity, emphasizing how factors such as severe hypoxemia can impact health-related quality of life (HRQL) after discharge. (Killien EY, et al. Pediatr Crit Care Med. 2024;25:816-827). Dr. Killien is an attending physician in the pediatric ICU and an assistant professor at Seattle Children’s Hospital, University of Washington School of Medicine, in Seattle, Washington.

SCCM Pod-531: CRRT Fluid Strategies: What Clinicians Need to Know

Host Ludwig Lin, MD, welcomes Raghavan Murugan, MD, MS, FRCP, FCCM, a professor and leading expert in critical care nephrology. They discuss the latest insights on fluid management strategies during continuous renal replacement therapy (CRRT), drawing from recent research and white papers. Dr. Murugan emphasizes the importance of updated education on CRRT fluid removal practices to enhance clinical outcomes and patient care in critical settings. This podcast is sponsored by Baxter Health.

SCCM Pod-530 PCCM: Essential Communication in Pediatric Critical Care Transfers

Host Maureen A. Madden, DNP, RN, CPNC-AC, CCRN, FCCM, sits down with Christina L. Cifra, MD, MS, to discuss communication strategies for interfacility transfers to the pediatric intensive care unit (PICU). Dr. Cifra shares insights from her recent study on verbal handoffs during transfers, examining the challenges and vital elements of communication during these high-stakes situations (Thirnbeck CK, et al. Pediatr Crit Care Med. 2024;52:162-171). Dr. Cifra is an attending physician in the Division of Medical Critical Care at Boston Children's Hospital and assistant professor of pediatrics at Harvard Medical School in Boston, Massachusetts.

SCCM Pod-529: Bridging the Gap: Communication During Sepsis Transfers

Patients with sepsis are regularly transferred to intensive care units, but there is a dearth of literature that describes the type of communication occurring between the receiving and referring clinicians after these transfers take place. The Society of Critical Care Medicine's (SCCM) Diagnostic Excellence Program sought to gain a better understanding of these communications through an in-depth survey. In this podcast, host Kyle B. Enfield, MD, discusses the survey results with grant principal investigator Greg S. Martin, MD, MSc, FCCM.
Dr. Martin also discusses a new toolkit created by SCCM to facilitate better transfer communication. Learn more about the toolkit and the Diagnosis Excellence Program at sccm.org/diagnosticexcellence.
This podcast offers 0.25 hours of accredited continuing education (ACE) credit. Learn more at https://sccm.org/diagnosticexcellence
The Diagnostic Excellence Program is funded by the Gordon and Betty Moore Foundation through a grant program administered by the Council of Medical Specialty Societies to support the development and dissemination of resources and programs to improve the timeliness, accuracy, safety, efficiency, patient-centeredness, and equity of diagnostic outcomes for patients in the United States.
Dr. Martin, a past SCCM president, is the James Paullin Distinguished Professor and division director of pulmonary, allergy, critical care and sleep medicine at Emory University. He is an international authority on critical care medicine and an expert on sepsis, COVID-19, and ARDS, having conducted groundbreaking clinical trials on these conditions, coauthored the Sepsis-3 definition, and published seminal papers for diagnosing and treating critically ill patients.

SCCM Pod-528: The Impact of Advanced Practice Provider Retention on Quality

Retaining highly skilled advanced practice nurses and physician assistants in intensive care units is vital for maintaining excellent quality and safety in critical care. In the third episode of SCCM's podcast series on quality and safety in critical care, Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, is joined by Roy H. Constantine, MPH, PA-C, PhD, FCCM, and Jose Chavez, DNP, CNS, RN, CCRN, FCCM, to discuss best practices for retention and how retention impacts patient outcomes in critical care settings.

SCCM Pod-527 The Impact of Clinician Retention on ICU Care Quality

The importance of retaining seasoned physicians in the ICU is crucial for maintaining high standards of patient care. In the second episode of SCCM’s podcast series on quality and safety in critical care, Elizabeth H. Mack, MD, MS, FCCM, is joined by Alexander O. Sy, MBA, MD, MSL, FCCM, to discuss effective retention strategies, their direct impact on patient outcomes, and the broader effects on healthcare teams and organizational efficiency.

SCCM Pod-526 CCM: Alteplase Dosing in Pulmonary Embolism

Host Samantha Gambles Farr, MSN, AG-ACNP, FNP-C, RNFA, is joined by Roman Melamed, MD, to discuss the comparative effectiveness of reduced-dose versus full-dose alteplase for acute pulmonary embolism, focusing on patient outcomes and complications. They will highlight study findings on significant improvements in hemodynamic and respiratory parameters in both groups, with a lower rate of hemorrhagic complications in the reduced-dose group (Melamed R, et al. Crit Care Med. 2024;52:729-742). Dr. Melamed is a critical care intensivist and director of the Pulmonary Embolism Program at Abbott Northwestern Hospital in Minneapolis, Minnesota, USA, and an adjunct associate professor at the University of Minnesota.

