CCPEM Podcast Episodes

The COACT trial demonstrated no improvement in 90-day mortality for post-arrest patients without evidence of an ST-segment elevation MI who were randomized to immediate or delayed coronary angiography.  However, the COACT Trial included only OHCA with a shockable rhythm and overall had a very low number of patients that had an acute thrombus at the time of angiography.  In this podcast, we discuss the recently published TOMAHAWK study that evaluated OHCA patients due to either a shockable or nonshockable rhythm and had no evidence of a STEMI.  Should this study change our post-arrest management of OHCA patients with a non-diagnostic ECG?

The administration of IVFs is nearly universal in critically ill patients.  In recent years, several studies have suggested improved outcomes with the use of balanced crystalloids solutions in contrast to 0.9% NS.  In this podcast, we discuss the recently published BaSICS Trial that evaluated Plasma-Lyte 148 with 0.9% NS in critically ill patients.  Does this study provide practice-changing evidence to make that switch?

Ventilated ED patients may be at high risk for awareness with paralysis, thereby increasing the risk of long-term psychological sequelae.  In this podcast, we discuss the results of the recently published ED-AWARENESS Study and its implications for managing the ventilated ED patient.

Current international guidelines recommend TTM for adult patients with ROSC from OHCA who remain comatose or unable to follow verbal commands.  However, the overall level of evidence for this recommendation remains of low certainty.  In this podcast, we discuss the results of the recently published TTM2 Trial and its implications on the management of post-cardiac arrest patients.

More than 3 million patients develop ARDS each year across the globe.  Like any therapy, mechanical ventilation can induce further lung injury and cause patient harm if misapplied.  In this podcast we bring you up to speed on the latest, evidence-based titration of mechanical ventilation in patients with ARDS.

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.

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.