Critical Matters

In this episode, Dr. Zanotti discusses the management of acute life-threatening asthma exacerbations in the ICU with this guest, Dr. Haney Mallemat, a physician trained in EM/IM and Critical Care. Dr. Mallemat is currently an Associate Professor of Emergency Medicine and Internal Medicine at the Cooper Medical School at Rowan University. Additional Resources: How Not to Kill an Asthmatic – Presented at CODA Change by Haney Mallemat: https://codachange.org/severe-asthma Management of Acute Life-Threatening Asthma Exacerbations in the Intensive Care Unit. Talbot T, et al. Appl. Sci 2024: https://www.mdpi.com/2076-3417/14/2/693 ResusX,- a medical resuscitation conference created by Dr. Mallemat: https://www.resusx.com Last Week Now! - A curated newsletter by ResusX: https://www.resusx.com/newsletter Keynotable – a course for beginners and seasoned speakers: https://www.keynotable.net Books mentioned in this episode: How to Win Friends and Influence People. By Dale Carnegie: https://bit.ly/49WlcOd

In this episode, Dr. Zanotti is joined by Dr. Stephen Pastores to discuss the 2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia, published by the Society of Critical Care Medicine. Dr. Pastores is Program Director for Critical Care Medicine and Vice-Chair of Education for the Department of Anesthesiology and Critical Care Medicine at Memorial Sloan Kettering Cancer Center. In addition, Dr. Pastores is a professor of anesthesiology and medicine at Weill Cornell Medical College in New York, NY. Additional resources: 2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia. Crit Care Medicine 2024: https://journals.lww.com/ccmjournal/pages/articleviewer.aspx?year=9900&issue=00000&article=00275&type=Fulltext Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. ADRENAL Trial. N Engl J Med 2018. https://www.nejm.org/doi/full/10.1056/NEJMoa1705835 Hydrocortisone plus Fludrocortisone for Adults with Septic Shock. APROCCHSS Clinical Trial. N Engl J of Med 2018: https://www.nejm.org/doi/full/10.1056/NEJMoa1705716 Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomized controlled trial. The Lancet 2020: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(19)30417-5/abstract Hydrocortisone in Severe Community-Acquired Pneumonia. CAPE-COD Trial. N Eng J Med 2023: https://www.nejm.org/doi/full/10.1056/NEJMoa2215145 Books mentioned in this episode: Elon Musk. By Walter Isaacson: https://bit.ly/3PVXWsG The Autumn Ghost: How the Battle Against a Polio Epidemic Revolutionized Modern Medical Care. By Hannah Wunsch: https://bit.ly/4avevns

In this episode, Dr. Zanotti discusses the delicate balance of conflict resolution in healthcare. Conflict is common in our daily work in the ICU. Many clinicians avoid conflict and have negative feelings towards it. However, conflict, when managed appropriately, can lead to significant benefits for our patients and teams. Dr. Zanotti's discussion is based on a webinar he presented earlier this month as part of Sound Critical Care Leadership Week. Additional Resources: Watch the full webinar: https://youtu.be/R3wz29W3C4g Conflict Management in the ICU. Previous Critical Matters podcast episode with Dr. Joshua Kayser. https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=1378454077 Books Mentioned in this Episode: Nonviolent Communication. By Marshal B. Rosenberg: https://bit.ly/4a8h0fp Getting to YES: Negotiating Agreement Without Giving In. By Roger Fisher and William Ury: https://bit.ly/3TSD5J3 Possible: How We Survive (and Thrive) in an Age of Conflict. By William Ury: https://bit.ly/4aauFCK Crucial Conversations: Tools For Talking When Stakes are High. By Joseph Grenny, et al: https://bit.ly/43AU6La The Anatomy of Peace: Resolving the Heart of Conflict. By the Arbinger Institute: https://bit.ly/4a1v0HL