SCCM Pod-525 PCCM: Extracorporeal Cardiopulmonary Resuscitation Outcomes in Pediatric Patients

Host Marilyn N. Bulloch, PharmD, BCPS, FCCM, is joined by Catherine Beni, MD, PhD, to discuss a study aimed at determining outcomes of extracorporeal CPR (ECPR) in pediatric patients without congenital cardiac disease and identifying associations with in-hospital mortality of factors such as initial arrest rhythm and patient demographics (Beni CE, et al. Pediatr Crit Care Med. 2023 Nov;24:927-935). Catherine Beni, MD, PhD, is a resident physician in the department of surgery at the University of Washington in Seattle, Washington.

SCCM Pod-524 PCCM: Impact of Neighborhood on Pediatric ICU Outcomes

Host Maureen A. Madden, DNP, RN, CPNC-AC, CCRN, FCCM, is joined by Michael C. McCrory, MD, MS, FCCM, to discuss a multicenter retrospective study evaluating the impact of neighborhood, as categorized by the Child Opportunity Index, on pediatric intensive care unit (PICU) outcomes such as mortality, illness severity, and PICU length of stay. The study highlights the disparities in PICU admissions based on socioeconomic factors (McCrory MC, et al. Pediatr Crit Care Med. 2024 Apr;25:323-334). Michael C. McCrory, MD, MS, FCCM, is an associate professor in the departments of Anesthesiology and Pediatrics at Wake Forest University School of Medicine in Winston-Salem, North Carolina.

SCCM Pod-523 CCM: Clinical Predictors of Seizures in ICU Patients

Host Elizabeth H. Mack, MD, MS, FCCM, is joined by Samuel Snider, MD, and Michael Fong, MD, to discuss a retrospective cohort study that examined factors such as cardiac arrest, brain neoplasms, and EEG patterns to determine their association with status epilepticus and isolated seizures in critically ill patients, aiming to improve monitoring and treatment strategies for high-risk patients (Snider SB, et al. Crit Care Med. 2023 Aug;51:1001-1011). Samuel Snider, MD, is a board-certified neurologist at Brigham and Women's Hospital and an instructor of neurology at Harvard Medical School in Boston, Massachusetts. Michael Fong, MD, is an assistant professor adjunct at the Yale School of Medicine in New Haven, Connecticut.

SCCM Pod-522 PCCM: Early Adrenaline vs. Standard Fluid in Pediatric Septic Shock

Host Elizabeth H. Mack, MD, MS, FCCM, is joined by Luregn J. Schlapbach, MD, PhD, FCICM, to discuss the Pediatric Critical Care Medicine article, "Resuscitation With Early Adrenaline Infusion for Children With Septic Shock: A Randomized Pilot Trial" (Harley A, et al. Pediatr Crit Care Med. 2024 Feb;25:106-117). The study found that a fluid-sparing algorithm for children presenting with septic shock using early adrenaline is feasible. Dr. Schlapbach is a professor and chief of intensive care and neonatology at the University Children's Hospital in Zurich, Switzerland.

SCCM Pod-521 CCM: Can ICU Liberation Bundle Compliance Impact Post-Intensive Care Syndrome Rates?

Host Kyle B. Enfield, MD, FCCM, is joined by Daisuke Kawakami, MD, to discuss the Critical Care Medicine article, “Evaluation of the Impact of ABCDEF Bundle Compliance Rates on Postintensive Care Syndrome: A Secondary Analysis Study.” (Kawakami D, et al. Crit Care Med. 2023 Dec;51:1685-1696). The study examines how compliance with the ICU Liberation Bundle (A-F) impacts post-intensive care syndrome and intensive care unit mortality rates Dr. Kawakami is a physician in the Department of Emergency and Critical Care Medicine at St. Marianna University School of Medicine in Kawasaki, Japan. Learn more about the ICU Liberation Bundle at sccm.org/iculiberation.

