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April 16, 2015

Concise Critical Appraisal

Examining the Efficacy of L-citrulline Supplementation
GCR Expression in Critically Ill Children with Cardiovascular Dysfunction

Education

Register for Upcoming ICU Liberation Events
Critical Care Ultrasound Courses Expected to Sell Out Early
Register Now for Sepsis Without Walls Conference
No-Cost, Online CME Activities from the 44th Critical Care Congress
Virtual Critical Care Rounds: Adult Now Available
Webcast Explores Implementing New ABCDEF Bundle in Your ICU
Register for ECMO Management Course
Gain Realistic, Hands-On Ultrasound Training

SCCM News

Apply Now for THRIVE Support Group Network Funding
Application Deadline Tomorrow for THRIVE Support Group Network Funding
Submit Your Abstract for SCCM’s 45th Critical Care Congress
Apply for the THRIVE Innovation Award
Volunteers Sought for Nepal Relief Efforts
Start Preparing for Critical Care Awareness Month
ACEP Seeking Mentors
Listen to the Latest iCritical Care Podcasts
Apply For ICU Design Citation Award
Examining the Efficacy of L-citrulline Supplementation

Chronic lung disease in neonates and infants can lead to progressive hypoxia-induced pulmonary hypertension. The development of pulmonary hypertension has been associated with increasing mortality in certain infants, and the therapies available are inadequate. Fike et al set out to determine whether starting L-citrulline (in newborn piglets) after the onset of pulmonary hypertension inhibits disease progression and improves nitric oxide production by recoupling endothelial nitric oxide synthase.

The authors found that oral L-citrulline treatment started after disease onset improves nitric oxide production by recoupling endothelial nitric oxide synthase and inhibits the further development of chronic hypoxia-induced pulmonary hypertension in this piglet model. This is an important translational study with novel treatment implications. Some clinical studies have already been done using prophylactic L-citrulline supplementation. However, more work using the supplement after the physiologic insult has occurred are clearly needed, and this study provides a strong background for further investigation.

Read the full Concise Critical Appraisal by logging into the SCCM eCommunity. Concise Critical Appraisal is a regular feature aimed at highlighting the best and most relevant literature from a variety of academic journals and encouraging discussion around recent studies and research.

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GCR Expression in Critically Ill Children with Cardiovascular Dysfunction

Various efforts have been made to better understand the interplay of glucocorticoid receptor (GCR) expression and critical illness, but many unknowns remain. Shibata et al hypothesized that a subset of critically ill children with cardiovascular (CV) collapse would demonstrate decreased expression of GCR and would have more severe illness (based on Pediatric Risk of Mortality [PRISM] III measurements) and more organ failure than critically ill children with no CV collapse.

In a comparison of these two groups, the investigators discovered a statistically significant decrease in GCR expression in CD4+ and CD8+ cells in critically ill children with CV failure. They also discovered that this diminished expression could be found in patients with higher PRISM III scores and those with greater organ failure burden. Ultimately, this study’s findings suggest that the lack of GCR expression in critically ill patients could serve as a risk factor for worsening severity of illness and CV failure.

Read the full Concise Critical Appraisal by logging into the SCCM eCommunity. Concise Critical Appraisal is a regular feature aimed at highlighting the best and most relevant literature from a variety of academic journals and encouraging discussion around recent studies and research.

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Critical Care Ultrasound Courses Expected to Sell Out Early

Focused ultrasound examinations in the critical care setting have become an extension of the clinical assessment because of their rapid, precise detection capabilities. Assist in the immediate management of patients by learning or enhancing point-of-care ultrasound skills. With the latest addition of Advanced Critical Care Ultrasound – Pediatric, the Society of Critical Care Medicine (SCCM) now offers four valuable ultrasound courses.

Critical Care Ultrasound (available in both Adult and Pediatric formats)

Gain the realistic training needed to perform and interpret ultrasound imaging with SCCM’s comprehensive, two-day Critical Care Ultrasound  or Critical Care Ultrasound – Pediatric course. In each, participants benefit from guided, focused skill stations featuring live models and interactive presentations to reinforce key learning points. Extensive faculty coverage ensures a significant hands-on experience for each participant.