In this episode, Dr. Zanotti is joined by Dr. Craig Rackley to discuss the role of ECMO – extracorporeal membrane oxygenation in supporting patients with acute respiratory failure. Dr. Rackley is a practicing pulmonary critical care physician and an associate professor of Medicine at Duke University School of Medicine. He is the medical director of Adult ECMO in the Duke Division of Pulmonary, Allergy, and Critical Care Medicine. Dr. Rackley is also a recognized clinician, educator, and researcher interested in respiratory failure, ARDS, and ECMO. Additional Resources Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. The CESAR Trial. Lancet 2009: https://pubmed.ncbi.nlm.nih.gov/19762075/ Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome. The EOLIA Trial. N Eng J of Med 2018: https://www.nejm.org/doi/full/10.1056/NEJMoa1800385 Bertini P, Guarracino F, Falcone M, et al. ECMO in COVID-19 Patients: A Systematic Review and Meta-analysis. J Cardiothorac Vasc Anesth 2022: https://pubmed.ncbi.nlm.nih.gov/34906383/ Books mentioned in this episode Endurance: Shackleton’s Incredible Voyage. By Alfred Lansing: https://bit.ly/43g71C1 South!: The Story of Shackleton’s Last Expedition 1914-1917. By Ernest Shackleton: https://bit.ly/49NyJbU

In this episode, we will discuss critical care management of acute neuromuscular disorders. We will focus on the Guillain-Barre Syndrome and Myasthenia Gravis. My guest is Dr. Kamran Athar, who is trained in critical care medicine and neurocritical care. He is a practicing neurointensivist at the Farber Institute for Neuroscience in Philadelphia. Dr. Athar is an assistant professor of Medicine and Neurology at the Jefferson School of Medicine in Philadelphia. Additional Resources: Neuromuscular Disorders in the Intensive Care Unit. T B Birch. American Academy of Neurology 2021: https://pubmed.ncbi.nlm.nih.gov/34618763/ The clinical management of neuromuscular disorders in intensive care. M S Damian and EFM Wijdicks. Neuromuscular Disorders 2019: https://www.sciencedirect.com/science/article/abs/pii/S0960896618304231 Books Mentioned in this Epsiode: When Breath Becomes Air. By Paul Kalanithi: https://www.amazon.com/When-Breath-Becomes-Kalanithi-Paul/dp/1784701998/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=1706814212&sr=8-1

In this episode, Dr. Zanotti is joined by Dr. Eddy Fan for a discussion about Respiratory Support in ARDS. Dr. Fan is an associate professor in the Interdepartmental Division of Critical Care Medicine and the Institute of Health Policy, Management, and Evaluation at the University of Toronto. He is also a staff intensivist at the University Health Network/Mount Sinai Hospital. Dr. Fan is currently the Medical Director of the Extracorporeal Life Support Program at the Toronto General Hospital and the Director of Critical Care Research at the University Health Network/Mount Sinai Hospital. Dr. Fan’s research has focused on advanced life support for acute respiratory failure and patient outcomes from critical illness. He is a co-author of the ESICM ARDS Clinical Guidelines. Additional Resources: ESICM guidelines on acute respiratory distress syndrome: definition, phenotyping, and respiratory support strategies. Intensive Care Med 2023: https://pubmed.ncbi.nlm.nih.gov/37326646/ An Update on Management of Adult Patients with ARDS. Official ATS Clinical Practice Guideline. Am J Respir Crit Care Med 2024; https://www.atsjournals.org/doi/full/10.1164/rccm.202311-2011ST Prone Positioning in Severe Acute Respiratory Distress Syndrome. PROSEVA Clinical Trial. N Engl J of Med 2013: https://www.nejm.org/doi/full/10.1056/nejmoa1214103 Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome. The EOLIA Trial. N Eng J of Med 2018: https://www.nejm.org/doi/full/10.1056/NEJMoa1800385 Books mentioned in this episode: A Portrait of the Artist as a Young Man. By James Joyce: https://bit.ly/49kzmtn

In this episode, we discuss the management of seizures in the intensive care unit. Our guest is Dr. Brandon Foreman – an internist and neurologist with fellowship training in epilepsy and Neurocritical care. Dr. Foreman is an Associate Professor of Neurology at the University of Cincinnati Medical College. He is the Associate Director for Neurocritical Care Research. An excellent clinician, researcher, and educator focusing on Clinical Neurophysiology and Neurocritical care. Additional Resources: Seizure Management in the Intensive Care Unit. Boggs JG. Curr Treat Options Neurol 2021: https://pubmed.ncbi.nlm.nih.gov/34697528/ American Epilepsy Society – Website with multiple clinical Guideline: https://pubmed.ncbi.nlm.nih.gov/34697528/ Treating Rhythmic and Periodic EEG Patterns in Comatose Survivors of Cardiac Arrest. Ruijter BJ, et al. N Engl J Med 2022: https://pubmed.ncbi.nlm.nih.gov/35196426/ Books mentioned in this episode: Siddhartha: A Novel. By Hermann Hesse: https://www.amazon.com/Siddhartha-Novel-Hermann-Hesse Netflix- Reference Guide on Our Freedom and Responsibility Culture https://igormroz.com/documents/netflix_culture.pdf

