Long after acute infection has resolved, many survivors of severe COVID-19 experience persistent symptoms. Understanding the causes of long COVID and developing effective treatments pose a challenge for clinicians and researchers alike. In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Kyle B. Enfield, MD, speaks with Matthew Baldwin, MD, MS, about his article published in the March 2026 issue of Critical Care Explorations that examines post-acute sequelae of COVID-19 in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) survivors over a three-year period.

One of the study’s most notable findings is that approximately one in four study patients, many of whom were middle-aged and previously healthy, continued to meet criteria for long COVID three years after infection. This finding emphasizes the burden of chronic illness caused by COVID-19 infection and the need to focus research and treatment efforts on this population of ALI/ARDS survivors.

Drs. Baldwin and Enfield discuss the relevance of inflammatory, thromboinflammatory, and endothelial biomarkers in understanding illness due to COVID-19. Surprisingly, the study found no association between long COVID symptoms and these biomarkers. Dr. Baldwin contextualizes this finding and encourages future studies to employ multiomics to better uncover the underlying mechanisms of these symptoms.

The discussion emphasizes the patient-centered approach of the study, which examines functional outcomes as well as biomarkers. Dr. Baldwin encourages clinicians to validate the experiences of severe COVID-19 survivors and guide them towards the next step in their recovery as researchers continue to look for better therapies.

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Propofol remains a cornerstone sedative for mechanically ventilated critically ill patients and is supported by PADIS guidelines and favored for its rapid onset, titratability, and limited side effects. However, its use in hemodynamically unstable patients remains a persistent clinical dilemma. In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Kyle Enfield, MD, is joined by Scott Benken, PharmD, MHPE, BCCCP, and Nathan Smischney, MD, MS, to explore the risks, benefits, and evolving evidence surrounding propofol use in this high-risk population.  

The discussion examines the physiologic basis of propofol-associated hypotension and how that can manifest in different patients, such as those with sepsis and septic shock. Patient selection and real-time assessment of hemodynamic trends are essential. Additional considerations include the recognition of and monitoring for propofol infusion syndrome, a rare but life-threatening complication.  

The episode also explores alternative drugs such as dexmedetomidine and ketamine, highlighting the benefits and risks of each. Emerging strategies are discussed, including a ketamine-propofol combination called ketafol and its utility in balancing sedation and hemodynamic stability. 

Listeners will gain expert insights into propofol use in the ICU and a deeper understanding of patient-centered approaches to sedation. 

Resources referenced in this episode:  

Sustaining critical care delivery in today’s healthcare environment requires more than resilience—it also calls for collective solutions to systemic challenges.

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, Past President Jose L. Pascual, MD, PhD, FRCS(C), FACS, FCCM, elaborates on the session presented during the 2026 Critical Care Congress, Critical Care Under Pressure: Sustaining the Workforce and Infrastructure Amid Rising Demands.

Joined by host Marilyn Bulloch, PharmD, BCPS, FCCM, Dr. Pascual examines the complex forces reshaping critical care, from shrinking ICU capacity and hospital closures to persistent workforce shortages and shifting training pipelines. He highlights concerning trends such as reduced entry into certain critical care pathways, particularly anesthesiology. At the same time, he points to encouraging growth in other pathways, with increasing participation from clinicians in emergency medicine, neurology, and surgery.

The conversation underscores disparities in access to care, particularly for rural and community hospitals. Dr. Pascual explores the tension between the regionalization of specialized care and the need to maintain equitable access across health systems, emphasizing the importance of thoughtful resource distribution and collaboration across institutions. Beyond workforce numbers, the evolution of leadership in critical care is also impactful, including the migration of experienced clinicians into administrative roles and the potential need for cyclical leadership models that maintain clinical engagement.

Meeting these challenges requires innovation and cooperation. Dr. Pascual highlights advancements in education, particularly the expansion of simulation-based training, as critical tools for maintaining competency and improving team performance.

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Sepsis is a global health emergency, with nearly half of all septic patients being children.

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, Samantha Gambles Farr, MSN, NP-C, CCRN, RNFA, speaks with Niranjan Kissoon, MD, MBBS, FRCP(C), FACPE, MCCM, about his Thought Leader presentation at the 2026 Critical Care Congress, Making Sepsis the Next Success Story in Global Health. The panel also discusses how access and equity play a part in how sepsis is treated.

From a global perspective, Dr. Kissoon emphasizes that the most important thing is advocacy and prevention from a governmental level by creating national action plans, making sure the healthcare system is resilient, and utilizing technology and innovation to create better ways of providing care; and from a societal level by educating patients and families about nutrition, hygiene, vaccinations, and seeking care early.