Advanced Critical Care Ultrasound (available in both Adult and Pediatric formats)

In both the Advanced Critical Care Ultrasound and Advanced Critical Care Ultrasound – Pediatric one-day courses, fundamental skills and knowledge are expanded and focus on the specialty-specific use of echocardiography in the management of the critically ill patient. Participants are provided with important cardiovascular information for the noninvasive management of the hemodynamically unstable patient.

The summer ultrasound courses will be held August 16 to 18, 2015, at the Fairmont Chicago, Millennium Park, in Chicago, Illinois, USA. Space for these courses is limited. Visit the ultrasound courses webpage, and register today to guarantee your seat!

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Register for Upcoming ICU Liberation Events

The Society of Critical Care Medicine’s (SCCM) ICU Liberation Initiative aims to engage clinicians in improving practice and patient outcomes related to pain, agitation, delirium, and early mobility. Take advantage of two upcoming learning opportunities that will provide strategies to help reduce the risk of long-term consequences from an intensive care unit (ICU) stay.

Webcast: Successfully Overcoming Assessment and Treatment Challenges for ICU Pain
May 28, 2015
1:00 p.m. – 2:00 p.m. Central Time
Register online today

In this webcast, Céline Gélinas, PhD, RN, associate professor of nursing at McGill University, Aaron M. Joffe, DO, associate professor, Department of Anesthesiology & Pain Medicine at Harborview Medical Center, and Kathleen Puntillo, RN, PhD, FAAN, FCCM, professor emerita of nursing at University of California, San Francisco, will provide an overview of the landscape of pain assessment and management in ICU patients within the context of the ABCDEF bundle and offer suggestions for interventions. The presentation will conclude with a question-and-answer segment.  Registration for this webcast is complimentary.

Learning Objectives

  • Describe the importance of pain assessment and analgesic management within the framework of the ABCDEF bundle
  • Discuss the assessment of pain in non-communicative patients through use of the Critical-Care Pain Observation Tool (CPOT)
  • Evaluate pharmacological options for treating pain in critically ill patients
  • Provide answers to frequently asked questions about pain assessment and management challenges that occur in critical care practice

Live Event: ICU Liberation and Animation: Implementing the Pain, Agitation and Delirium Guidelines
September 9-10, 2015
Nashville, Tennessee, USA
Register online today

Secure your seat for this two-day didactic and simulation conference, held in partnership with Vanderbilt University Medical Center. Participants will review implementation strategies and discuss approaches to enable a more effective and lasting application of the pain, agitation and delirium (PAD) guidelines by utilizing the multiprofessional team.

During this conference, which will be held at Vanderbilt University Medical Center in Nashville, Tennessee, USA, internationally recognized faculty will present lectures on patient management strategies and engage participants in clinical scenarios through small-group simulation labs. Hospitals are encouraged to send a team of two or more participants who will then be able to implement these strategies within their hospital’s ICU after the conference.

If you have any questions regarding either event, please contact SCCM Customer Service at +1 847 827-6888.

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No-Cost, Online CME Activities from the 44th Critical Care Congress

Several videos featuring the industry-supported sessions from the Society of Critical Care Medicine’s (SCCM) 2015 Critical Care Congress in Phoenix, Arizona, USA, are now available in the SCCM Store. Whether you missed the 2015 Congress or couldn’t make it to all the sessions of interest, you can experience the educational content from the most popular sessions online at your convenience. Earn free continuing medical education (CME) credits by viewing any of the following webcasts and then applying for credit.

Acinetobacter baumannii: Coming to a Hospital Near You
Supported by an educational grant from The Medicines Company
This session discusses susceptibility patterns and patient risk factors, the emergence of Acinetobacter as an important nosocomial pathogen and treatment options and principles for prevention.

Best Practices for the Management of Invasive Fungal Infections in the ICU
Supported by an educational grant from Astellas Scientific and Medical Affairs, Inc.
Strategies for early diagnosis and appropriate treatment options are presented for patients at risk for invasive fungal infections.

Brain Function After Cardiac Arrest
Supported in part by an educational grant from ZOLL Medical Corporation
This session looks at the value of hypothermia versus strict normothermia for neuroprotection after cardiac resuscitation, the role of advanced monitoring and main predictive factors.

Breaking the Blood Bank: Anemia and Coagulation
Supported in part by an educational grant from CSL Behring
Alternative strategies are outlined for instances when blood products cannot be used, and available clinical data validate strategies for the patient in whom blood products are not a therapeutic option.

