ICU Ed and Todd-Cast

Episode 37! In this episode we talk about glycemic control in the ICU. We liked the flipped script and so we're again going old article first. NICE-SUGAR or "Intensive versus conventional glucose control in critically ill patients" was published in NEJM 2009 and then we talk about TGC-Fast or "Tight Blood-Glucose Control without Early Parenteral Nutrition in the ICU" published NEJM September of 2023 NICE SUGAR: https://pubmed.ncbi.nlm.nih.gov/19318384/ TGC-Fast: https://pubmed.ncbi.nlm.nih.gov/37754283/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 36! In this episode we talk about tranexamic acid in GI bleeds. We flip the script a little bit and talk about our OLD article first, HALT-IT or "Tranexamic acid in upper gastrointestinal bleed in patients with cirrhosis: A randomized controlled trial" published in Lancet in 2020. This sets the stage for our new trial "Tranexamic acid in upper gastrointestinal bleed in patients with cirrhosis" published in Kumar et al in Hepatology (a new journal for us!) HALT-IT: https://pubmed.ncbi.nlm.nih.gov/32563378/ TXA and cirrhosis: https://pubmed.ncbi.nlm.nih.gov/38441903/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 35! In this episode we talk about extubation practices with "Effect of aggressive vs conservative screening and confirmatory test on time to extubation among patients at low or intermediate risk: a randomized clinical trial" published in Intensive Care Medicine by Hernandez et al. We then talk about an observation study by Zarrabian et al published in the Blue Journal "Liberation from Invasive Mechanical Ventilation with Continued Receipt of Vasopressor Infusions". SPEED UP: https://pubmed.ncbi.nlm.nih.gov/38353714/ Extubation on Pressors: https://pubmed.ncbi.nlm.nih.gov/35107416/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 34! In this episode we talk about oxygen targets! Specifically we go over the two oxygen target analyses that were published simultaneously with ISICEM. We spend most of our time with HOT-COVID published by Nielson et al and then dip a little into individualized treatment effects of oxygen targets published by Buell et al - both published in JAMA March 2024. The latter is a complex topic and we hit some of the high points but please reach out to us if you want a more in depth discussion! HOT-COVID: https://pubmed.ncbi.nlm.nih.gov/38501214/ Individualized Treatment Effects: https://pubmed.ncbi.nlm.nih.gov/38501205/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 33! In this episode we are excited to be joined by Eddy Fan and Whitney Gannon, two extraordinary ECMO researchers to talk about VENT-AVOID or " Extracorporeal Carbon Dioxide Removal to Avoid Invasive Ventilation During Exacerbations of Chronic Obstructive Pulmonary Disease" published March 2024 by Duggal et al in the ATS Blue Journal. VENT-AVOID: https://pubmed.ncbi.nlm.nih.gov/38261630/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 32! We got a lot of feedback on our last episode so we decided to address it in a full episode! A lot of listeners asked us about vasopressors specifically vasopressin and angiotensin-2 so we talk about VASST, VANISH, and ATHOS-3. It is a full episode but a good one! VASST: https://pubmed.ncbi.nlm.nih.gov/18305265/ VANISH: https://pubmed.ncbi.nlm.nih.gov/27483065/ ATHOS-3: https://pubmed.ncbi.nlm.nih.gov/28528561/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 31! This episode we talk first about invasive vs non-invasive blood pressures from an observational paper titled "Accuracy of Noninvasive Blood Pressure Monitoring in Critically Ill Adults" published in journal of Intensive Care Medicine by Haber et al and then for our old trial we further the discussion of blood pressure by talking about the 65 trial! Non-invasive vs invasive blood pressure: https://pubmed.ncbi.nlm.nih.gov/38215002/ 65 Trial: https://pubmed.ncbi.nlm.nih.gov/32049269/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 30! This episode is a little different. We recap the SCCM conference first. THEN we go into PROPHY-VAP or "Ceftriaxone to prevent early ventilator-associated pneumonia in patients with acute brain injury" published January 2024 by Professor Dahyot-Fizelier in Lancet Respiratory Medicine. Then we dive into our long neglected mailbag to review listener questions about MINT, intubation timing, ACORN, and all the steroids in ARDS talk PROPHY-VAP: https://pubmed.ncbi.nlm.nih.gov/38262428/ SCCM Steroid guidelines: https://pubmed.ncbi.nlm.nih.gov/38240492/ Counter-Point should we use steroids in ARDS: https://pubmed.ncbi.nlm.nih.gov/33422201/ sRAGE in NIV and HFNC: https://pubmed.ncbi.nlm.nih.gov/38250011/ Anaerobes in Aspiration: https://pubmed.ncbi.nlm.nih.gov/37250794/ Anaerobes in Gut: https://pubmed.ncbi.nlm.nih.gov/36229047/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 29! We stray a little bit from our new and old article structure to talk about two recently published but slightly different ARDS recommendations from ATS and ESCIM. We compare and contrast them and give our takes on the data and evidence. Thanks to everyone who emails in and gives feedback, we will do our mail bag next episode! ATS Guidelines: https://pubmed.ncbi.nlm.nih.gov/38032683/ ESICM guidelines: https://pubmed.ncbi.nlm.nih.gov/37326646/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 28! In this episodes we talk about ECMO! PRONECMO evaluated the effect of prone positioning on patients already on ECMO by Schmidt et al in JAMA December 2023 and then EOLIA by Combes et al in NEJM 2018 which is our old article which randomized patients to ECMO or not. Great discussion here! PRONECMO: https://pubmed.ncbi.nlm.nih.gov/38038395/ EOLIA: https://pubmed.ncbi.nlm.nih.gov/29791822/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 27! In this episodes we sit down to talk all about the "when" to intubate a patient centered around acute poisoning in the NICO trial or "Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning: A Randomized Clinical Trial" published by Freud et al in JAMA November 2023. We ended up talk a lot about that so we cut our old article a little bit short and discuss a couple of JAMA articles about definitive airways in out of hospital cardiac arrest NICO: https://pubmed.ncbi.nlm.nih.gov/38019968/ PART: https://pubmed.ncbi.nlm.nih.gov/30167699/ Prehospital advanced airway: https://pubmed.ncbi.nlm.nih.gov/23321764/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

