Critical Matters

In this episode of Critical Matters, we will discuss the critical care management of the patient with anaphylaxis. Our guest is Dr. Guha Krishnaswamy. Dr. Krishnaswamy is a Professor of Medicine in the Section of Pulmonary, Critical Care, Allergy and Immunology and the Section of Infectious Diseases in the Wake Forest School of Medicine. He is also chief, of the Section of Allergy, Asthma and Immu...

May is Mental Health Awareness Month, a time to reflect on important aspects of mental health, work to alleviate its burden, and reduce the stigma associated with mental health problems. After an unprecedented year in critical care with the COVID-19 pandemic, these topics are more relevant than ever. In this episode of Critical Matters, we will discuss the topic of clinician well-being. We will di...

In this episode of Critical Matters, we will discuss judgment under uncertainty and how to make better decisions. The episode is based on a recent webinar I had the opportunity to present as part of Sound Critical Care’s Leadership Week. During this episode I will discuss judgments in the context of the COVID-19 pandemic, explore the science behind how we make decisions and finally share some thou...

In this episode of Critical Matters, we will discuss ICU Liberation and the A-F Bundles during the COVID-19 pandemic. Our guest is Dr. Wesley Ely (@WesElyMD), professor of medicine at Vanderbilt University School of Medicine. He is the co-director of the Center for Critical Illness, Brain dysfunction, and Survivorship (CIBS Center), which has enrolled thousands of patients into clinical trials, an...

In this episode of Critical Matters, we will discuss the evidence-based management of severe and fulminant Clostridioides difficile infection(CDI) in the intensive care unit. Our guest is Dr. Max W. Adelman, a member of the Division of Infectious Diseases and the Department of Medicine, at Emory University School of Medicine in Atlanta. Additional Resources: Critical Care Management of the Patient...

In today's episode of Critical Matters, we will discuss the use of Extracorporeal Life Support (ECLS) in the form of extracorporeal membrane oxygenation (ECMO) for the treatment of the sickest patients with COVID-19 induced ARDS. Our guest is Dr. Jenelle Badulak. Dr. Badulak is an emergency physician and intensivist caring for patients in the Emergency Department, Cardiothoracic Intensive Care Uni...

Burnout is a major problem in critical care medicine. The COVID-19 pandemic has exacerbated this problem. However, we as clinicians should aspire to more from our careers than the mere elimination or mitigation of burnout. In today's episode of the podcast, we will explore some ideas that go beyond burnout. This is a recent talk given by Dr. Zanotti entitled, “Finding Joy in our Work, The Path to...

In this episode of Critical Matters, we will continue our discussion on the management of acute-on-chronic liver failure (ACLF) in the ICU. Part 2 will cover pulmonary, rena,l and endocrine recommendations for ACLF patients. In a previous episode (Management of ACLF: Part 1) we covered an introduction to ACLF, cardiovascular, and hematology management recommendations. Our guest is Dr. Nanchal, a p...

In this episode of Critical Matters, we will discuss the management of acute-on-chronic liver failure (ACLF) in the ICU. Our guest is 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 the lead author of the Society of Critical...

In this episode of Critical Matters, we will discuss thrombosis in COVID-19. We will discuss the pathophysiology, diagnosis, and management of arterial and venous thrombosis in COVID-19. Our guest is Dr. Gregory Piazza, a cardiovascular medicine specialist at Brigham and Women’s Hospital in Boston. Dr. Piazza is the Director of the Vascular Medicine Section, in the Division of Cardiovascular Medic...

In this episode of Critical Matters, we will discuss how to make teams better. Teams are ubiquitous in the practice of critical care medicine. Understanding the elements that are required for a high functioning team is essential in our quest to deliver high-value critical care. This episode is based on a presentation given by Dr. Zanotti during the latest Sound Critical Care Leadership Week. Addit...

In this episode of Critical Matters, we will discuss brain death by neurologic criteria. Brain death remains an important topic within the practice of critical care medicine. However, there are still inconsistencies in concept, criteria, practice, and documentation of brain death. Today we will discuss this topic through the lens of "The World Brain Death Project." Our guest is Dr. David Greer, Ch...

In this episode of Critical Matters, we will discuss innovation in care through the lens of process and workflow. Over the last several months, we have discussed new drugs, novel therapeutic approaches, and ventilator management strategies. However, the most vital source of innovation and success has been adapting to COVID-19 with new ICU workflows. Our guest is Dr. Laura Rock, a pulmonary and cri...

