In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Elizabeth H. Mack, MD, MS, FCCM, speaks with Anil Sachdev, MD, FICCM, of the Institute of Child Health, Sir Ganga Ram Hospital in New Delhi, India about his team’s study, “Transpulmonary Pressure-Guided Mechanical Ventilation in Severe Acute Respiratory Distress Syndrome in the PICU: Single-Center Retrospective Study in North India, 2018–2021,” published in the March 2025 issue of Pediatric Critical Care Medicine.

Dr. Sachdev explains the development and implementation at his institution of a protocol for transpulmonary pressure (TPP) monitoring in pediatric patients with severe acute respiratory distress syndrome. His team compared outcomes of patients receiving TPP-guided ventilation with those receiving conventional mechanical ventilation. Study findings suggested that TPP monitoring enabled the use of higher positive end-expiratory pressure with greater clinician confidence, resulting in improved oxygenation.

Study limitations included small sample size and challenges of equipment availability, cost, and obtaining parental consent. The study was conducted in part during the COVID-19 pandemic, which further constrained resources and study participation.

The discussion concludes with Dr. Sachdev’s insights into practical challenges of TPP monitoring, including inserting delicate esophageal catheters in infants and young children and the necessity of correct catheter position for accurate readings.

Resources referenced in this episode:

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Kyle B. Enfield, MD, FCCM, speaks with Garrett McDougall, MS, MSc, and Ben Forestell, MD, of McMaster University about their recent study, “Direct Laryngoscopy Versus Video Laryngoscopy for Intubation in Critically Ill Patients: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Trials,” published in the November 2024 issue of Critical Care Medicine. The study included 20 randomized controlled trials encompassing 4569 patients to investigate whether video laryngoscopy (VL) offers advantages over direct laryngoscopy (DL) for intubation in critically ill patients. 

A key finding of the study was that VL probably improves first-pass success rates and reduces the risk of esophageal intubation and dental injury. These benefits extend across the spectrum of operator experience, especially among novice operators but also among seasoned operators.  

Drs. McDougall and Forestell discuss findings that surprised them, such as seeing equal benefit for standard VL and hyperangulated VL devices. Additionally, no clear benefits were found for patients who were intubated emergently with VL as compared to those who underwent elective intubation.

The discussion covers what could be next for resuscitation and airway research in critically ill patients. There may be more to learn about scenarios involving difficult airways, soiled airways, and emergent versus elective intubation. More research on device characteristics could also provide important insights.

To wrap up, the guests underscore the importance of maintaining both VL and DL proficiency since DL can be a more appropriate choice for some patients.

Resources referenced in this episode:

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn N. Bulloch, PharmD, BCPS, FCCM, speaks with Christy C. Forehand, PharmD, BCCCP, FCCM, about retaining highly skilled pharmacists in the ICU setting. Dr. Forehand, a clinical pharmacy specialist and residency program director at Augusta University Medical Center and the University of Georgia College of Pharmacy, shares evidence-based insights and personal reflections on how pharmacist retention directly impacts quality and safety in patient care.

The conversation highlights growing concerns around burnout and attrition among ICU pharmacists, underscoring how their involvement improves clinical and economic outcomes—ranging from medication safety and reduced ventilator days to optimized transitions of care.

Drawing on American College of Clinical Pharmacy (ACCP) publications and American Society of Health-System Pharmacists (ASHP) guidance, Dr. Forehand outlines strategies for building retention plans that prioritize recognition, advancement opportunities, career mentorship, and structural supports such as protected administrative time. She emphasizes how institutional practices such as improved scheduling, remote work models, and role-specific stipends can prevent burnout while reinforcing team trust and efficiency.

Resources referenced in this episode:

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Kyle B. Enfield, MD, FCCM, speaks with Brian T. Wessman, MD, FACEP, FCCM, and Fajun Wang, MD, about maximizing professional growth through active engagement with SCCM.

Drawing on their personal experiences, the guests reflect on how early involvement through residency, fellowship, and the Fundamental Critical Care Support (FCCS) course ignited long-term involvement in the Society.

Drs. Wessman and Wang outline actionable strategies for new and seasoned members alike. They emphasize the value of committee and section participation, trainee liaison roles, and the mentorship programs, particularly the initiative tailored for international medical graduates. The conversation sheds light on the application process and professional significance of becoming a Fellow of the American College of Critical Care Medicine (FCCM).

Whether you're navigating your first SCCM Congress or considering applying for FCCM designation, this episode is a comprehensive guide to supersizing your SCCM membership—turning involvement into influence and professional growth into sustained impact.

Resources referenced in this episode:

Mark E. Hamill, MD, FCCM, a trauma surgeon, intensivist, and past chair of the Society of Critical Care Medicine’s (SCCM) Fundamental Critical Care Support (FCCS) Committee, discusses the evolution, impact, and future of training of critical care.

In this SCCM podcast, Dr. Hamill reflects on his decade-long journey with FCCS, beginning with local implementation at his former institution to eventually leading national and international Fundamentals efforts. He shares powerful stories from training initiatives in Rwanda, Palestine, and war-time Ukraine—highlighting the program’s global reach and ability to empower frontline clinicians.