Crystalloid Versus Colloid: The Debate Rages On!
Supported in part by educational grants from Baxter Healthcare Corporation and Grifols
This session discusses controversies in fluid resuscitation, data from recent fluid trials, current practices, and the science behind fluid choice.

Diagnosis and Application of Current and Emerging Therapeutic Interventions for Hyponatremia in the Critical Care Patient
Supported by an educational grant from Otsuka America Pharmaceutical, Inc.
This session examines the diagnosis, presentation and impact of hyponatremia on patient outcomes, the safety and efficacy of current and emerging therapies and individualized treatment approaches in critical care patients.

Fluids Make the Difference in Organ Function and Survival with Sepsis
Supported in part by an educational grant from Baxter Healthcare Corporation
In this session, faculty discuss the current evidence for fluid therapy in sepsis, the application of individualized fluid therapy and differentiating intravenous fluids based on composition and safety profile.

Is Repair After Acute Kidney Injury Linked to Long-Term Outcomes?
Supported in part by an educational grant from Astute Medical, Inc.
This session presents the epidemiology, risk and adverse long-term outcomes of chronic kidney disease, the mechanisms of organ interaction and repair in acute kidney injury, and new biomarkers in the assessment of injury, recovery and treatment response.

Your Patient Is Positive for Clostridium difficile: “Oh Feces!”
Supported in part by an educational grant from Cubist Pharmaceuticals, Inc.
This session discusses the role of probiotics, the development of treatment algorithms and fecal transplantation as they relate to Clostridium difficile.

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Register Now for Sepsis Without Walls Conference

The Society of Critical Care Medicine (SCCM) and The Johns Hopkins University School of Medicine have partnered to bring you Sepsis Without Walls: Ensuring All Patients Receive Optimal, Time-Sensitive Care, which will be held September 25, 2015, at The Johns Hopkins University School of Medicine in Baltimore, Maryland, USA. The focus of this one-day interactive conference will be on strategies to identify, diagnose and manage patients who present with signs and symptoms of sepsis, irrespective of their care unit.

Early detection of sepsis, with the timely administration of appropriate antibiotics, appears to be the single most important factor in reducing morbidity and mortality from sepsis. Thus, healthcare providers need a high index of suspicion for the presence of sepsis and must begin appropriate antimicrobials quickly. Join the multiprofessional panel of leading experts who will focus on problem solving through case studies in developing effective strategies in specific patient populations.

Space for this course is limited. Register online or contact SCCM Customer Service at +1 847 827-6888 to reserve your spot.

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Webcast Explores Implementing New ABCDEF Bundle in Your ICU

Registration is now open for Road Map for Implementing the New ABCDEF Bundle in Your ICU, the latest webcast from the Society of Critical Care Medicine’s (SCCM) ICU Liberation series. Juliana Barr, MD, FCCM, and Mary Ann Barnes-Daly, RN, BSN, CCRN, DC, will provide a strategy for intensive care unit (ICU) teams striving to implement the new ABCDEF bundle. Faculty will examine the new element of the bundle: family engagement and empowerment.

The bundle includes:

A = Assess, Prevent and Manage Pain
B = Both Spontaneous Awakening Trials and Spontaneous Breathing Trials
C = Choice of Sedation
D = Delirium: Assess, Prevent and Manage
E = Early Mobility and Exercise
F = Family Engagement and Empowerment

Learning Objectives

  • Review elements of the new ABCDEF bundle
  • Develop a mental model for successful implementation of bundle elements in an ICU

This 60-minute webcast will take place on Tuesday, May 12, 2015, at 2:00 p.m. Central Time. Registration is complimentary for all participants.

Register online today using your Customer ID and password. If you have any questions, please contact SCCM Customer Service at +1 847 827-6888.

The ICU Liberation Initiative aims to engage clinicians in improving practice and patient outcomes related to pain, agitation, delirium, and early mobility.

Learn About the ABCDEF Improvement Collaborative

The Society of Critical Care Medicine is holding a series of informational conference calls to answer questions about ICU Liberation’s ABCDEF Improvement Collaborative. The Collaborative is seeking U.S. hospitals interested in improving outcomes for patients and families by reliably implementing the newly modified bundle. The calls will provide a platform for discussing the application process and posing questions about the program. If you are interested in applying for participation in the Collaborative, now is your chance to learn more.