In this episode of Critical Matters, we will discuss mechanical ventilation. Our guest is Dr. Eduardo Mireles-Cabodevila, a practicing pulmonary critical care physician and Director of the Medical Intensive Care Unit at the Cleveland Clinic. His areas of clinical interest are critical care medicine, application of mechanical ventilation, acute and chronic respiratory failure, and extracorporeal li...

In this episode of Critical Matters, we will take a deep dive into the topic of corticosteroids in COVID-19 ARDS. Our guest is Todd Rice, MD, an Associate Professor of Medicine in the Division of Allergy, Pulmonary and Critical Care Medicine at Vanderbilt University. Dr. Rice is an accomplished physician-scientist focused on research in patients with sepsis, ARDS, and acute respiratory failure. He...

In this episode of Critical Matters, we will discuss hypotension and new data on Angiotensin II within the context of our path towards personalized vasopressor support. Our guest is Dr. Ashish K. Khanna. Dr. Khanna is an anesthesia and critical care practicing physician. He is Associate Professor, and Section Head for Research, in the Department of Anesthesiology, Section on Critical Care Medicine...

In this episode of Critical Matters, we will discuss racism in healthcare. Our guest is Dr. Gregory R. Johnson. Dr. Johnson is Chief Medical Officer of Hospital Medicine for Sound Physicians. In his role as CMO for Hospital Medicine, he has clinical leadership responsibility for over 200 hospital medicine programs and thousands of clinicians that care for millions of patients every year. Dr. Johns...

In this episode of Critical Matters, we discuss the management of COVID induced ARDS. Our guest is Dr. Eddy Fan, 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 and a Staff Intensivist at the University Health Network/Mount Sinai Hospital. He is currently the Medical Direct...

In this episode of Critical Matters, we discuss pregnancy, critical care, and COVID-19. Our guest is Dr. Cesar Padilla. Dr. Padilla is an attending physician in the Department of Intensive Care and Resuscitation in the Cleveland Clinic in OHIO. He is a practicing anesthesia critical care physician with additional expertise and training in obstetric anesthesia. He is extremely interested in promoti...

In this episode of Critical Matters, we discuss challenges related to providing compassionate patient aligned care in the intensive care unit within the frame of COVID-19. We also explore “The Pause”, a simple yet innovative practice with the power to transform our practices. Our guest is Dr. Silvia Perez Protto, an anesthesia and critical care attending at the Cleveland Clinic. Dr. Perez Protto i...

In this episode of the Critical Matters, we will discuss acute kidney injury (AKI) in patients with COVID-19. Our guest is Dr. Claudio Ronco, a thought leader in the field of acute kidney injury and nephrology critical care. Dr. Ronco is professor of Nephrology at the University of Padua. Dr. Ronco is also Director of the Department of Nephrology Dialysis & Transplantation and of the International...

In this episode of Critical Matters, we continue our exploration and discussion on respiratory support and mechanical ventilation with COVID-19. Our guest is Dr. John J. Marini, a thought leader in the field of critical care. Dr. Marini is Director of Academic Programs in Research and Education for the Department of Medicine of the Regions Hospital in St. Paul, Minnesota. In most of his research,...

In this episode of Critical Matters, we discuss ethical issues related to the COVID-19 pandemic. Our guest is Arthur L. Caplan, Ph. D. Dr. Caplan is the director of the Division of Medical Ethics at New York University Langone Medical Center and School of Medicine. He is the author and editor of 35 books and 750 peer-reviewed articles. Dr. Caplan is a recognized thought leader and expert in the fi...

On this episode of Critical Matters, we will focus on respiratory support and mechanical ventilation with COVID-19. Our guest is Dr. Luciano Gattinoni, a thought leader in the field of critical care. Dr. Gattinoni introduced the concept of lung rest by extracorporeal CO2 removal in acute respiratory failure. He pioneered the use of thoracic CT in ARDS, which culminated in the "baby lung", lung rec...

In this episode of Critical Matters, we continue to discuss issues related to the COVID- 19 pandemic. The numbers of cases continue to rapidly climb in the US and the world. There are serious concerns for adequate supplies of personal protective equipment for clinicians. In today’s episode we talk about the rational use of personal protective equipment. We try to focus on facts over fear. The disc...