SCCM Podcast

SCCM Pod-463 CCM: Clazakizumab for COVID-19: Friend or Foe?

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.

SCCM Pod-465 PCCM: Who’s Got the Right Dose?

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.

SCCM Pod-467 PCCM: AHA Guidelines Address Calcium During Pediatric Cardiopulmonary Arrest

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.

SCCM Pod-466: Hyperammonemia, the Silent Killer

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.

SCCM Pod-462 APP: Bullying in the Workplace

Are there bullies in the world of advanced practice providers (APPs)? How is bullying defined in a clinical environment? In this podcast, hosted by Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, three APPs from different hospitals debate incivility and workplace culture. They also address interpersonal relationships among APPs, physicians, and nurses.

SCCM Pod-461 PCCM: A Novel Machine Learning Model to Predict PICU Transfer

Unrecognized clinical deterioration during illness requiring hospitalization is associated with high risk of mortality and long-term morbidity among children. In this podcast hosted by Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, Anoop Mayampurath, PhD, discusses a novel machine learning model that identifies ICU transfers in hospitalized children more accurately than current tools.

SCCM Pod-460 CCE: Multiple PCR for Direct Detection of Bloodstream Infection After Pediatric Cardiac Surgery

Nosocomial infections are a prevalent cause of death and complications in critically ill children. Conventional cultures are able to detect only up to 25% of bacteremias. Several studies have suggested that molecular tests could be a faster and effective tool for detection of bacterial infections.

SCCM Pod-459: Processed EEG Monitoring in the ICU

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.

SCCM Pod-458 CCM: Association of Catecholamine in Patients with Septic Shock

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.

SCCM Pod-457 CCM: Increased incidence of ventilator-acquired pneumonia in COVID-19 patient

While little is known about the epidemiology of ventilator-acquired pneumonia among COVID-19 patients, some studies suggest a higher risk of ventilator-associated pneumonia in this specific population. Ashish K. Khanna, MD, FCCP, FCCM, is joined by Charles-Herve Vacheron, MD, to discuss the Cohort exposed/nonexposed study among the REA-REZO surveillance network.

SCCM Pod-456 PCCM: Effects of Excessive Oxygen Supplementation

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.

SCCM Pod-453 Extracorporeal Blood Purification

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. Host Pamela Peeke is joined by Javier Neyra to discuss clinical cases and the use of extracorporeal blood purification in COVID-19 patients.

SCCM Pod-449 FNP in ICU

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.

SCCM Pod-444 HF20 Filter Set for CRRT in Low Weight Patients

​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.

SCCM Pod-443 How the Pneumonia Panel Aids in Antimicrobial Stewardship and in the Fight Against COVID-19

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.

SCCM Pod-441 Connections Between COVID-19, Sepsis, and Fluid Management

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.

SCCM Pod-440 Optimal Sedation in Patients Who Receive Neuromuscular Blocking Agent Infusions for ARD

Two previously published trials (ARDS et Curarisation Systematique and Reevaluation of Systemic Early Neuromuscular Blockade) presented equivocal evidence on the effect of neuromuscular blocking agent infusions in patients with acute respiratory distress syndrome.

SCCM Pod-439 The Association Between Antibiotic Delay and Hospital Mortality

Rapid delivery of antibiotics is a cornerstone of sepsis therapy, although time targets for specific components of antibiotic delivery are unknown. Host Ludwig H. Lin, MD, is joined by Stephanie Parks Taylor, MD, to discuss the significance of time lead for suspected sepsis patients, how to use a generous time window wisely, and new and reconfigured technologies opportunities.

SCCM Pod-438 Patient-Ventilator Dyssynchronies and Their Mechanisms

The prevalence and consequences of dyssynchronies are largely underestimated due to frequent lack of monitoring.

SCCM Pod-437 Enteral Feeding Intolerance in the Mechanically Ventilated Critically Ill

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.