Saving Lives Podcast: Critical Care w/eddyjoemd

Albumin is one of those topics where everyone has an opinion, but very few people actually look at the cost-benefit data. In this lecture, I’m breaking down why the 5% albumin you’re hanging might be a waste of money, and where the 25% concentration actually moves the needle in septic shock and cardiac surgery. In this episode, we cover: The "Cool" Science: Where does this stuff come fro...

A new prospective multicenter cohort of 250 patients with shock examines the safety and outcomes of peripheral vasopressor administration. Extravasation events were rare and clustered only after several days of infusion, while norepinephrine use and simple physiologic markers correlated with survival. In this episode, I translate the findings into bedside guardrails—which sites and gauges to use,...

Intravenous dihydropyridine calcium channel blockers can quietly worsen oxygenation by blunting hypoxic pulmonary vasoconstriction. In this episode, we break down the bedside mechanism, which agents are implicated, who’s at highest risk (post-op atelectasis, obesity, pneumonia, focal ARDS, COPD), how soon it happens, and exactly what to do. The Vasopressor & Inotrope Handbook Amazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠...

In this episode of  Saving Lives: Critical Care Conversations , we discuss new evidence from the University of Pennsylvania that challenges how we time inotropic therapy in acute decompensated heart failure–related cardiogenic shock. This retrospective cohort study found that patients who received inotropes within eight hours of meeting SCAI stage C criteria had a 28-day mortality of 17%, compared...

In this episode of the Saving Lives Podcast, Eddy Joe breaks down a 2025  Journal of Critical Care  study examining how the choice of the internal jugular vein for initial central line placement impacts outcomes when patients later need hemodialysis catheters. You'll learn why using the left IJV first may reduce the need for repeat procedures and complications. Essential insights for optimizin...

In this episode, we dive into a new pilot RCT exploring the addition of acetazolamide to furosemide in critically ill patients. We break down the study’s methods, findings, and practical implications for fluid management in the ICU. Could this inexpensive, decades-old drug be the key to sustaining diuresis and preventing metabolic alkalosis? Tune in to find out. The Vasopressor & Inotrope Hand...

In this episode of the Saving Lives Podcast, we review a July 2025 study from the Journal of Intensive Care comparing methylprednisolone and hydrocortisone for severe pneumonia treatment. The discussion focuses on how these findings may influence clinical decisions, particularly for patients with septic shock. The Vasopressor & Inotrope Handbook Amazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/47qJZe1⁠⁠⁠⁠⁠⁠...

In this episode of the Saving Lives Podcast, we break down a 2025 study from  Intensive Care Medicine  that emulates a target trial on the use of sodium bicarbonate in ICU patients with metabolic acidosis. With over 6,000 patients across 12 Australian ICUs, the study reveals a small but significant reduction in mortality and RRT use with bicarbonate therapy. Tune in to learn how this could transfo...

In this episode of the Saving Lives Podcast, we review a comprehensive 2025 meta-analysis on mortality risk factors in pulmonary embolism. Learn which clinical signs, biomarkers, and imaging findings most strongly predict outcomes — and how they can guide triage and therapy decisions in acute PE cases. A must-listen for anyone managing thromboembolic disease in the critically ill patients. The Vas...

In this episode of the Saving Lives Podcast, we review a 2025 NEJM-Evidence study analyzing over 21,000 cases of severe hyponatremia to determine the safest and most effective correction rates. Learn why moderate correction (8–10 mmol/L/day) may actually reduce mortality, and how central pontine myelinolysis (CPM) remains rare even with faster correction. The Vasopressor & Inotrope Handbook I...

In this episode, we analyze a June 2025 study from the  Journal of Intensive Care , which shows that lower hemoglobin levels at admission are strongly associated with worse outcomes in cardiogenic shock. We dive into the data from the FRENSHOCK registry, uncover key subgroup findings, and discuss implications for transfusion strategies. Could this shift how we manage anemia in shock? Tune in and f...

In this episode of the Saving Lives Podcast, we reviews a 2024 multicenter study on valproic acid for hyperactive delirium and agitation in ICU patients. The findings show that VPA may help reduce sedation needs, improve ventilator synchrony, and resolve delirium without major adverse effects. Tune in for practical insights into this emerging option for complex critical care cases. The Vasopressor...