In this episode, we discuss the evaluation of fever in the adult ICU patient. We discuss updates from the recently published Society of Critical Care Medicine and Infectious Diseases Society of America clinical guidelines. My guest is Dr. Andre Kalil, a critical care and infectious disease physician. Dr. Kalil is a Professor in the Division of Infectious Disease and Director of Transplant Infectious Disease at the University of Nebraska Medical Center (UNMC). A renowned clinician, educator, and researcher, Dr. Kalil has received many distinctions, including the 2021 Scientist Laureate Award at UNMC. Dr. Kalil is an author of the 2023 Society of Critical Care Medicine and The Infectious Disease Society of America Guidelines for Evaluating New Fever in Adult Patients in the ICU. Additional Resources: Society of Critical Care Medicine and the Infectious Diseases Society of America guidelines for Evaluation New Fever in Adult Patients in the ICU. Crit Care Medicine 2023. https://pubmed.ncbi.nlm.nih.gov/37902340/ Executive Summary: Guidelines for Evaluating New Fever in Adult Patients in the ICU. Crit Care Medicine 2023. https://pubmed.ncbi.nlm.nih.gov/37902339/ Guidelines for the evaluation of new fever in critically ill adult patients: 2008 Update. Crit Care Medicine 2008/ https://pubmed.ncbi.nlm.nih.gov/18379262/ Books mentioned in this episode: Splendid Solution: Jonas Salk and the Conquest of Polio. By Jeffrey Kluger https://www.amazon.com/Splendid-Solution-Jonas-Conquest-Polio/dp/0425205703/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=1702571365&sr=8-2

In this episode, we discuss the topic of Brain Death / Death by Neurologic Criteria. We discuss updates from the recently published American Academy of Neurology, American Academy of Pediatrics, Child Neurology Society, and Society of Critical Care Medicine clinical guidelines. Our Guest is Dr. David Greer. Dr. Greer is a neurologist with additional vascular neurology and neurocritical care training. He is the Chair of the Boston University School of Medicine Department of Neurology. Dr. Greer is a renowned clinician, educator, and researcher. He has an extensive list of publications and awards. He is the first author of the “Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Guideline” we will discuss today. Additional Resources: Pediatric and Adult Brain Death / Death by Neurologic Criteria Consensus Guideline. David Greer, et al. Neurology 2023: https://n.neurology.org/content/early/2023/09/13/WNL.0000000000207740 Determination of Brain Death / Death by Neurologic Criteria. The World Brain Death Project. D. Greer et al. JAMA 2020 https://pubmed.ncbi.nlm.nih.gov/32761206/ Determination of Brain Death / Death by Neurologic Criteria. The World Brain Death Project. VIDEO: https://edhub.ama-assn.org/jn-learning/video-player/18529668 Controversies in Brain Death Declaration: Legal and Ethical Implications in the ICU. S Biel, et al: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223748/ Books mentioned in this episode: The Boys in the Boat. By Daniel J. Brown: https://www.amazon.com/Boys-Boat Team of Rivals: The Political Genius of Abraham Lincoln. By Doris Kearns Goodwin: https://t.ly/7F1My Nine Stories. By JD Salinger: https://t.ly/qM5w_

In this episode, we will discuss Central Line-Associated Bloodstream Infections (CLABSI). My guest is Dr. Naomi O’Grady, a critical care and infectious disease physician at the National Institutes of Health. She is Chief of the Internal Medicine Service and an attending physician in the Clinical Center's Critical Care Medicine Department (CCMD). Her research focuses on strategies to reduce the incidence of antimicrobial-resistant pathogens in the ICU and catheter-related bloodstream infections. Additional Resources: Prevention of Central Line-Associated Bloodstream Infections. N. O’Grady. New Engl J Med 2023: https://pubmed.ncbi.nlm.nih.gov/37733310/ Sustaining reductions in central line-associated bloodstream infections in Michigan intensive care units: a 10-year analysis. P Pronovost, et al. Am J Med Qual 2016: https://pubmed.ncbi.nlm.nih.gov/25609646/ Bloodstream infection event (central line-associated bloodstream infection and non central-line associated bloodstream infection.) National Healthcare Safety Network: https://www.cdc.gov/nhsn/pdfs/pscmanual/4psc_clabscurrent.pdf Books Mentioned in this Episode: Nancy Drew Book Series. By Carolyn Keene. Nancy Drew Books: https://tinyurl.com/4rjx6st8 The Checklist Manifesto. By Atul Gawande The Checklist Manifesto- Atul Gawande: https://tinyurl.com/5pccn98p