Phone: +1 866 740-1260
Access Code: 9966907

Monday, April 20, 2015 — 11:30 a.m. Eastern Time
Wednesday, April 29, 2015 — 11:30 a.m. Eastern Time
Wednesday, May 6, 2015 — 11:30 a.m. Eastern Time

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Virtual Critical Care Rounds: Adult Now Available

Virtual Critical Care Rounds (VCCR), developed by the Society of Critical Care Medicine (SCCM), is designed to better prepare students, residents and fellows to contribute to the diagnosis and management of the critically ill patient during their intensive care unit (ICU) rounds.

VCCR: Adult, the enhanced replacement for the Adult Resident ICU (RICU) program, features:

  • Professionally narrated modules with clear learning objectives, engaging case studies, interactive questions, and a list of additional resources for further exploration
  • An expanded topic selection with lectures developed by leading experts on each subject
  • SCCM’s new, more efficient learning management platform, which allows program directors to view and monitor participants’ progress throughout the courses

The VCCR: Adult program contains two courses. VCCR I focuses on student level learning and features 18 modules covering topics such as antibiotics in the ICU, basic mechanical ventilation and organ donation. VCCR II, aimed at the resident and fellow levels, contains 15 modules exploring such topics as neurologic emergencies, sepsis and septic shock, and hemorrhagic shock. The VCCR courses are available as program director-led or self-directed products.

Visit www.sccm.org/VCCR to make a purchase or for more details.

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Gain Realistic, Hands-On Ultrasound Training

The Society of Critical Care Medicine (SCCM) now offers four Critical Care Ultrasound courses to help you build and enhance your ultrasound knowledge. The Critical Care Ultrasound courses will be held August 16 to 18, 2015, at the Fairmont Chicago, Millennium Park, in Chicago, Illinois, USA.

Obtain the realistic training needed to perform and interpret ultrasound imaging at Critical Care Ultrasound and Critical Care Ultrasound – Pediatric. During these two-day courses, participants benefit from guided, focused skill stations featuring live models and interactive presentations to reinforce key learning points. Extensive faculty coverage ensures a significant hands-on experience for each participant.

Attend Advanced Critical Care Ultrasound or Advanced Critical Care Ultrasound – Pediatric on August 18, 2015, to expand upon your fundamental skills and knowledge and focus on the specialty-specific use of echocardiography in the management of the critically ill patient. In both of these one-day courses, participants are provided with important cardiovascular information for the noninvasive management of the hemodynamically unstable patient.

These courses are expected to sell out early. Visit the ultrasound courses webpage and register today to guarantee your seat or contact SCCM Customer Service at +1 847 827-6888.

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Register for ECMO Management Course

Explore the basic management principles common to extracorporeal membrane oxygenation (ECMO) programs for both adult and pediatric patients with the Society of Critical Care Medicine’s (SCCM) ECMO Management course.

Led by expert faculty, this intense two-day simulation course will provide a comprehensive overview of ECMO programs. Participants will rotate through lectures and simulation scenarios. Each simulation group will have a maximum of 10 participants and two facilitators.

Learning Objectives

  • Identify the different components of the ECMO circuit and diagnose equipment malfunction
  • Determine the optimal ECMO settings in diseases commonly treated by ECMO
  • Recognize and manage the most common ECMO emergencies

This course will be held August 28 and 29, 2015, at the University of Arizona Center for Simulation and Innovation in Phoenix, Arizona, USA.

Register online today with your customer ID and password. Please contact SCCM Customer Service at +1 847 827-6888 with any questions.

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Submit Your Abstract for SCCM’s 45th Critical Care Congress

Abstract submission for the Society of Critical Care Medicine’s (SCCM) 45th Critical Care Congress is now open. Contribute to the advancement of critical care by submitting your original investigative research and case reports for presentation at the 2016 Congress, to be held in Orlando, Florida, USA. If accepted, your work will be on display in the Poster Hall from February 21 through February 23, 2016, and be published in Critical Care Medicine, the number one critical care subspecialty journal. You also will benefit from:

  • Star Research Presentation Opportunity: Authors of the top 64 abstracts are invited to give oral presentations during the regular Congress program without competition from other continuing education/continuing medical education sessions.
  • Research-in-Focus Theaters: Authors are invited to provide short presentations of their work moderated by a professor in the Exhibit Hall.
  • Awards: Multiple awards are offered for excellence and special accomplishments in critical care research, education and/or practice.

Complimentary registration is also available to one author per accepted abstract. To be eligible, the individual must be listed as the primary author on the original abstract form and be a member of SCCM in a category other than full physician as of August 3, 2015.

Abstracts may be submitted until 12:00 p.m. Central Daylight Savings Time on August 3, 2015. Visit www.sccm.org/abstracts for complete details on submission instructions, formatting guidelines and available awards.

The 2016 Critical Care Congress will be held February 20 to 24, 2016, in Orlando, Florida, USA. This five-day event will bring together more than 6,000 critical care clinicians from around the world, offering opportunities to share creative and stimulating ideas, make valuable connections and obtain inspired perspectives. Registration opens June 2015.

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Apply Now for THRIVE Support Group Network Funding

In support of the THRIVE initiative, the Society of Critical Care Medicine (SCCM) is proud to fund the first round of seed grants to foster an international network of in-person support groups linking survivors of critical illness and their families. These groups will offer survivors mutual support and the opportunity to share solutions to the challenges of recovery after an intensive care unit (ICU) stay.

Via a brief, expedited application process, SCCM will select up to five sites to inaugurate the initial networks. Participation is open to institutions that already have a support group in place, as well as those that wish to establish a new support system for patients. Participants will join together in regular calls to share knowledge about nurturing such groups and helping them grow. The goal of these grants is not to fund ICU follow-up clinics but rather to develop peer-support models with strong survivor co-leadership as the foundation for growing an international network. SCCM expects to add additional groups in each of the next two years.

Applications are due June 15, 2015.

If you have any questions, please contact SCCM staff partner Adair Andrews at aandrews@sccm.org.

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Application Deadline Tomorrow for THRIVE Support Group Network Funding

In support of the THRIVE initiative, the Society of Critical Care Medicine (SCCM) is proud to fund the second round of seed grants to foster an international network of in-person support groups linking survivors of critical illness and their families. These groups will offer survivors mutual support and the opportunity to share solutions to the challenges of recovery after an intensive care unit (ICU) stay.

Via a brief, expedited application process, SCCM will select five new sites to join the collaborative. Participation is open to institutions that already have a support group in place, as well as those that wish to establish a new support system for patients. Participants will join together in regular calls to share knowledge about nurturing such groups and helping them grow. The goal of these grants is not to fund ICU follow-up clinics but rather to develop peer-support models with strong survivor co-leadership as the foundation for growing an international network.

Applications are due June 17, 2016.

If you have any questions, please contact SCCM staff partner Adair Andrews at aandrews@sccm.org.

Also, learn more about post-intensive care syndrome and the efficacy of peer support groups by reading an informative peer-reviewed article that recently appeared in Advanced Critical Care.

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Start Preparing for Critical Care Awareness Month

As May approaches, it is time for intensive care unit (ICU) teams to consider how they will celebrate National Critical Care Awareness and Recognition Month (NCCARM). ICUs mark this special month in various ways, from sharing blue treats with staff or providing educational symposia, staff recognition ceremonies or ICU tours. Other units invite former patients and their families to meet staff and share their progress.

Regardless of how you celebrate NCCARM this year, be sure you wear blue on Friday, May 20, 2016, and share your stories and photos with the Society of Critical Care Medicine. You can inspire other ICUs as we all celebrate the extraordinary contributions of our critical care colleagues in May.

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ACEP Seeking Mentors

The American College of Emergency Physicians (ACEP) Ultrasound and Critical Care (US/CC) Subcommittees are building a database for those interested in serving as mentors in critical care/emergency ultrasonography. The goals are still in the development phase, but may include the following:  1) an online question and answer forum; 2) a blog/vlog question and answer forum, and 3) development of regional mini-fellowships.

The ACEP US/CC Subcommittees need volunteers to participate. If you are interested, please submit your preferred contact information to ACEP.USCC.Mentorship@gmail.com and include a brief bio about your training and current position.

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Ensuring the Safe Use of Parenteral Nutrition

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