In this episode of the Saving Lives Podcast, we discuss a study from  Intensive Care Medicine  that explores whether baseline serum chloride and pH affect outcomes with balanced fluids versus saline. The findings from the PLUS trial show no significant interaction, but intriguing trends suggest that hyperchloremic patients may benefit more from balanced fluids. The Vasopressor & Inotrope Handb...

In this episode of the Saving Lives Podcast, we break down a randomized trial from CHEST (2025) comparing Normosol-R vs. Lactated Ringer’s in critically ill adults. Learn whether acetate/gluconate-buffered fluids offer advantages over lactate-buffered solutions regarding acid-base balance, kidney function, and mortality. Tune in to hear how this study impacts critical care fluid management! The Va...

In this episode of the Saving Lives Podcast, we review a 2025 study from  Critical Care Medicine  comparing lactated Ringer’s and normal saline for initial fluid resuscitation in sepsis-induced hypotension. The findings suggest that LR may improve survival and increase hospital-free days compared to NS, supporting current guidelines favoring balanced crystalloids. Tune in for a deep dive into the...

In this episode of the Saving Lives Podcast, we review a nationwide study on cardiogenic shock in general ICUs, recently published in the  European Heart Journal: Acute Cardiovascular Care . Discover why non-ischemic heart failure now leads cardiogenic shock admissions, which patient groups face the highest mortality, and how early ICU intervention can improve outcomes. Stay tuned for critical ins...

In this episode of the Saving Lives Podcast, we explore a systematic review and meta-analysis from the Journal of Critical Care on sleep interventions in ICU patients. We learn about the effectiveness of pharmacologic and non-pharmacologic strategies in reducing delirium and discover how improving sleep could transform critical care outcomes. The Vasopressor & Inotrope Handbook I have written...

In this episode of the Saving Lives Podcast, we dive into the latest research from CHEST, exploring how sepsis order sets can improve care value. Learn about the impact of these sets on reducing mortality, lowering hospital costs, and their role in streamlining sepsis management. Discover why order sets can be a game-changer for hospitals and society in addressing sepsis care. The Vasopressor &amp...

In this episode of the Saving Lives Podcast, Eddy Joe breaks down a study comparing continuous glucose monitoring systems (CGMS) to conventional point-of-care monitoring in ICU patients. Learn how CGMS improves glycemic control, reduces variability, and eases nursing workloads, even without reducing mortality. The Vasopressor & Inotrope Handbook I have written "The Vasopressor & Inotrope H...

In this episode of The Saving Lives Podcast, we explore Propofol Infusion Syndrome (PRIS), looking at this complication's incidence, laboratory, and clinical manifestations. Hat tip to the authors. The Vasopressor & Inotrope Handbook I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patient...

In this episode of The Saving Lives Podcast, we dive into a compelling study from the Annals of Intensive Care, exploring the prevalence and impact of hyperdynamic left ventricular systolic function in septic patients. Unpacking the findings, we discuss how this condition influences mortality rates and what it means for clinical practice in intensive care units. The Vasopressor & Inotrope Hand...

In this episode of The Saving Lives Podcast, we delve into the intricate subject of advance directives in the intensive care setting. Titled "Deciphering the Complex World of Advance Directives in ICU Care: Challenges and Solutions," the episode explores the historical background, implementation challenges, and the impact of advance directives on patient care within ICUs. Let's highlight the pract...

In this episode, we discuss recent findings on the potential risks of left atrial appendage closure (LAAC) in cardiac surgery patients without prior atrial fibrillation. The study highlights an increased risk of new-onset postoperative AF and prolonged hospital stays without clear benefits in mortality or stroke prevention. The Vasopressor & Inotrope Handbook I have written "The Vasopressor &a...

In this episode of the Saving Lives Podcast, Eddy Joe explores the TRISCEND II trial’s groundbreaking findings on transcatheter tricuspid valve replacement (TTVR) for severe tricuspid regurgitation. Learn about the quality-of-life improvements, procedural risks, and future directions for this innovative therapy. The Vasopressor & Inotrope Handbook I have written "The Vasopressor & Inotrope...

In this episode of the Saving Lives Podcast, we dive into the DecatSepsis trial, exploring the role of dexmedetomidine in reducing mortality and managing septic shock. Discover how this sedative could help mitigate the harmful effects of the hyperadrenergic state in septic patients. The Vasopressor & Inotrope Handbook I have written "The Vasopressor & Inotrope Handbook: A Practical Guide f...