To err is human. In today’s episode, we will discuss the science behind learning to fail, in other words: “failing well”. We will discuss our flawed relationship to failure, how to better understand failure, and how to learn from failure. I am joined by Amy Edmondson, the Novartis Professor of Leadership and Management at the Harvard Business School. For the last 2 decades, she has studied the elements of high-performing teams in complex environments. She has coined the term “psychological safety” and has made critical insights into teaming, learning from failure, and innovation. She is the author of several books and multiple academic papers and a regular contributor to the Harvard Business Review. Her latest book “Right Kind of Wrong: The Science of Failing Well”, was released in September of this year on hardback. Additional Resource: Right Kind of Wrong. The Science of Failing Well. By Amy Edmondson: https://www.amazon.com/Right-Kind-Wrong-Science-Failing-ebook/dp/B0BTZT9CXV#:~:text=In%20Right%20Kind%20of%20Wrong,from%20flubs%20of%20all%20stripes Critical Matters podcast episode – The Fearless ICU, a discussion with Amy Edmondson on Psychological safety and teaming: https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=1220843524 Faculty page for Amy Edmondson. A great jumping point to her vast body of work: https://www.hbs.edu/faculty/AmyEdmondson Strategies for Learning from Failure. By A. Edmondson. Harvard Business Review 2011: https://hbr.org/2011/04/strategies-for-learning-from-failure Books Mentioned in this Episode: Adapt: Why Success Always Starts with Failure. By Tim Hartford: https://shorturl.at/mpQU1 Being Wrong: Adventures in the Margin of Error. By Kathryn Shulz: https://shorturl.at/qAHJ0 Principles: Life and Work. By Ray Dalio: https://shorturl.at/JRSZ1

Organ transplantation has proven to be life-saving for thousands of patients and a growing number of disease processes. However, the gap between available organs for transplant and patients on organ transplant waiting lists continues to grow. In this episode, we will discuss the ICU management of the organ donor. Our guest is Dr. George Williams. He is a Professor of Anesthesiology, Critical Care and Pain Medicine, and Vice Chair for Critical Care Medicine at the McGovern Medical School of the University of Texas in Houston. Dr. Williams is also Medical Co-Director of the Surgical Intensive Care Unit at Lyndon B. Johnson General Hospital, and Executive Medical Director, for the Donor Specialty Care Unit- Memorial Hermann Hospital TMC. He is an Immediate Past-President of the Texas Society of Anesthesiologists and currently serves as Chair, for the American Society of Anesthesiologists Committee on Critical Care Medicine. Additional Resources: Management of the Potential Organ Donor in the ICU. A clinical guideline published by the Society of Critical Care Medicine: https://www.sccm.org/Clinical-Resources/Guidelines/Guidelines/Management-of-the-Potential-Organ-Donor-in-the-ICU Website for the United Network for Organ Sharing (UNOS): https://unos.org/ Critical Matters podcast episode – Death By Neurological Criteria: https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=1304762116 The rise of organ donation after circulatory death: a narrative review. Gardiner D, et al. ANESTHESIA 2020: https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15100 Books Mentioned in this Episode: The Holy Bible, KJV: https://shorturl.at/wyLM4

