|Pod-347 High-Quality Randomized Controlled Trials in Pediatric Critical Care
Margaret Parker, MD, MCCM, speaks Mark Duffett, PhD, about the article, “High-Quality Randomized Controlled Trials in Pediatric Critical Care: A Survey of Barriers and Facilitators," published in the May 2017 issue of Pediatric Critical Care Medicine. In this article, Dr. Duffett and coauthors identify barriers and facilitators of conducting high-quality randomized controlled trials in pediatric critical care from the perspective of trialists in the field. Dr. Duffett is a Pharmacist in the Department of Pediatrics at McMaster University in Ontario, Canada. Pediatr Crit Care Med. 2017; 18(5):405-413. Released: 8/17/17
SCCM Pod-346 Delays in Antibiotic Administration for Sepsis
Todd Fraser, MD, speaks with Christopher W. Seymour, MD, MSc, about the article, “Delays From First Medical Contact to Antibiotic Administration for Sepsis,” published in Critical Care Medicine. Dr. Seymour's article contends that "the time from first healthcare contact to antibiotic administration in sepsis, termed 'total medical contact delay,'" is not fully understood. He discusses the association between total medical contact delay and in-hospital mortality among community-acquired sepsis patients in a large retrospective cohort. He also discusses strategies to help reduce delays. Dr. Seymour is Assistant Professor of Critical Care and Emergency Medicine at the University of Pittsburgh School of Medicine in Pittsburgh, Pennsylvania. He is also a core faculty member in the Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center in the Department of Critical Care, where he contributes to the Program on Critical Care Health Policy. Crit Care Med. 2017; 45(5):759-765. Released: 8/10/17
SCCM Pod-345 International Survey of Critically Ill Children with Acute Neurological Insults
Margaret Parker, MD, MCCM, speaks with Ericka L. Fink, MD, MS, about the PANGEA study (Prevalence of Acute Critical Neurological Disease in Children: A Global Epidemiological Assessment), published in the April 2017 issue of Pediatric Critical Care Medicine. Sixteen percent of children in pediatric intensive care units (ICUs) have acute neurological conditions with brain damage due to cardiac arrest, traumatic brain injury, or other causes. The study's findings underscore the need for “transformational ideas” to improve outcomes for this large group of critically ill children at high risk of adverse clinical outcomes. Dr. Fink is an Associate Professor of Pediatrics at the University of Pittsburgh and works in the Division of Pediatric Critical Care Medicine at Children’s Hospital of Pittsburgh in Pittsburgh, Pennsylvania. Pediatr Crit Care Med. 2017; 18(4):330-342. Released: 8/3/17
SCCM Pod-VCCR9 Continuous Renal Replacement Therapy
Sean P. Kane, PharmD, BCPS, speaks with Joshua Trob, MD about continuous renal replacement therapy. In the episode, the indications, timing of initiation, and intensity of renal replacement therapy are discussed. Dr. Trob is a board certified nephrologist in private practice, the chair of the Pharmacy and Therapeutics committee at Advocate Condell Medical Center in Libertyville, Illinois, and the medical director of a dialysis clinic in Lake Bluff, Illinois.
SCCM Pod-344 Developing an ICU Diary in the Pediatric ICU
Todd Fraser, MD, speaks with Jenny Tcharmtchi, BSN, RN, CCRN, about the article, “Family Experience in the PICU,” published in Critical Connections, the Society of Critical Care Medicine's newsletter. Ms. Tcharmtchi discusses her unit’s effort to better understand the family experience in the ICU through development of a survey. She also discusses implementing an ICU diary to facilitate communication between patient families and ICU staff. Ms. Tcharmtchi is a nurse leader in the pediatric intensive care unit at Texas Children’s Hospital in Houston, Texas. The Critical Connections article is available at http://bit.ly/2uzXKq4. Released: 7/13/17
SCCM Pod-343 Patient Diaries in the ICU
Dr. Ludwig Lin, MD, speaks with Christina Jones, PhD, RN, about the ICU Patient Diary Network. Dr. Jones discusses the widespread adoption of ICU diaries in the United Kingdom, various models that institutions are using, and the overall positive impact that implementation has had on patients, families, and providers. Patients suffering from post-traumatic syndrome disorder (PTSD) after the ICU is also addressed. Dr. Jones is a retired nurse consultant in critical care rehabilitation in the ICU at Whiston Hospital in Prescot, United Kingdom, and honorary reader at the University of Liverpool’s Institute of Aging and Chronic Disease in Liverpool. She is now the research manager for the support group charity, ICUsteps. Dr. Jones has no relevant disclosures. Released 6/29/17
SCCM Pod-VCCR8 Ketamine for Refractory Status Epilepticus
Sean P. Kane, PharmD, BCPS, speaks with Karen Berger, PharmD, BCPS, BCCCP about refractory status epilepticus. In the episode, the use of continuous sedatives is discussed for refractory epilepticus with a focus on the novel use of ketamine in "super-refractory" status epilepticus patients. Dr. Berger is a neurocritical care clinical pharmacist at Weill Cornell Medical Center in New York, New York and the President-Elect for the NYC Society of Health-System Pharmacists.
SCCM Pod-342 Clinician Pro/Con: Paralysis and Proning in ARDS
Margaret Parker, MD, MCCM, speaks with John J. Marini, MD, about the Congress session "Clinician Pro/Con: Paralysis and Proning in ARDS," which was presented at the 45th Critical Care Congress in Orlando, Florida. Dr. Marini served as moderator for this session and is Professor of Medicine at the University of Minnesota and Director of Research at Regions Hospital in Saint Paul, Minnesota. In this interview, Dr. Marini reflects on the use of neuromuscular blockers and prone position in ARDS. View the Congress session at http://bit.ly/2s0Kk5j. Released 6/22/17
SCCM Pod-VCCR7 The Basics of Veno-Arterial and Veno-Venous ECMO and the Indications of ECMO Therapy
Sean P. Kane, PharmD, BCPS, speaks with Elliott Cohen, MD about extracorporeal membrane oxygenation (ECMO). In the episode, the basics of Veno-Arterial (VA) and Veno-Venous (VV) ECMO are outlined and the indications of ECMO therapy are discussed. Dr. Cohen is the medical director of Advocate Condell's Adult ECMO Program. He is co-medical director of Advocate Condell's Intensive Care Unit and medical director of the medical center's Pulmonary Rehabilitation Program in Libertyville, Illinois.
SCCM Pod-VCCR6 Vasopressor Selection in Septic Shock
Sean P. Kane, PharmD, BCPS, speaks with Scott T. Benken, PharmD, BCPS-AQ Cardiology about vasopressor selection in septic shock. In the episode, each vasopressor agent is discussed individually regarding its receptor profile, adverse effect profile, and the comparative clinical evidence supporting its use in this patient population. Dr. Benken is a clinical pharmacist in the medical and cardiothoracic surgery ICU at the University of Illinois Hospital & Health Sciences System in Chicago, Illinois.