Niranjan Kissoon, MD, MBBS, FRCP(C), FACPE, MCCM, is a professor in the Department of Pediatrics (Pediatrics and Surgery, Emergency Medicine) at the University of British Columbia in Vancouver, British Columbia, Canada. He is the past president of the World Federation of Pediatric Critical and Intensive Care Societies and currently serves as president of the Global Sepsis Alliance. He is cochair of the pediatric Surviving Sepsis Campaign, vice president of the Canadian Sepsis Foundation, and chair of World Sepsis Day and the International Pediatric Sepsis Initiative. He also serves on the Sepsis Alliance USA and the African Sepsis Alliance advisory boards and is also a founding member of the Caribbean Sepsis Alliance.

What is precision medicine, and how should precision medicine be handled in the face of guidelines and protocols?

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, speaks with Michael R. Pinsky, MD, FAPS, MCCM, about his Thought Leader presentation at the 2026 Critical Care Congress, The Effective Management of Shock: Moving From Physiology to Guidelines to Precision Medicine and Ultimately Personalized Medicine. The panel also discusses how to titrate care for individual patients.

Protocols and guidelines are the foundation for patient care and are instrumental for having all healthcare professionals on the same baseline when treating patients. Precision medicine involves individualizing care for a specific patient, and Dr. Pinsky emphasizes that guidelines should never supersede an understanding of pathophysiology at the bedside, including observing your patient and paying attention to how individual patients respond to specific treatments. Monitoring the individualized response is required for the best care.

Michael R. Pinsky, MD, FAPS, MCCM, is a professor of critical care medicine, bioengineering, and anesthesiology at the University of Pittsburgh in Pittsburgh, Pennsylvania, USA. He is also Docteur Honoris Casusa at the Université René Descartes Paris V School of Medicine in Paris, France. In 2012, he became one of the first 20 critical care physicians to receive a Master of Critical Care Medicine (MCCM) from SCCM. He is currently an emeritus (honorary) at UPMC. At the University of Pittsburgh, he is vice-chair emeritus for the Department of Critical Care Medicine and a faculty member at the Center for Critical Care Nephrology and the Center for Military Medicine Research.

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In this episode of the Society of Critical Care Medicine (SCCM) Podcast, Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FNCS, FCCM, is joined by Aarti Sarwal, MD, FAAN, FNCS, RPNI, FCCM, and Brian L. Erstad, PharmD, FCCP, FASHP, MCCM, to discuss the 2026 guidelines for neuromuscular blockade in adult patients with acute respiratory distress syndrome.

The guidelines, “Society of Critical Care Medicine Guidelines for the Administration of Neuromuscular Blockade in Adults With Acute Respiratory Distress Syndrome,” were published in the March issue of Critical Care Medicine.

Drs. Sarwal and Erstad discuss how the evidence in two key trials, ACURASYS and PETAL-ROSE, has helped shape the recommendations provided in the SCCM guidelines. Despite how influential these trials were in shaping the recommendations, only conditional recommendations were made due to low or very low quality of evidence. The lack of evidence proved to be a driving factor in including a call to action in the guidelines. Future research priorities largely revolve around precision medicine and finding more patient-specific interventions to improve patient outcomes.

Aarti Sarwal, MD, FAAN, FNCS, RPNI, FCCM, is a professor of neurology and the division chair of neurocritical care at Virginia Commonwealth University (VCU) School of Medicine in Richmond, Virginia, USA. She is also an associate editor of Critical Care Medicine, secretary of the American Society of Neuroimaging, and director of VCU-Wake Forest neuro-ultrasound courses. Brian L. Erstad, PharmD, FCCP, FASHP, MCCM, is a tenured professor and interim dean at the University of Arizona R. Ken Coit College of Pharmacy in Tucson, Arizona, USA. He is also a center investigator for the Center for Health Outcomes, a member of the BIO5 Institute and Comprehensive Center for Pain & Addiction and Pharmacoeconomics Research Center, and a codirector for the Arizona Clinical and Translational Research Graduate Certificate Program.

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Older adults consist of approximately half of the patients in the ICU, with that number expected to grow in the coming decades.

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn N. Bulloch, PharmD, BCPS, FCCM, is joined by Bram Rochwerg, MD, MSc(Epi), FRCPC, FCCM, and Lauren E. Ferrante, MD, MHS, to discusses new guidelines on caring for older adults in the ICU and the difficulties in finding research that focuses on those patients.

The guidelines, “Society of Critical Care Medicine Guidelines on Caring for Older Adults in the ICU,” will be published in an upcoming issue of Critical Care Medicine.

The panel details the process and methodology behind the guidelines, the dearth of studies focusing on older patients in the ICU, and the difficulty of finding studies that enroll older adults who are on multiple medications. The guidelines offer two conditional recommendations and offer priorities for aging-friendly research topics to help provide stronger guidance in the future.