In this episode of the podcast, we will discuss Hospital Sepsis Programs with the recently released CDC Hospital Sepsis Program Core Elements document as an anchor. Our guest is Dr. Hallie Prescott, an Associate Professor in Pulmonary & Critical Care Medicine at the University of Michigan, and a staff physician at the Ann Arbor Veterans Affairs Healthcare System. Dr. Prescott’s primary focus of research has been on sepsis care and outcomes. She serves as co-chair of the international Surviving Sepsis Campaign Guidelines and as lead for the Michigan Hospital Medicine Safety Consortium’s Sepsis Initiative. Additional Resources: CDC Hospital Program Sepsis Program Core Elements: https://www.cdc.gov/sepsis/pdfs/sepsis-core-elements-H.pdf CDC Additional Sepsis Clinical Resources: https://www.cdc.gov/sepsis/core-elements/resources.html SCCM Surviving Sepsis Guidelines: https://journals.lww.com/ccmjournal/pages/articleviewer.aspx?year=2021&issue=11000&article=00021&type=Fulltext Characterising an implementation intervention in terms of behaviour change techniques and theory: the ‘Sepsis Six’ clinical care bundle. Steinmo S, et al. Implementation Science 2015: https://implementationscience.biomedcentral.com/articles/10.1186/s13012-015-0300-7 Effect of a Multicomponent Sepsis Transition and Recovery Program on Mortality and Readmissions After Sepsis: The Improving Morbidity During Post-Acute Care Transitions for Sepsis Randomized Clinical Trial. Crit Care Medicine 2022: https://escholarship.org/content/qt4j222757/qt4j222757_noSplash_ad94a5b7db24a75b6176198a51129f5a.pdf Books mentioned in this episode: The Autumn Ghost: How the Battle Against a Polio Epidemic Revolutionized Modern Medical Care. By Hannah Wunsch: https://www.amazon.com/Autumn-Ghost-Against-Epidemic-Revolutionized/dp/1771649453/ref=sr_1_1?crid=K1OFKS5NTQM4&keywords=the+autumn+ghost+hannah+wunsch&qid=1694808152&sprefix=autumn+ghosts%2Caps%2C108&sr=8-1

In this episode, Dr. Zanotti discusses advances in the management of cardiogenic shock. His guest is Dr. Jacob Jentzer, a cardiac intensivist trained in both Cardiology and Critical Care Medicine who practices full-time in the Cardiac Intensive Care Unit at Mayo Clinic in Rochester, MN. As the Director of Cardiac Intensive Care Unit Research at Mayo Clinic, he is active in Intensive Care Unit patient outcomes research, with a particular focus on the outcomes of patients with cardiogenic shock and cardiac arrest. Additional Resources Concise Definitive Review: Advances in the Management of Cardiogenic Shock. Jentzer JC et al. Crit Care Medicine 2023: https://pubmed.ncbi.nlm.nih.gov/37184336/ SCAI clinical expert consensus statement on the classification of cardiogenic shock. Baran DA, et al.: https://www.ncbi.nlm.nih.gov/pubmed/31104355 SCAI stages of cardiogenic shock stratify mortality risk. Jentzer JC et al.: https://www.ncbi.nlm.nih.gov/pubmed/?term=SCAI+stages+of+cardiogenic+shock+stratify+mortality+risk Advances in the Staging and Phenotyping of Cardiogenic Shock: Part 1. Jentzer JC, et al. JACC Advances 2022: https://www.jacc.org/doi/10.1016/j.jacadv.2022.100120 Machine Learning Approaches for Phenotyping in Cardiogenic Shock and Critical Illness: Part 2. Jentzer JC, et al. JACC Advances 2023: https://www.jacc.org/doi/10.1016/j.jacadv.2022.100126 Extracorporeal Life Support in Infarct-Related Cardiogenic Shock. ECLS-SHOCK Investigators. New Eng J of Med 2023: https://pubmed.ncbi.nlm.nih.gov/37634145/ Book Recommendations: The Hobbit by JRR Tolkien: https://bit.ly/44S0tZD The Lord of the Rings Trilogy by JRR Tolkien: https://bit.ly/45Q9NP0 The House of God. By Samuel Shem: https://bit.ly/48gnusc

