A Year in Review: Key Articles from the 2019 Critical Care Literature

ccpempod

A plethora of literature was published during the course of 2019.  In this podcast, we review several key articles published in the 2019 critical care literature that pertain to the resuscitation and management of select critically ill patients.  Simply a great way to start 2020!

Benzodiazepine-Refractory Status Epilepticus – Which Drug is Second-Line?

ccpempod

Up to one-third of patients with status epilepticus will not respond to benzodiazepines.  Unfortunately, treatment of benzodiazepine-refractory status epilepticus is not well studied.  The longer seizures persist, the worse patients do.  In this podcast, we discuss the results of the recently completed ESETT trial that evaluated three anticonvulsant medications for status epilepticus.

Amniotic Fluid Embolism – (AFE)

ccpempod

Amniotic fluid embolism (AFE) is a catastrophic syndrome that occurs very soon after delivery and is a significant cause of morbidity and mortality. Unfortunately, the diagnosis is often missed, or at the very least delayed. In this podcast, we discuss the clinical presentation, diagnosis, and management of this critical illness. Check it out!

The PrePARE Trial – Do IVFs Prevent Peri-Intubation CV Collapse?

ccpempod

Up to 25% of critically ill patients who undergo RSI and endotracheal intubation (ETI) may suffer cardiovascular collapse.? Many clinicians administer IVFs during RSI and ETI in hopes of preventing cardiovascular collapse, though this has never been studied…until now.? In this podcast we discuss the results of the recently published PrePARE Trial, as well as provide some thoughts on maximizing a patient’s physiology before performing ETI.

TTM For Nonshockable Rhythms?

ccpempod

Current guidelines for post-cardiac arrest management recommend TTM (32C to 36C) for all patients with coma after resuscitation from cardiac arrest. The benefit of TTM is primarily seen in patients who present with a shockable rhythm.  However, nonshockable rhythms are now the most common presenting rhythm in patients with cardiac arrest. The use of TTM in patients with nonshockable rhythms remains controversial. In this podcast, we discuss the latest randomized article on the use of TTM in patients with cardiac arrest with a nonshockable rhythm. Should these results change YOUR practice?

Extubating in the ED

ccpempod

Given the development of ED-ICUs and the ever increasing boarding of critically ill patients in the ED, extubation in the ED has become a more common practice. Selecting the appropriate patient and following a practical, organized approach is paramount to safely and successfully performing this procedure. In this podcast, we discuss the pearls and pitfalls of ED Extubation.  Simply an outstanding discussion that you can’t miss!

Do ED-Based ICUs Make a Difference?

ccpempod

Over the past decade, the annual hours of critical care delivered in US emergency departments has sharply risen. Undoubtedly, many critically ill patients remain in the ED for numerous hours awaiting an ICU bed.  In an attempt to improve the delivery of critical care to boarding ED patients, several hospitals and health care systems have recently implemented ED-based ICUs.  In this podcast, we discuss a recent article published in JAMA Open Network evaluating the impact on mortality and resource utilization of an ED-based ICU.

Updates in Post-Arrest Care

ccpempod

Over 500,000 patients suffer sudden cardiac arrest each year in the United States.  Though survival rates are improving, there remains significant variation in outcomes by region.  In recent years, numerous advances in post-resuscitation care have been associated with improved outcomes.  In this podcast, we discuss the key elements of post-arrest care along with current controversies. Most importantly, we discuss what you NEED to know when caring for the post-arrest patient in order to maximize outcomes!

Resuscitating The Critically Ill Geriatric Patient

ccpempod

The World’s population is aging. By 2030, 20 percent of the US population will be over the age of 65 years.  Older patients have a number of age-related physiologic changes that impact their disease presentation and resuscitation.  In this podcast, we review common physiologic changes in the geriatric patient and provide critical resuscitation pearls when confronted with the sick, geriatric patient.

Critically Ill Patients with Vibrio Infection

ccpempod

With increasing water temperatures, there is a rise in the incidence of V.vulnificus infections in non-endemic regions.  Patients with V.vulnificus infection are often critically ill, can quickly decompensate, and crash within hours.  In this podcast, we discuss the clinical characteristics of this serious infection, along with the current treatments of choice. A very hot and timely topic!