Central to the discussion is Dr. Hamill’s published study, “Impact of Standardized Multidisciplinary Critical Care Training on Confidence with Critical Illness and Attitudes Towards Interprofessional Education and Multidisciplinary Care” (Hamill ME, et al. J Intensive Care Med. 2024;39:320-327). The study analyzed survey data from 328 multidisciplinary learners and demonstrated significant increases in participants’ self-assessed confidence across key critical care domains—including sepsis, respiratory failure, shock, and neurologic illness—after completing FCCS. The findings support what many instructors have long observed anecdotally: FCCS builds competence, fosters interprofessional collaboration, and enhances learners’ readiness to respond to critically ill patients.

Dr. Hamill also explains the study’s methodology, including retrospective precourse analysis and a three-month follow-up, and shares insights about future research plans involving simulation-based evaluation to assess knowledge retention and behavior change.

Whether you are considering hosting a Fundamentals course, becoming an instructor, or expanding your training programs, this podcast episode offers compelling evidence of FCCS’s lasting value in skills acquisition and elevating the culture of care.

Aarti Sarwal, MD, FAAN, FNCS, FCCM, professor of neurology at Virginia Commonwealth University Health System, explores the nuanced intersection of neurology and critical care, offering practical insights for clinicians across disciplines.

Dr. Sarwal shares her perspective on the unique challenges of managing neurocritically ill patients, particularly when impairment presents challenges in administering a neurologic examination. She emphasizes that “the brain is the barometer of critical illness,” urging clinicians to prioritize daily neurologic evaluations and integrate neuromonitoring even in non-neurologic ICU populations. Listeners will gain an overview of tools such as continuous EEG, transcranial Doppler, emboli monitoring, and multimodal neuromonitoring platforms, including the role of neuro-ultrasound in expanding point-of-care capabilities.

This episode also highlights the need for multidisciplinary collaboration and a shared decision-making model that extends across the continuum of care—from early ICU admission to post-discharge recovery.

Listeners will appreciate Dr. Sarwal’s reflections on neuroprognostication and the ethical dimensions of care withdrawal, particularly the danger of therapeutic nihilism in patients whose outcomes are uncertain. Referencing a 2023 review she coauthored (Crit Care Med. 2023;51:525-542), Dr. Sarwal outlines a practical framework for neuromonitoring that integrates structural, electrical, vascular, and metabolic insights.

This conversation provides a timely and inclusive look at the future of neurocritical care—where technology, teamwork, and training converge to support better patient outcomes.

In this forward-looking episode of the SCCM Podcast, Daniel F. McAuley, MD, explores how the clinical and research communities are rethinking acute respiratory distress syndrome (ARDS), shifting from a one-size-fits-all model to a focus on identifying and targeting modifiable traits. Building on his Thought Leader Session at the 2024 Critical Care Congress, Dr. McAuley unpacks the major thematic shift toward precision medicine in critical care.

Instead of treating ARDS as a single, homogenous condition, researchers are increasingly identifying biologically distinct subgroups—especially hyper- and hypoinflammatory phenotypes—that may respond differently to therapies. These insights are fueling a new generation of trials that aim to prospectively apply this knowledge to treatment strategies.

Central to this evolution is the Precision medicine Adaptive platform Network Trial in Hypoaemic acutE respiratory failure (PANTHER), of which Dr. McAuley is a team member. PANTHER is a Bayesian adaptive platform randomized clinical trial studying novel interventions to improve outcomes for patients with acute hypoxemic respiratory failure. Designed to be adaptive and biomarker informed, PANTHER will test therapies such as simvastatin and baricitinib, based on real-time phenotyping of patients with ARDS.

Throughout the episode, Dr. McAuley reflects on how advances in machine learning and biomarker identification are making precision treatment more feasible. He discusses the importance of maintaining evidence-based supportive care, such as lung-protective ventilation and prone positioning, while integrating new targeted therapies. Discover the latest investigations into potential therapeutic agents—including mesenchymal stromal cells, statins, and extracorporeal carbon dioxide removal—as Dr. McAuley aims to translate early findings into tangible improvements in patient outcomes.

This episode offers critical insights into the changing landscape of ARDS research and patient care, as Dr. McAuley articulates a hopeful vision for the future—one in which targeted, individualized treatments can improve outcomes for patients with one of critical care’s most challenging conditions.

Dr. McAuley is a consultant and professor in intensive care medicine in the regional intensive care unit at the Royal Victoria Hospital and Queen’s University of Belfast. He is program director for the  Medical Research Council/National Institute for Health and Care Research (MRC/NIHR) Efficacy and Mechanism Evaluation Program and scientific director for programs in NIHR.