In this episode, Dr. Zanotti discusses the management of acute-on-chronic liver failure (ACLF) in the ICU. He is joined by Dr. Nanchal, a practicing critical care physician with an interest in liver disease. He is a Professor in the Division of Pulmonary and Critical Care Medicine, at the Medical College of Wisconsin, in Milwaukee. Dr. Nanchal is also the lead author of the Society of Critical Care Medicine’s Guideline for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU. Additional Resources Executive Summary for Guideline for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-transplant Medicine, Infectious Disease, and Gastroenterology Considerations: https://journals.lww.com/ccmjournal/pages/articleviewer.aspx?year=2023&issue=05000&article=00010&type=Fulltext Guideline for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-transplant Medicine, Infectious Disease, and Gastroenterology Considerations: https://journals.lww.com/ccmjournal/pages/articleviewer.aspx?year=2023&issue=05000&article=00011&type=Fulltext Guideline for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Cardiovascular, Endocrine, Hematologic, Pulmonary, and Renal Considerations: https://journals.lww.com/ccmjournal/Fulltext/2020/03000/Guidelines_for_the_Management_of_Adult_Acute_and.29.aspx Previous Episodes of Critical Matters on the Topic of Acute-on-Chronic Liver Failure: https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=953807698 https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=965563996 Books Mentioned in this Episode: Noise: A Flaw in Human Judgement. By Daniel Kahneman, et al: https://bit.ly/3sqfRin Seven Brief Lessons on Physics. By Carlo Rovelli: https://bit.ly/45jv82N Anaximander: And the Birth of Science. By Carlo Rovelli: https://bit.ly/3sqgqbZ

In this episode of Critical Matters, Dr. Zanotti is joined by Dr. Nitin Puri. As a critical care physician, Dr. Puri is the Division Head for Critical Care Medicine, and Co-Director for the Center for Critical Care Medicine at Cooper University Health System. He is an Associate Professor of Medicine at Cooper Medical School of Rowan University, in Camden, New Jersey. Together, they discuss medical errors in healthcare. Additional Resources: “To Err is Human: Building a Safer Health System.” The landmark publication y the Institute of Medicine highlighting medical errors as a critical cause of deaths in the US healthcare system: https://www.ncbi.nlm.nih.gov/pubmed/25077248 Medical error – the third leading cause of death in the US: https://www.ncbi.nlm.nih.gov/pubmed/27143499 The Safety of Inpatient Health Care. New England Journal of Medicine 2023; https://www.nejm.org/doi/full/10.1056/NEJMsa2206117 The Communication and Optimal Resolution (CANDOR) toolkit from the Agency for Healthcare Research and Quality (AHRQ). CANDOR is a process that health care institutions and providers can use to respond in a timely, thorough and fair way when medical errors occur and cause patient’s harm: https://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/candor/introduction.html A powerful video on to topic of disclosure of medical errors. Worth a view: https://www.youtube.com/watch?time_continue=4&v=xeMWizTodYw Books Mentioned in this Episode: The Fearless Organization: Creating Psychological Safety in the Workplace for Learning, Innovation, and Growth. By Amy Edmondson: https://bit.ly/3OQe1zV Pachinko. By Min Lee Jee: https://bit.ly/3DNJegK

In this episode of the podcast, we will discuss oncologic emergencies. Dr. Zanotti is joined by Dr. R Scott Stephens, a pulmonary/critical care physician and associate professor of medicine and oncology at the Johns Hopkins University School of Medicine. He is the Director of Oncology and Bone Marrow Transplant Critical Care at Johns Hopkins Hospital and the Sidney Kimmel Comprehensive Cancer Center. A recognized clinician, educator, and researcher Dr. Stephens has expertise and interest in ARDS, ECMO, and oncologic critical care. Additional Resources: Oncologic Emergencies for the Intensivist – the Old, the New, and the Deadly. Thandra K, et al. J Intensive Care Med 2020: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886674/ Oncologic Emergencies – Traditional and Contemporary. Spring J, and Munshi L. Crit Care Clin 2020: https://pubmed.ncbi.nlm.nih.gov/33190777/ Critically Ill Patients with Cancer: A Clinical Perspective. Martos-Benitez F, et al. World J clin Onco 2020: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7643188/ Management of Febrile Neutropenia: ESMO Clinical Practice Guidelines. Annals of Oncology 2016: https://www.annalsofoncology.org/article/S0923-7534(19)31643-6/pdf Books Mentioned in this Episode: The Elements of Style. By William Strunk and EB White: https://amzn.to/3KddG7C The Structure of Scientific Revolutions: By William Kuhn: https://bit.ly/43HkS34 The Physicists: The History of a Scientific Community in Modern America. By Daniel Kevles: https://bit.ly/477Z8jO American Prometheus: The Triumph and Tragedy of j. Robert Oppenheimer. By Kai Bird and Martin Sherwin: https://bit.ly/479AEqn

