SCCM Podcast

What form of renal replacement therapy should clinicians use for patients in the intensive care unit (ICU)? New research has connected the renal replacement therapy choice with mortality end points and renal replacement therapy dependency in patients with acute kidney injury. In this podcast episode, experts discuss their research in this area. Ron Wald, MDCM, MHP, professor of medicine at the University of Toronto, discusses his article, “Initiation of Continuous Renal Replacement Therapy Versus Intermittent Hemodialysis in Critically Ill Patients With Severe Acute Kidney Injury: A Secondary Analysis of STARRT-AKI Trial,” published in the November 2023 issue of Intensive Care Medicine. Jay Koyner, MD, professor of medicine and director of the nephrology intensive care unit at the University of Chicago, discuss his article, “Initial Renal Replacement Therapy (RRT) Modality Associates With 90-Day Postdischarge RRT Dependence in Critically Ill AKI Survivors,” published in the August 2024 issue of Journal of Critical Care. This podcast is sponsored by Vantive U.S. Healthcare. Vantive supports true patient-focused treatments with industry-leading CRRT technology and is a partner dedicated to optimizing your clinical success in treating patients with acute kidney injury. Our commitment to you starts with education and provides complete support every step of the way. Visit us at vantive.com.

In this enlightening discussion, Dr. Matthew Kirschen, an associate professor in critical care at Children's Hospital of Philadelphia, shares insights on the updated brain death guidelines. He explains the collaborative efforts that led to a unified protocol for both adults and children. Key topics include the challenges of assessing brain death in complex cases, such as those involving posterior fossa injuries, and the legal and ethical considerations surrounding the determination process. Dr. Kirschen emphasizes the importance of standardized evaluations to enhance accuracy and patient care.

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.

Host Ludwig Lin, MD, welcomes Dr. Raghavan Murugan, a renowned professor of critical care medicine and a leader in critical care nephrology. They delve into innovative fluid management strategies in continuous renal replacement therapy (CRRT). Dr. Murugan discusses the critical importance of updated CRRT practices for improved clinical outcomes. He emphasizes the advantages of CRRT over traditional methods and highlights the need for personalized fluid management approaches tailored to individual patient needs in the ICU.

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.

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.

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.

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.

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.

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.