Critical Matters

In this episode, we discuss compassion in the ICU with Dr. Stephen Trzeciak. Dr. Trzeciak is Chief of Medicine at Cooper University Health Care, and Professor and Chair of Medicine at Cooper Medical School of Rowan University in Camden, New Jersey. He is the co-author of a recently published book “Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference. In addition, Dr. Trzeciak and his research group have published several original research papers focusing on compassion in healthcare. Additional Resources: Healthcare provider compassion is associated with lower PTSD symptoms among patients with life-threatening medical emergencies: a prospective cohort study: http://bit.ly/2Wio1re Development and Validation of a Tool to Measure Patient Assessment of Clinical Compassion: http://bit.ly/2JR1ifr For patients, caregiver compassion is essential. The Washington Post: https://wapo.st/30yYtW1 Books and Albums Mentioned in This Episode: Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference by S. Trzeciak and A. Mazzarelli: https://amzn.to/2JQXv1y The Joshua Tree by U2: https://amzn.to/2JvU4hu The Koln Concert by Keith Jarrett: https://amzn.to/2VVBYMn

In this episode, we discuss Toxicology in the ICU. This is part two of a two-part series. Today’s episode will focus on specific toxic ingestions and their management. Our guest is Dr. Jerrold B. Leikin. Dr. Leikin is the Director of Medical Toxicology at North Shore University Health System-OMEGA, which includes several hospitals in Illinois. In addition, he is a Clinical Professor of Medicine at the Pritzker School of Medicine (University of Chicago) and Professor of Medicine and Pharmacology at Rush Medical College. Additional Links: American Association of Poison Control Centers Website: https://aapcc.org/ A three-part review series published in CHEST on Toxicology in the ICU. Part 1: https://bit.ly/2OhO2k5 Part 2: https://bit.ly/2UuLQY1 Part 3: https://bit.ly/2OiGM7A Albums Mentioned in this Episode: Live at the BBCby The Beatles: https://amzn.to/2vIrX5M

In this episode, we discuss toxicology in the ICU. This is part one of a two-part series. Today’s episode will focus on an overview of toxic ingestions and their general management. Our guest is Dr. Jerrold B. Leikin. Dr. Leikin is the Director of Medical Toxicology at North Shore University Health System-OMEGA, which includes several hospitals in Illinois. In addition, he is a Clinical Professor of Medicine at the Pritzker School of Medicine (University of Chicago) and Professor of Medicine and Pharmacology at Rush Medical College. Additional Links: American Association of Poison Control Centers Website: https://aapcc.org/ A three-part review series published in CHEST on Toxicology in the ICU. Part 1: https://bit.ly/2OhO2k5 Part 2: https://bit.ly/2UuLQY1 Part 3: https://bit.ly/2OiGM7A Books and Albums Mentioned in This Episode: Pops: A Life of Louis Armstrong by Terry Teachout: https://amzn.to/2IBYB1w Louis Armstrong: An Extravagant Life by Laurence Bergreen: https://amzn.to/2PnkvWC Complete Hot Five & Hot Seven Recordings 2 by Louis Armstrong: https://amzn.to/2Vjvbep

In this episode, we discuss the long term effects of critical illness on cognitive impairment. Our guest is Dr. James Jackson. Dr. Jackson is the Assistant Director of The ICU Recovery Center at Vanderbilt, a Research Associate Professor, and the lead psychologist for the Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center at the Vanderbilt University School of Medicine. Additional Links: The BRAIN-ICU Study, a seminal prospective study that established the prevalence of long term cognitive dysfunction in critical illness survivors: https://bit.ly/2InupDw Cognitive outcomes after critical illness. A recent review article on the topic: https://bit.ly/2NLIuR1 Link to the CIBS Center website, which contains a wealth of resources for intensivists: https://bit.ly/2HfdQ0n Books Mentioned in This Episode: Fly Fishing Through the Midlife Crisis by Howell Raines: https://amzn.to/2OX9Bqp