In this episode, we will discuss the evaluation and initial management of acute disorders of consciousness in the ICU. Our guest is Dr. Cherylee Chang, a practicing neuro intensivist, a Professor of Neurology, and the Division Chief of Neurocritical Care, in the Department of Neurology, at Duke University, in Durham, North Carolina. Additional Resources State-of-the-Art Evaluation of Acute Adult Disorders of Consciousness for the General Intensivist. Chang C, et al. Critical Care Medicine 2023: https://pubmed.ncbi.nlm.nih.gov/37070819/ Neurocritical Care Society Curing Coma Campaign. Provencio J, et al. Neurocrit Care 2020: https://pubmed.ncbi.nlm.nih.gov/32578124/ NIH Stroke Scale: https://www.ninds.nih.gov/health-information/public-education/know-stroke/health-professionals/nih-stroke-scale Updated nomenclature of delirium and acute encephalopathy: statement of ten Societies. Intensive Care Med 2020: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210231/ Critical Matters podcast episode on CNS Infections: https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=1533382963 Books mentioned in this episode: Bed Number Ten. By Sue Baier and Mary Zimmeth Schomaker: amzn.to/3O8Fmgp The Diving Bell and the Butterfly. By Jean-Dominique Bauby: bit.ly/44Hxhon Clinical Neuroanatomy Made Ridiculously Simple. By Stephen Goldberg: https://amzn.to/3PUF7Xu

In this episode, we will discuss prone position ventilation in adult respiratory distress syndrome (ARDS). Despite clinical trials demonstrating a benefit on mortality, the adoption of prone position ventilation has been challenging. We will discuss the impact the COVID-19 pandemic had on the use of prone position ventilation and lessons learned that can help increase the proper use of this treatment modality moving forward. Our guest is Dr. Chad Hochberg, a member of the Division of Pulmonary and Critical Care Medicine, Department of Medicine, at John Hopkins University Medical School in Baltimore, Maryland. Additional Resources Factors Influencing the Implementation of Prone Positioning during the COVID-19 Pandemic. Hochberg C, et al. Ann Am Thorac Soc, 2023; https://pubmed.ncbi.nlm.nih.gov/35947776/ Declining Use of Prone Positioning After High Initial Uptake in COVID-19 Adult Respiratory Distress Syndrome. Hochberg C, et al. Crit Care Med 2023: https://pubmed.ncbi.nlm.nih.gov/37294144/ ESICM Guidelines on ARDS 2023. Intensive Care Medicine 2023: https://link.springer.com/article/10.1007/s00134-023-07050-7 ATS/ESICM/SCCM Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome: https://www.atsjournals.org/doi/10.1164/rccm.201703-0548S Prone Position for Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis. Munshi L, et al. Ann Am Thorac Soc 2017: https://pubmed.ncbi.nlm.nih.gov/29068269/ Prone Positioning in Severe Acute Respiratory Distress Syndrome. Guerin C. Et al. PROSEVA Trial. New Eng J Med 2013: https://www.nejm.org/doi/full/10.1056/nejmoa1214103 Books Mentioned in this Episodes The Omnivore’s Dilemma: A Natural History of Four Meals, By Michael Pollan: https://bit.ly/42FpndS

In this episode of Critical Matters, we discuss Central Nervous System (CNS) Infections. Our discussion focuses on the management of meningitis and encephalitis in the ICU. My guest is Dr. Catherine Albin, a neuro intensivist at the Emory Healthcare System in Atlanta, Georgia. Dr. Albin holds a faculty position as Assistant Professor of Neurology and Neurosurgery, in the Division of Neurocritical Care of Emory University School of Medicine. Additional Resources Infectious Meningitis and Encephalitis. R Bystritsky and F Chow: https://pubmed.ncbi.nlm.nih.gov/34798976/ Critical care management of meningitis and encephalitis: an update. M Thy, et al.: https://pubmed.ncbi.nlm.nih.gov/35975963/ Infectious Disease Society of America’s Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis: https://pubmed.ncbi.nlm.nih.gov/28203777/ Books Mentioned in this Episode The Acute Neurology Survival Guide. By Catherine Albin and Sahar Zafar :bit.ly/45Ttfuo Why We Sleep: Unlocking the Power of Sleep and Dreams. By Matt Walker: https://bit.ly/3MNoWs0