ECMO for Cardiac Arrest and Massive PE

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Despite continued advances in resuscitation, favorable outcomes for patients with OHCA who receive standard resuscitation remain dismal.  In recent years there has been significant interest in the use of ECMO for OHCA.  However, the evidence demonstrating the efficacy of ECMO in OHCA remains limited.  In this podcast we review the recent ARREST Trial, which evaluated ECMO-facilitated resuscitation in OHCA.  In addition, we also discuss a recent systematic review on VA-ECMO for massive PE.

COVID-19 Updates March 2021

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In recent weeks, there have been several important studies and guidelines published that have served to improve our understanding of treating critically ill patients with COVID-19 infection.  In this podcast, we highlight the latest update from the SSC and discuss studies on convalescent plasma and IL-6 antagonists.

The HOT-ICU Study

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Critically ill patients with acute hypoxic respiratory failure receive supplemental oxygen as a component of their treatment.  In recent years, exposure to high levels of FiO2 with resultant “hyperoxia” have been associated with increased mortality in critically ill patients.  At present, there is no clinical practice guideline on oxygenation targets for adult patients with hypoxic respiratory failure.  In this podcast, we discuss the recently published HOT-ICU trial that evaluated a lower versus high oxygenation target in adult patients with acute hypoxic respiratory failure.

2020 – A Year in Review

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To say that 2020 has been a challenging year would be a gross understatement.  The courage and determination that all healthcare providers have shown in confronting the COVID-19 pandemic has been nothing short of inspirational.  In addition to the thousands of COVID-19 patients, we have also needed to manage many other critical illness conditions that have presented to our various settings.  In this annual podcast, we review key articles published in 2020 on various aspects of select critical conditions.

2020 AHA Updates: Post-Arrest Care

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The period following ROSC from cardiac arrest is a time when lives can be saved…or lost.  A systematic and comprehensive approach to post-arrest care is associated with improved survival to discharge with good neurologic function.  In this podcast, we discuss the recently published 2020 AHA Updates to Cardiopulmonary Resuscitation and Emergency Cardiovascular Care with attention to Post-Arrest care.

2020 AHA Guidelines for Cardiopulmonary Resuscitation

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Approximately 350,000 adults in the US experience an out-of-hospital cardiac arrest (OHCA).  Despite numerous potential improvements in treatments, survival from OHCA remains essentially unchanged since 2012. The American Heart Association (AHA) just released its 2020 Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.  In this podcast, we review the key updates and recommendations that impact the acute care provider managing the patient in cardiac arrest.

Electrical Storm

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Although electrical storm is an uncommon presentation, it is important that we readily recognize and treat these patients to prevent rapid progression to cardiac arrest.  Effective management can be complex.  In this podcast we discuss the management of patients with unstable and stable electrical storm.

Acute Liver Failure

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Patients with acute liver failure can be incredibly sick and have an exceedingly high mortality.  Early identification and prompt, evidence-based management of the patient with acute liver failure may improve patient-centered outcomes.  In this podcast, we discuss updated guidelines for the management of adult patients with acute liver failure. Key resuscitation topics include fluid resuscitation, blood pressure targets, vasopressor selection, bleeding and thrombosis risk, and mechanical ventilation.  

Ketamine in the Critically Ill

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Ketamine is a well-known anesthetic used commonly in the ED for RSI and procedural sedation.  In this podcast, we review the use of ketamine in other critical illness states, such as status asthmaticus, status epilepticus, acute pain management, and acute alcohol withdrawal syndrome.