Critical Care Scenarios

From constipation to hepatorenal syndrome. Fan favorite Elliot Tapper (@ebtapper, @ebtapper), gastroenterologist, transplant hepatologist, academic chief of hepatology, and director of the cirrhosis program at the University of Michigan, returns to answer a grab-bag of GI questions. Learn more at the Intensive Care Academy! Takeaway lessons

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In this discussion, Dr. Michael Lanspa, an intensivist and director of the Intermountain Critical Care Echocardiography Core Lab, dives into the world of point-of-care ultrasound. He highlights common pitfalls faced by practitioners and shares strategies to enhance ultrasound skills in critical care. Key topics include evaluating cardiac function with echocardiographic techniques and understanding the complexities of Doppler measurements. Dr. Lanspa also elaborates on the clinical relevance of measurements like S prime and TAPSE, emphasizing practical approaches to improving patient outcomes.

Justin Fraser, a leading expert in cerebrovascular and neuro-interventional surgery, delves into the revolutionary thrombectomy procedure for treating acute ischemic strokes. He shares insights on advancements in technology and patient transfer protocols that optimize outcomes. The discussion also highlights innovative treatments like tenecteplase, the evolution of multidisciplinary collaboration in neurointerventional surgery, and the ethical challenges faced in acute care. Fraser's expertise showcases how evolving practices are reshaping patient care in this critical field.

In this engaging discussion, Stephanie Martin, an MFM obstetrician and co-owner of Clinical Concepts and Obstetrics, dives into the complexities of maternal-fetal monitoring in critically ill pregnant patients. She highlights the unique challenges faced in ICU settings, emphasizing interdisciplinary collaboration and the delicate balance of maternal and fetal health. Listeners learn key techniques for assessing fetal well-being, the significance of clear communication, and the intricacies of managing high-risk pregnancies, all delivered with insightful anecdotes and expert advice.

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Carolina Maciel, MD, MSCR, FAAN, is a triple board-certified expert in neurology and neurocritical care. She dives into the nuances of EEGs in the ICU, explaining when and how to interpret these essential brain monitoring tools. The conversation highlights the importance of prolonged EEG monitoring for accurate insights, particularly in complex cases. Carolina emphasizes the need for collaboration between clinicians and EEG specialists to enhance patient outcomes while navigating the challenges of analyzing EEG data in critically ill patients.

Philippe Rola, intensivist, master of the VEXUS scan, and founder of the Hospitalist and Resuscitationist conference, shares his recent model of four hemodynamic interfaces to describe the entire circulatory system. Register for the H&R conference (May 22-23 2025) here with the discount code provided in the show. (No, we’re not sponsored, just a cool event.) … Continue reading "Lightning rounds 51: Hemodynamic interfaces with Philippe Rola"

A roundup from members of the SCCM’s ICU Liberation committee, recorded at SCCM Congress 2025. Included:

Matt Siuba, an intensivist renowned for his expertise in right heart catheterization, shares his insights on the intricate art of placing pulmonary artery catheters. He highlights common pitfalls and essential techniques, offering practical tips to boost confidence for novice practitioners. The discussion covers the importance of proper positioning, communication within the medical team, and the role of ultrasound in ensuring accuracy. Listeners will gain valuable strategies for overcoming challenges in critical care settings.