SCCM Podcast

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.

Host Kyle Enfield, MD, FCCM, welcomes Adriano Targa, PhD, to discuss the article, “Sleep and Circadian Health of Critical Survivors: A 12-Month Follow-Up Study,” published open access in the August 2024 issue of Critical Care Medicine (Henríquez-Beltrán M, et al. Crit Care Med. 2024;52:1206-1217). They will discuss the prevalence of sleep disturbances and circadian rhythm fragmentation in critical survivors, the impact of factors such as invasive mechanical ventilation and hospitalization duration, and associations among sleep quality, mental health, and respiratory function one year post-discharge. Dr. Targa is a researcher at the Center for Biomedical Research Network - CIBER in Madrid, Spain. Find more expert-developed articles from Critical Care Medicine at ccmjournal.org.

Heather Meissen, a nurse practitioner and associate clinical professor at Emory Healthcare, emphasizes the critical role of publishing for nurses. She explores how bedside nurses can identify gaps in patient care that lead to impactful research. The discussion highlights the importance of mentorship, practical tips for starting research, and tackling imposter syndrome. Meissen also addresses the peer review process, offering guidance on handling feedback and spotting predatory journals, empowering nurses to share their valuable insights and improve patient care through their writing.

In this discussion, Ron Wald, a University of Toronto professor specializing in acute kidney injury, and Jay Koyner, a University of Chicago expert in nephrology, dive into cutting-edge research on renal replacement therapies. They compare continuous renal replacement therapy (CRRT) and intermittent hemodialysis, revealing how treatment choices impact survival and recovery in critically ill patients. Insightful findings from their studies illuminate the importance of CRRT in managing acute kidney injury and optimizing patient outcomes.

Matthew Kirschen, an associate professor in critical care at Children's Hospital of Philadelphia and lead author on new brain death guidelines, joins the discussion. He sheds light on the essential updates in brain death determination for both children and adults. The conversation emphasizes collaboration among medical organizations, the complexities with specific cases like pregnancy, and methods for accurate evaluation despite challenges. Kirschen also stresses the importance of thorough training and legal frameworks for critical care teams.

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 welcomes Dr. Raghavan Murugan, a leading expert from the University of Pittsburgh, to delve into fluid management strategies during continuous renal replacement therapy (CRRT). They discuss how updated practices can improve outcomes for acute kidney injury patients. Dr. Murugan highlights the importance of individualized fluid removal techniques, the balancing act required for hemodynamic stability, and the integration of new tools for assessing fluid status. The conversation underscores the critical role of education in enhancing patient care in ICU settings.

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.