SCCM Pod-520: Implementation Science: From Evidence to Practice

Delve into the realm of implementation science and its significance in bridging the gap between research-based evidence and critical care practice. Host Marilyn N. Bulloch, PharmD, BCPS, FCCM, is joined by Anne E. Sales, PhD, RN, to discuss the complexity of implementation science, which involves understanding human behavior change within organizational constraints. They explore examples such as hypertension treatment to illustrate the challenges and opportunities of implementing evidence-based practices. They discuss the importance of context, resources, and stakeholder engagement in successful implementation efforts in the critical care setting where complex interventions and rapid changes are common. Dr. Sales is a nurse and professor at the Sinclair School of Nursing and the Department of Family and Community Medicine in the School of Medicine at the University of Missouri, and associate dean for implementation research and health delivery effectiveness in the School of Medicine. She is a research scientist at the Center for Clinical Management Research at the VA Ann Arbor Health System in Ann Arbor, Michigan, USA.

SCCM Pod-519: Crisis and Chaos: Pandemic Perspectives

Improving health literacy is vital for addressing disparities in healthcare access and quality. Join Host Kyle B. Enfield, MD, FSHEA, FCCM, and Jerome Adams, MD, MPH, FASA, as they discuss the urgent need for health equity initiatives and innovative solutions to systemic healthcare challenges. Learn why providing accessible information and empowering individuals to advocate for their health is key. Dr. Adams was the 20th U.S. Surgeon General when the COVID-19 pandemic began and 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. He presented his perspectives during the 2024 Critical Care Congress in a thought leader session and shares additional insights during this podcast episode. While Dr. Adams was 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. Previously he was Indiana’s state health commissioner, 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.

SCCM Pod-518: Achieving Sustainable Healthcare in Africa

The Society of Critical Care Medicine’s (SCCM) new global health project, Africa Infrastructure Relief and Support (AIRS), will ensure the availability of medical oxygen to patients in the Gambia, Liberia, and Sierra Leone, made possible by a $5.5 million grant from Direct Relief and in collaboration with the Johns Hopkins Global Alliance of Perioperative Professionals (GAPP) and the Institute of Global Perioperative Care (IGPC).
Host Samantha Gambles Farr, MSN, AG-ACNP, FNP-C, CCRN, RNFA, is joined by John B. Sampson, MD, executive director of GAPP and a critical care anesthesiologist at Johns Hopkins University, to discuss the AIRS project. AIRS tackles challenges such as energy shortages and outdated infrastructure to tailor solutions to each country. AIRS prioritizes sustainability and capacity building to empower local communities and address global health disparities. Listeners are urged to support AIRS by raising awareness, advocating for sustainable healthcare, and exploring collaboration and funding opportunities.

SCCM Pod-517: Benefits of Hemodynamic Monitoring in Critical Care

This episode of the Society of Critical Care Medicine Podcast offers insights on hemodynamics monitoring in critically ill patients. Kyle Enfield, MD, FCCM, is joined by Courtney Bennett, DO, FCC, FASE, to discuss foundational concepts in hemodynamic monitoring and shock management, stressing the importance of understanding data quality and ongoing debates in critical care. SCCM offers a hemodynamic monitoring skills precourse as part of its Critical Care Congress programming. Courtney Bennett, DO, FCC, FASE, is an associate professor at Lee Valley Health Network in Allentown, Pennsylvania, USA.

SCCM Pod-516: Bedside Practices in Hemodynamic Management

While advanced monitoring technology can provide valuable information, the importance of clinical judgment and examination should not be minimized. Host Ludwig H. Lin, MD, is joined by Maurizio Cecconi, MD, to discuss the integration of clinical judgment with technology when assessing hemodynamic instability and shock. They emphasize the importance of fluid challenges tailored to individual patient characteristics, along with standardized approaches. Dr. Cecconi explores the role of big data and artificial intelligence (AI) in treatment refinement and advocates for global access to care. He highlights fluid responsiveness dynamics and the interaction between fluids and vasopressors, urging a cautious approach to fluid administration due to its drug-like effects.
Dr. Cecconi is an anesthesiologist and intensive care specialist and chair of the Department of Anesthesia and Intensive Care at Humanitas Research Hospital and University in Milan, Italy. This podcast is sponsored by Baxter Healthcare.

SCCM Pod-515: Ultrasound Training and Humanitarian Missions

Host Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, is joined by Susanna Rudy, ACNP, DNP, to discuss her journey from developing ultrasound training programs to volunteering in conflict zones and pandemic hotspots. She also highlights the crucial role of advanced practice providers (APPs) in critical care. Dr. Rudy is an acute care family medicine and emergency medicine nurse practitioner at Vanderbilt University in Nashville, Tennessee, USA. Dr. Rudy believes in seizing opportunities for professional growth and humanitarian service.

SCCM Pod-514: Current Concepts: Managing Liver Failure in the ICU

This is the fifth 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 Paritosh Prasad, BA, BS, MBA, MD, to discuss the management of acute and acute-on-chronic liver failure.