Central venous catheter (CVC) placement is common in critically ill patients for a variety of indications. Thrombocytopenia is also quite common in critically ill patients. Unfortunately, literature and guideline recommendations vary on the threshold for prophylactic platelet transfusion in patients undergoing a procedure. In this podcast we discuss a recent trial that evaluated prophylactic platelet transfusion in patients with severe …
VL versus DL…And The Winner Is?
Over 1 million critically ill patients undergo intubation each year in the United States. Though direct laryngoscopy remains the most common technique worldwide for intubation, the use of video laryngoscopy has significantly increased. Studies evaluating video to direct laryngoscopy have thus far produced mixed results. In this podcast, we review the latest randomized trial, the DEVICE Trial, that assessed video with …
Do Etomidate and Propofol Increase Mortality in the Critically Ill?
Both etomidate and propofol are commonly used sedative agents in critically ill patients. Recent literature has suggested that these agents may result in increased harm and mortality. In this podcast, we discuss the most recent two systematic reviews and meta-analyses that evaluated etomidate and propofol in critically ill patients. Do we need to change our practice?
Should We Add Fludrocortisone to Hydrocortisone for Septic Shock?
The use of steroids in patients with sepsis and septic shock has been controversial for decades. At present, the Surviving Sepsis Campaign recommends the administration of corticosteroids to patients with persistent shock despite fluid and vasopressor administration. In recent years, several trials have evaluated the addition of fludrocortisone, a potent mineralocorticoid, to hydrocortisone in septic shock. In this podcast, we …
Should We Administer Steroids in Severe CAP?
In recent years, numerous trials have investigated the administration of corticosteroids in patients with pneumonia and have produced mixed results. In this podcast, we discuss the latest randomized trial, the CAPE COD trial, that evaluated whether the administration of hydrocortisone to ICU patients with severe CAP reduced mortality. Is this a therapy we should look to administer in the ED …
ECPR for OHCA? – The INCEPTION Trial
In recent years, several single center trials have demonstrated positive outcomes in patients with OHCA randomized to receive ECPR compared with patients who received standard resuscitation.  Not surprisingly, these single center studies have limitations that impact the generalizability of these results.  In the current podcast, we discuss the recently published INCEPTION Trial, which is a multicenter, randomized trial that compared the effect …
Should We Use a Liberal or Restrictive Fluid Strategy in Sepsis – The CLOVERS Trial
Intravenous fluid (IVF) administration is a central tenet to the resuscitation of patients with sepsis and sepsis-induced hypotension. At present, the administration of large volumes of IVF is common, though based on low quality of evidence. In this podcast, we review and interpret the recently published CLOVERS Trial, which compared the use of a liberal fluid strategy with a restrictive …
Top Critical Care Articles of 2022
Given the increase in critically ill patients who present to the ED in need of resuscitation, along with the increase in those who board in the ED awaiting an ICU bed, it is imperative that the emergency physician be knowledgeable about recent literature in resuscitation and critical care medicine. In this podcast, we discuss important articles published in 2022 that …
Double Sequential External Defibrillation for Refractory Ventricular Fibrillation
More than 350,000 cardiac arrests occur each year in North America. Approximately 100,000 of these arrests are due to shockable rhythms. Unfortunately, many patients have refractory ventricular fibrillation and do not respond to many attempts at standard defibrillation. In this podcast, we discuss a recent study that evaluated double sequential external defibrillation and vector-change defibrillation compared to standard defibrillation in …
What is the Optimal SpO2 Target in Vented Patients?
Approximately 3 million critically ill patients are intubated and initiated on mechanical ventilation each year in the United States. A critical component of mechanical ventilation is the adjustment of FiO2 to maintain adequate arterial oxygen saturation.  However, the optimal oxygenation target in critically ill adult patients receiving mechanical ventilation remains uncertain. In this podcast we discuss a recently published study, the …