Dr. Fred Rincon, an Associate Professor of Neurology and expert in neurocritical care, dives deep into the complex subject of brain death determination. He covers the historical context and legal foundations of brain death concepts from the 1960s. Learn about the crucial brainstem exams, the apnea test mechanics, and the role of drug considerations. Fred also emphasizes effective communication with families and the need for compassion in critical care, sharing insights on navigating the emotional complexities of these discussions.

n this episode of Critical Matters, we provide a quick recap on five things we learned after attending the annual Society of Critical Care Medicine Critical Care Congress. Four recent clinical studies released ahead of print during the congress are briefly discussed in addition to some thoughts on ECMO. Additional Resources: Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults: https://bit.ly/2GRFbEH Effect of Titrating Positive End-Expiratory Pressure (PEEP) with Esophageal Pressure-Guided Strategy vs. an Empirical High PEEP-FiO2 Strategy on Death and Days Free From Mechanical Ventilation Among Patients with Acute Respiratory Distress Syndrome: https://bit.ly/2T38pqV Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock: https://bit.ly/2UcyoJ3 Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis: https://bit.ly/2Xx4O35 Books Mentioned in This Episode: The Art of Living: The Classical Manual on Virtue, Happiness, and Effectiveness. Epictetus by Sharon Lebell: https://amzn.to/2ECiYIp

In this episode of Critical Matters, we discuss what happens to patients who survive the ICU. Our guest is Dr. Carla Sevin, Director for The ICU Recovery Center at the Vanderbilt School of Medicine. Dr. Sevin discusses current concepts regarding the post-intensive care syndrome (PICS) and shares her views on how we can prevent, identify, and treat it. Additional Resources: Link to Society of Critical Care Medicine webpage containing a host of resources related to the Post-Intensive Care Syndrome (PICS): https://bit.ly/2S34Xam Link to Understanding Your ICU Stay: Information for Patients and Families booklet: https://bit.ly/2SN6S7u Link to the CIBS Center website, which contains a wealth of resources for intensivists on the topic of ICU liberation and survivorship: https://bit.ly/2HfdQ0n Link to review article, Treatment of the Post-ICU Patient in an Outpatient Setting: https://bit.ly/2UUXkVg Books Mentioned in This Episode: In Shock: My Journey from Death to Recovery and Redemptive Power of Hope by Rana Awdish, MD: https://amzn.to/2SOLwX6 A View from the Edge — Creating a Culture of Caring by Rana Awdish, MD: https://bit.ly/2E6t1FF

Wesley Ely, a professor of medicine at Vanderbilt University and co-director of the CIBS Center, dives into the critical impact of delirium on ICU patients. He discusses innovative assessment methods like the CAM-ICU and highlights the long-term cognitive risks, including dementia, following ICU stays. Ely emphasizes non-pharmacological strategies to enhance patient environments and improve outcomes, such as natural light and physical activity. Communication during patient transitions is also crucial, advocating for structured care approaches to manage delirium effectively.

In this episode of Critical Matters, we discuss burnout in healthcare. Burnout is an increasing problem in critical care that impacts growing numbers of providers, nurses and healthcare professionals working in the intensive care unit. This episode is based on a webinar I presented on the topic followed by a panel discussion with physician leaders. Additional Resources: An Official Critical Care Societies Collaborative Statement: Burnout Syndrome in Critical Care Health Care Professionals: A Call for Action: https://bit.ly/2M1PGFq Why Doctors Hate Their Computers by Atul Gawande, MD: https://bit.ly/2JCw1uz Institute for Healthcare Improvement White Paper – Framework for Improving Joy in Work: https://bit.ly/2zHs16F

Dr. Ram Subramanian, Medical Director of Liver Transplantation at Emory School of Medicine, sheds light on the intricate management of critically ill patients with cirrhosis. He shares insights on navigating complications like hepatic encephalopathy and acute GI bleeds, highlighting proactive strategies for better outcomes. The conversation dives into transplant eligibility criteria and the importance of multidisciplinary approaches for patient care, emphasizing tailored interventions like TIPS and the role of support systems in improving patient survival.