This was easily our most requested article to discuss and for good reason - Eddie and Todd recently published the ACORN trial or "Cefepime vs Piperacillin-Tazobactam in Adults Hospitalized With Acute Infection" in JAMA October 2023. We recognize our bias as the first and last authors on the paper so we wanted to get some other smart people in the studio to balance us out so we partnered with Furf and Monty of PulmPEEPs for this episode. It is simul-dropping on their feed as well. Thank you to them for a great episode and the opportunity to talk about our trial! ACORN: https://pubmed.ncbi.nlm.nih.gov/37837651/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 25! In this episode we talk about the MINT trial or "Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia" published in NEJM November 2023 by Carson et al. We supplement this with a recent observational cohort study that gives Todd anxiety titled "Intracerebral Hemorrhage Among Blood Donors and Their Transfusion Recipients" by Zhao et al in JAMA September 2023. MINT: https://pubmed.ncbi.nlm.nih.gov/37952133/ TRACS: https://pubmed.ncbi.nlm.nih.gov/20940381/ REALITY: https://pubmed.ncbi.nlm.nih.gov/33560322/ ICH in transfusions: https://pubmed.ncbi.nlm.nih.gov/37698562/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 24! Three trials about COVID were published with ESICM which we talk about all three here. COVID has been decreasing in prevalence in our ICU at least so we anchor our discussion around what we can learn from these trials about ARDS in general or what we can carry forward to future pandemics compared to our typical "Are we using this in our practice". Simvastatin: https://pubmed.ncbi.nlm.nih.gov/37888913/ Vitamin C: https://pubmed.ncbi.nlm.nih.gov/37877585/ Convalescent Plasma: https://pubmed.ncbi.nlm.nih.gov/37889107/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 23! We spend a little bit of time talking about our recent conference related travel and food experience but dive into our coverage of the trials that released with ESICM including "Inhaled Amikacin to Prevent Ventilator-Associated Pneumonia" by Ehrmann et al published in NEJM and "Landiolol and Organ Failure in Patients With Septic Shock" by Whitehouse et al in JAMA, both October 2023 AMIKINHAL: https://pubmed.ncbi.nlm.nih.gov/37888914/ STRESS-L: https://pubmed.ncbi.nlm.nih.gov/37877587/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 22! In this episode we talk about "Peripheral Administration of Norepinephrine: A Prospective Observational Study" published August 2023 by Yerke et al in CHEST. For our old article we talk about "Effect of midodrine versus placebo on time to vasopressor discontinuation in patients with persistent hypotension in the intensive care unit (MIDAS)" by Santer et al published October 2020 by Santer et al. No mailbag this time, we recorded this episode ahead of time to account for travel schedules. Peripheral Pressors: https://pubmed.ncbi.nlm.nih.gov/37611862/ MIDAS: https://pubmed.ncbi.nlm.nih.gov/32885276/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Live show? Thank you so much to the organizers of the ACNP/PA Critical Care Bootcamp who invited us to do a live episode of the show! We talked about the AKIKI2 trial "Comparison of two delayed strategies for renal replacement therapy initiation for severe acute kidney injury" by Gaudry et al in Lancet 2021. AKIKI2: https://pubmed.ncbi.nlm.nih.gov/33812488/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 21! In this episode we talk about "Extracorporeal Life Support in Infarct-Related Cardiogenic Shock" published August 2023 by Thiele et al in NEJM. Then we dive into our neglected mail bad to try to answer some listener questions. ECLS-SHOCK: https://pubmed.ncbi.nlm.nih.gov/37634145/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 20! In this episode we talk about "Effect of Selective Decontamination of the Digestive Tract on Hospital Mortality in Critically Ill Patients Receiving Mechanical Ventilation" published October 2022 by the ANZICS group in JAMA. We have the first author and senior authors on the accompanying systematic review and meta-analysis, Naomi Hammond and Anthony Delany, all the way from Australia (!) on with us to talk to us about the trial. SuDDICU: https://pubmed.ncbi.nlm.nih.gov/36286097/ Meta-analysis: https://pubmed.ncbi.nlm.nih.gov/36286098/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Episode 19! In this episode we talk about "Oxygen-Saturation Targets for Critically Ill Adults Receiving Mechanical Ventilation" published November 2022 by Semler et al in the New England Journal of Medicine. We have the first author, Matt Semler, on with us to talk to us about the trial and his improv comedy claim to fame. PILOT: https://pubmed.ncbi.nlm.nih.gov/36278971/ If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!