Bram Rochwerg, MD, MSc(Epi), FRCPC, FCCM, is an associate professor, intensivist, and researcher based at McMaster University in Hamilton, Ontario, Canada, who focuses on intravenous fluid use in sepsis, the role of corticosteroids in acute hypoxemic respiratory failure, and clinical practice guideline methodology. Lauren E. Ferrante, MD, MHS, is an associate professor of medicine in the section of pulmonary, critical care, and sleep medicine at the Yale School of Medicine; director of the operations core of the Yale Claude D. Pepper Older Americans Independence Center; and an attending physician in the medical intensive care unit at Yale-New Haven Hospital in New Haven, Connecticut, USA.

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What has changed in the updated 2026 Surviving Sepsis Campaign (SSC) guidelines for children?

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Elizabeth H. Mack, MD, MS, FCCM, speaks with pediatric SSC guideline cochairs Scott L. Weiss, MD, MSCE, FCCM, and Pierre Tissieres, MD, DSc, about the latest guideline recommendations for the care of children with sepsis and septic shock. The updated guidelines emphasize the early identification of sepsis, an evolution to a more targeted way of treatment, and a more practical approach to guideline implementation. Other aspects of the previous guidelines, such as lactate measurements, continuous reassessment, and the role of point-of-care monitoring, were reinforced in the 2026 guidelines.

The guidelines, “Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026,” were released in the April issue of Pediatric Critical Care Medicine.

Key updates and new areas of emphasis include:  

Scott L. Weiss, MD, MSCE, FCCM, is division chief of critical care and vice-chair of research at Nemours Children’s Hospital (DuPont)-Delaware and professor of pediatrics and pathology and genomic medicine at the Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA. Pierre Tissieres, MD, DSc, is a professor of pediatrics and head of Pediatric ICU and Neonatal Medicine at Paris South University Hospitals in Paris, France.

This podcast is sponsored by Vantive. 

At Vantive, our mission to extend lives and expand possibilities starts with a commitment to continuous learning. We are committed to partnering with the medical community to support vital organ therapy innovation grounded in clinical evidence and focused on improving patient outcomes. The recent publication on endotoxic septic shock centers on an evidence-based approach to address clinical challenges in critical care and beyond as highlighted in our press release.

Resources referenced in this podcast: 

What has changed in the new 2026 Surviving Sepsis Campaign (SSC) guidelines for adults?

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, Kyle B. Enfield, MD, is joined by guideline cochairs Massimo Antonelli, MD, and Hallie C. Prescott, MD, MSc, FCCM, for a practical discussion on the biggest updates in the care of adults with sepsis and septic shock, from appropriate care during transport to the hospital to balancing timely antibiotics with antimicrobial stewardship. The panel also discusses hemodynamic resuscitation, vasopressor selection, global implementation, and the growing recognition that sepsis care does not end at hospital discharge.

The guidelines, “Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026,” were released in the April issue of Critical Care Medicine.

The episode highlights:  

Dr. Antonelli is a professor of anesthesiology and intensive care medicine at Università Cattolica del Sacro Cuore in Rome, Italy, and director of the general intensive care unit at Policlinico A. Gemelli University Hospital. Dr. Prescott is a professor of pulmonary and critical care medicine at the University of Michigan, Ann Arbor, Michigan, USA, and a staff physician at the Ann Arbor Veterans Affairs Healthcare System.

This podcast is sponsored by Vantive.

At Vantive, our mission to extend lives and expand possibilities starts with the commitment to continuous learning. We are committed to partnering with the medical community to support vital organ therapy innovation grounded in clinical evidence and focused on improving patient outcomes. The recent publication on endotoxic septic shock centers on an evidence-based approach to address clinical challenges in critical care and beyond as highlighted in our press release.

Resources referenced in this podcast: 

There is enormous heterogeneity in clinical outcomes and severity of septic shock, with some patients needing only supportive care in the ICU and others progressing to multiorgan system failure and death. How can clinicians identify patients at higher risk of death?

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn Bulloch, PharmD, BCPS, FCCM, is joined by John A. Kellum, MD, FCCM, to discuss high endotoxin activity as a possible endotype for septic shock. Dr. Kellum’s article, “Organ Failure, Endotoxin Activity, and Mortality in Septic Shock,” was published in the September 2025 compendium of Critical Care Explorations. Dr. Kellum is a professor and director of the Center for Critical Care Nephrology, as well as vice chair for the Department of Critical Care Medicine, at the University of Pittsburgh in Pittsburgh, Pennsylvania, USA.

The study used a novel biomarker called the endotoxin activity assay (EAA) to detect endotoxin in the blood. While the EAA is not good at identifying patients who are at risk for sepsis, Dr. Kellum said that, when combined with organ failure, it identifies patients at high risk for endotoxic septic shock. In the study, these patients had a mortality rate of 60%.

Neither the EAA nor the anti-endotoxin therapy is readily available. And, although endotoxic septic shock is rare, occurring in only a quarter of patients with septic shock, Dr. Kellum hopes that, through precision medicine, segmenting this population into treatable subgroups may allow better diagnostics and opportunities to develop or repurpose therapies in the future. This episode is sponsored by Prenosis.

Resources referenced in this episode: