Fluid resuscitation is a cornerstone of our treatment for circulatory failure and is often quite challenging to get right. In today’s episode of the podcast, we will discuss the prediction of fluid responsiveness. Our guest is Dr. Haney Mallemat, a critical care intensivist and emergency medicine clinician at Cooper University Health. He is also an associate professor of medicine and of emergency medicine at Cooper Medical School of Rowan University, in Camden, New Jersey.

Additional Resources:

Critical Care Now: A site for intensivists and resuscitationists. - https://criticalcarenow.com/

RESUS-X: The ultimate resuscitation educational experience. - https://bit.ly/3nXtWih

Prediction of fluid responsiveness: a review. Enev R, et al. 2021. - https://bit.ly/33NNHBT

Prediction of fluid responsiveness: an update. Monnet X, et al. 2016. - https://bit.ly/3H2R6ew

Predictors of fluid responsiveness in critically ill patients mechanically ventilated at low tidal volumes: systematic review and metanalysis. Alvarado Sanchez JI, et al. 2021 - https://bit.ly/3KJ6D5l

Music and Podcasts mentioned in this episode:

Haney’s musical recommendation – listen to the band Wilco. - https://wilcoworld.net/

99% Invisible. One of Haney’s favorite podcasts. Open access. - https://99percentinvisible.org/

The Joe Rogan Experience. Popular podcast on Spotify. - https://open.spotify.com/show/4rOoJ6Egrf8K2IrywzwOMk

EMRAP. A leading educational platform recommended by Haney. - https://www.emrap.org/

As we start a new year, we look forward with the hope to grow and improve critical care medicine. In today’s episode of the podcast, we will discuss a path forward focused on healing, recovery, and transformation.

Our guest is Dr. Wes Ely, professor of medicine at Vanderbilt University School of Medicine and co-director of the Center for Critical Illness, Brain dysfunction, and Survivorship (CIBS Center). Dr. Ely is the author of Every Deep-Drawn Breath – a wonderful book that will guide our discussion in this episode.

Additional Resources:

Link to the CIBS Center website, which contains a wealth of resources for intensivists on the topic of delirium: https://www.icudelirium.org

Kaleidoscope by Wes Ely: https://pubmed.ncbi.nlm.nih.gov/25599355/

Don’t give COVID-19 long-haulers the Silent Treatment by Wes Ely: https://bit.ly/3GfgJbC

ABCDEF Bundle and Supportive ICU Practices for Patients with Coronavirus Disease 2019 Infection - An International Point Prevalence Study. K Liu, et al. Critical Care Explorations 2021: https://bit.ly/3qepqgS

Caring for Critically Ill Patients with the ABCDEF Bundle - Results of the ICU Liberation Collaborative in Over 15,000 Adults: https://bit.ly/3FeX0Hw

Books Mentioned in this Episode:

Every Deep-Drawn Breath by Wes Ely: https://www.icudelirium.org/every-deep-drawn-breath

In Shock by Rana Awdish: https://amzn.to/3JY9p6n

Arrowsmith by Sinclair Lewis: https://amzn.to/339MJ2m

East of Eden by John Steinbeck: https://amzn.to/3JXpRDN

In today’s podcast episode, we will discuss Point of Care Ultrasonography (POCUS). We examine key trends in technology, the relationship of POCUS to consultative ultrasonography, growing clinical applications, and challenges with POCUS.

Our guest is Dr. Jose Luis Diaz-Gomez. Dr. Diaz- Gomez is the Chief of Transplant, Cardiovascular, and Mechanical Support Critical Care, and Director of Critical Care Echocardiography at Baylor, St. Luke’s Medical Center in Houston, Texas. He is a Senior Faculty in Cardiovascular Anesthesia and Critical Care at Baylor College of Medicine.

Additional Resources:

Point of Care Ultrasonography. By J.L. Diaz-Gomez et al. New England Journal of Medicine 2021: https://bit.ly/3JftVPt

Multi-organ point of care ultrasound for COVID-19 (PoCUS4COVID). Expert Consensus: https://bit.ly/3mrXvaF

Society of Critical Care Medicine Resources for critical care ultrasound: https://bit.ly/3yZsW1m

Point of care ultrasonography Certification – CHEST: https://bit.ly/32bZfyd

Books Mentioned in this Episode:

The Myth of Artificial Intelligence: Why Computers Can’t Think the Way We Do. By Erik Larson: https://amzn.to/3ySWDRm

Essentialism: The Disciplined Pursuit of Less. By Greg McKeown: https://amzn.to/3EfVeFT

In this episode of Critical Matters, we will discuss the Surviving Sepsis Campaign Guidelines 2021 update.

Our guest is Dr. Laura Evans. Dr. Evans is the medical director for critical care and professor in the division of pulmonary, critical care and sleep medicine at the University of Washington Medical Center. She is the current Surviving Sepsis Campaign guidelines co-chair and the lead author for the 2021 Surviving Sepsis Campaign Guidelines.

Additional Resources:

Surviving Sepsis Campaign Guidelines 2021: https://journals.lww.com/ccmjournal/Fulltext/2021/11000/Surviving_SepExecutive Summary: Surviving Sepsis Campaign Guidelines 2021: https://journals.lww.com/ccmjournal/Fulltext/2021/11000/Executive_Summary__Surviving_Sepsis_Campaign_.14.aspx

Society of Critical Care Medicine Resources for SSC: https://www.sccm.org/SurvivingSepsisCampaign/Home

Hanlon's Razor: https://thedecisionlab.com/reference-guide/philosophy/hanlons-razor/

Books Mentioned in this Episode: Good Night Stories for Rebel Girls: 100 Tales of Extraordinary Women by Elena Favilli and Francesca Vallo: https://www.amazon.com/Good-Night-Stories-Rebel-Girls/dp/0997895810/ref=sr_1_1?crid=13KK590LSPF64&keywords=good+night+stories+for+rebel+girls&qid=1638473265&sprefix=good+night+%2Caps%2C182&sr=8-1

In this episode of Critical Matters, we discuss the management of severe acute pancreatitis.

Our guest is Dr. Marc G Besselink (@MarcBesselink). He is Professor of pancreatic and hepatobiliary(HPB) surgery, at Amsterdam University Medical Centers in the Netherlands. Dr. Besselink is a member of the Dutch Pancreatitis Study Group and is the senior investigator of the POINTER clinical trial (recently published in the New England Journal of Medicine).

Additional Resources:

Acute Pancreatitis: https://bit.ly/3D6kONK

POINTER Clinical Trial - Immediate Versus Postponed Intervention for Infected Necrotizing Pancreatitis: https://bit.ly/3wxRLQN

PYTHON Clinical Trial - Early Versus On-demand Nasoenteric Tube Feeding in Acute Pancreatitis: https://bit.ly/3km1STK

APEC Clinical Trial - Urgent Versus Conservative ERCP for Acute Pancreatitis: https://bit.ly/3qlVK1I

Books Mentioned in this Episode:

The House of God by Samuel Shem: https://amzn.to/3wy8Lq2

In this episode of Critical Matters, we will discuss two important clinical questions regarding intravenous fluids. First: Does the composition of intravenous fluids impact patient outcomes? Second: Does the mode of administration (rapid bolus vs. slower infusion) matter?

Our guest is Michael J. Connor, Jr., MD, a practicing intensivist and nephrologist. He is an Associate Professor & Senior Physician of Critical Care Medicine & Nephrology at the Division of Pulmonary, Allergy, Critical Care, & Sleep Medicine, Emory University School of Medicine. In addition, Dr. Connor is the Director for Critical Care Nephrology at the Emory Critical Care Center at Grady Memorial Hospital.

Additional Resources:

Does Crystalloid Composition or Rate of Fluid Administration Make a Difference When Resuscitating Patients in the ICU?: https://bit.ly/DDtMOT

BaSICS Trial – Balanced Solutions vs. 0.9 % Saline: https://bit.ly/3pH7Q51

BaSICS Trial – Slower vs, Faster Intravenous Fluid Bolus Rates: https://bit.ly/2ZvYSgy

The SPLIT Randomized Clinical Trial: https://bit.ly/3El5op1

The SMART Clinical Trial: https://bit.ly/DGMDQb

Books Mentioned in this Episode:

Quiet: The Power of Introverts in a World that Can’t Stop Talking by Susan Cain: https://amzn.to/AZza5g

Talk Like TED: The 9 Public-Speaking Secrets of the World’s Top Minds by Carmine Gallo: https://amzn.to/3pG0e2V

In this episode of Critical Matters, we will discuss Ivermectin as a potential treatment for COVID-19. During the COVID-19 Delta surge, we have seen a sharp increase in the noise surrounding the use of Ivermectin. A record number of prescriptions have been filled during the last months and numerous news stories report families suing hospitals refusing to provide Ivermectin to patients. We will discuss the available evidence and the role of misinformation in this phenomenon.

Additional Resources:

The FDA approved drug Ivermectin inhibits replications of SARS-CoV2 in vitro: https://bit.ly/3ayUhvE

Ivermectin to prevent hospitalizations in patients with COVID-19 (IVER-COVID 19): https://bit.ly/3DCOwJZ

Effect of Ivermectin on Time to Resolution of Symptoms among Adults with Mild COVID-19: https://bit.ly/3v8QaQw

Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines: https://bit.ly/3lB7rPh

Ivermectin for the Treatment of Coronavirus Disease 2019: A Systematic Review and Meta-analysis: https://bit.ly/3mU9s8w

Ivermectin for preventing and treating COVID-19: Review: https://bit.ly/30dDzQD

Books Mentioned in this Episode:

Think Again: The Power of Knowing What You Don’t Know by Adam Grant: https://amzn.to/3j1CrGy

In this episode of Critical Matters, we will discuss the results of the recently published TTM2 clinical trial and the current state of evidence for Targeted Temperature Management in the post cardiac arrest patient.

Our guest is Dr. Niklas Nielsen. Dr. Nielsen is an associate professor at the Department of Clinical Sciences at Helsingborg, Lund University, and consultant in Anesthesiology and Intensive Care at Helsingborg Hospital. He was the principal investigator for the TTM1 and TTM 2 clinical trials.

Additional Resources:

The International Cardiac Arrest Registry (INTCAR): https://bit.ly/2Xbe0yt

Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest: https://bit.ly/3nad5Jo

Targeted Temperature Management at 33C versus 36C after Cardiac Arrest: https://bit.ly/38THRO9

Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm: https://bit.ly/2X19aUj

2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: https://bit.ly/3z0k7T3

Books Mentioned in this Episode:

Oxygen: The Molecule that Made the World by Nick Lane: https://amzn.to/2WYMmVz

Anna Karenina by Leo Tolstoy: https://amzn.to/3yVao0v

In this episode of Critical Matters, we will explore the Choosing Wisely for Critical Care. These are evidenced-based best practices to avoid waste and promote value in the practice of critical care medicine.

We are fortunate to have with us today three of the authors of the recently published guidelines for critical care medicine – Choosing Wisely for Critical Care: The Next Five. Our guests are Jerry Zimmerman, Pamela Smithburger, and Anita Reddy. Jerry Zimmerman is a physician from the Department of Pediatrics, Seattle Children’s Hospital, Harborview Medical Center, University of Washington School of Medicine, in Seattle. Pamela Smithburger is a doctor in clinical pharmacy from the University Of Pittsburgh School Of Pharmacy, in Pittsburgh. Anita Reddy is a physician from the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Cleveland Clinic, in Cleveland.

Additional Resources:

Choosing Wisely For Critical Care: The NEXT Five. Critical Care Medicine 2021: https://bit.ly/3hQFkbx

Medicine’s Ethical Responsibility for Health Care Reform- The Top Five List: https://bit.ly/36nDhGI

The Choosing Wisely Website – ABIM: https://bit.ly/3hLdsWt

Society of Critical Care Medicine – Choosing Wisely Website: https://bit.ly/3yG4TTN

Society of Critical Care Medicine – Knowledge and Education Group (KEG): https://bit.ly/36tKvJb

Books Mentioned in this Episode:

Pediatric Critical Care Medicine 6th Edition by Jerry Zimmerman Alexandre T. Rotta: https://amzn.to/3ADJk82

One Hundred Years of Solitude by Gabriel Garcia Marquez: https://amzn.to/3ARKJYS

Love in the Times of Cholera by Gabriel Garcia Marquez: https://amzn.to/3jXWsyL

In this episode of Critical Matters, we will discuss the management of the difficult airway.

Our guest is Dr. Thomas Heidegger. Dr. Heidegger practices anesthesia and intensive care medicine. He is a Professor in the Department of Anesthesia, Spital Grabs, in Grabs and the Department of Anesthesiology, and Pain Medicine, Bern University Hospital, University of Bern, in Bern – both in Switzerland.

Additional Resources:

Management of the Difficult Airway: https://bit.ly/2T0mXsj

Major Complications of Airway Management - Fourth National Audit Project (NAP4): https://bit.ly/2UwJZHT

Understanding Sensitivity and Specificity with the Right Side of the Brain: https://bit.ly/3gOqF1h

Canadian Airway Focus Group Updates Consensus-Based Recommendations for Management of Difficult Airways: https://bit.ly/3h0tkUt

Video - Face Mask Ventilation - Two-Handed Technique: https://bit.ly/3w0RNPj

Video - Emergent Surgical Airway (Cricothyrotomy): https://bit.ly/3zPsAKx

Books Mentioned in this Episode:

West Pulmonary Physiology: The Essentials: by John B. West and Andrew M. Luks; https://amzn.to/3gOdfm8

Thinking Fast and Slow by Daniel Kahneman: https://amzn.to/3d4bnTN

Noise: A Flaw in Human Judgment by Daniel Kahneman: https://amzn.to/35KpdXJ