The ICU Liberation Campaign from the Society of Critical Care Medicine (SCCM) has transformed critical care, but the COVID-19 pandemic and subsequent staffing challenges have posed major obstacles to maintaining progress. In this episode of the SCCM Podcast, host Ludwig H. Lin, MD, speaks with Juliana Barr, MD, FCCM, a key architect of the ICU Liberation Campaign. Dr. Barr was a lead author of the 2013 “Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit,” known as the PAD guidelines, an original cornerstone of the ICU Liberation Campaign (Barr J, et al. Crit Care Med. 2013;41:263-306). The guidelines’ recent 2025 update also addressed immobility and sleep disruption (Lewis K, et al. Crit Care Med. 2025;53:e711-e727).

Dr. Barr shares her personal journey from traditional ICU practices of heavy sedation and immobility to leading efforts that prioritize patient recovery, well-being, and post-ICU quality of life. She emphasizes how ICU Liberation reintroduced low-tech, high-impact interventions such as minimizing sedation, promoting early mobility, and engaging families—leading to better outcomes at lower costs. She cites the 2017 international survey by Morandi et al that demonstrated uneven but steady improvements in global ICU Liberation practices before the pandemic (Morandi A, et al. Crit Care Med. 2017;45:e1111-e1122).

Dr. Barr details the need for reeducation, multidisciplinary team engagement, and reworking electronic health record (EHR) systems to better support ICU Liberation goals.

Looking forward, Dr. Barr offers a "burning platform" approach, stressing that delaying ICU Liberation practices risks poorer patient outcomes. She advocates for cultural change, leadership engagement, real-time metrics visibility, and hospital-wide investment—including IT support to surface buried ICU Liberation Bundle data within EHRs.

By reframing ICU Liberation as a "team sport" and making best practices part of daily ICU culture, Dr. Barr believes institutions can reestablish the bundle’s momentum and reconnect healthcare teams to their core mission—helping patients return to meaningful lives after critical illness.

This conversation offers energizing, practical strategies for ICU teams at every stage of ICU Liberation implementation or reinvigoration.

Traditional career development frameworks often overlook the importance of well-being. This podcast episode emphasizes why wellness is essential to building a sustainable and fulfilling career. Host Kyle Enfield, MD, FCCM, is joined by Jennifer Duncan, MD, and Raquel Cabral, PhD, CPH, to explore how team members and leaders can integrate personal values, connection, and purpose into career decision-making.

Dr. Duncan, director of wellness for graduate medical education (GME), and Dr. Cabral, a staff psychologist for GME, both at Washington University School of Medicine, share insights from their work supporting trainees’ personal and professional growth. Together, they explore the nuanced meaning of well-being—not as constant happiness, but as a sense of satisfaction and alignment with a person’s values, even amid challenges.

The conversation highlights the importance of helping team members identify and live by their personal values as a foundation for career satisfaction. Dr. Cabral distinguishes between goals and values, underscoring that, while goals can be achieved or not, values guide how a person shows up in all aspects of life. She outlines how residents and other early-career professionals can uncover values by reflecting on meaningful or difficult work experiences. These reflections can then guide decisions about clinical rotations, job searches, and leadership opportunities.

Dr. Duncan emphasizes how small but intentional adjustments—such as carving out just 20% of one’s time for personally meaningful work—can protect against burnout. Both guests discuss the critical role leaders play in supporting well-being, from understanding each team members’ values to fostering a strong sense of community.

They refer to The Burnout Challenge (Maslach C, Leiter MP. Harvard University Press. 2024), which outlines six workplace drivers of burnout, including mismatches in values.

Finally, the episode highlights the work of the Mayo Clinic’s Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) Groups. The COMPASS randomized clinical trial (West CP, et al. Mayo Clin Proc. 2021;96:2606-2614) evaluated a small group established to promote well-being. The group was provided discussion topics without trained facilitators. Protected time was not provided but meal expenses were compensated. This model showed positive outcomes in reducing burnout and strengthening collegial connections.

This episode is part of SCCM’s Leadership, Empowerment, and Development (LEAD) series and offers actionable insights for anyone invested in building healthier, value-aligned medical careers.

Host Maureen A. Madden, DNP, RN, CPNC-AC, CCRN, FCCM, welcomes Kitman Wai, MD, and Sonali Basu, MD, to discuss the article, “Evolution of Pediatric Critical Care Medicine Physicians Clinical and Academic Profile by Gender,” published in the October 2024 issue of Pediatric Critical Care Medicine (Wai K, et al. Pediatr Crit Care Med. 2024;25:e376-e386). This is the first analysis of career and academic characteristics of practicing pediatric critical care medicine physicians. The authors also studied the association of gender and career trajectory. They will discuss the gender gap between male and female pediatric critical care physicians in academic metrics and rank, career trajectory factors such as burnout and academic versus nonacademic careers, and the study limitations.

Dr. Wai is a critical care specialist and director of critical care medicine fellowship at Children’s National Hospital in Washington, DC. Dr. Basu is a critical care specialist, associate chief of critical care medicine, and associate director of critical care fellowship at Children’s National Hospital in Washington, DC.

Find more expert-developed articles from Pediatric Critical Care Medicine at pccmjournal.org.