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December 18, 2014

Concise Critical Appraisal

Noninvasive Ventilation for Severe Exacerbations of COPD
The Efficacy of Subglottic Secretion Suctioning

Education

Stop CAUTI in the ICU
No Cost, Online CME Activities from the 43rd Critical Care Congress
44th Critical Care Congress On Demand Is Now Available
Registration Open for 2015 Adult Board Review Course
Webcast to Discuss Prone Positioning of ARDS Patients

SCCM News

It’s Not Too Late to Attend the 44th Critical Care Congress
SCCM Forms the SCCM-Weil Research Trust
David J. Martin Inducted as a Fellow of the Institute of Medicine of Chicago
New LearnICU.org Resources Available
SCCM’s 44th Critical Care Congress a Resounding Success
International Liaison Committee on Resuscitation Seeking Input
The Efficacy of Subglottic Secretion Suctioning

Pneumonia is a common ventilator-associated event (VAE), yet consensus on its definition (it had been traditionally referred to as ventilator-associated pneumonia [VAP]) is lacking. Despite this, many strategies have been shown to decrease its incidence. Damas et al conducted a single-center, randomized controlled trial in Belgium assessing the effect of subglottic secretion suctioning on VAP incidence.

They found that subglottic secretion suctioning resulted in a significant reduction of VAP prevalence. Though we now have consistent evidence showing the benefit of subglottic suctioning, cost analyses touting its worth and guidelines recommending its use, why has the critical care community not adopted this practice more widely?

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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Noninvasive Ventilation for Severe Exacerbations of COPD

Noninvasive ventilation (NIV) can be used for patients with chronic obstructive pulmonary disease (COPD), and previous reports have demonstrated a survival benefit when NIV is used in carefully selected patient populations. Lindenauer and colleagues sought to compare the outcomes for patients with COPD treated with NIV versus invasive mechanical ventilation (IMV) using data from a network of U.S. hospitals reporting to a voluntary, fee-supported quality improvement database.

The authors found that patients with COPD treated with NIV at the time of hospitalization had lower inpatient mortality, shorter length of stay and lower costs compared to those treated with IMV. A major strength of this study is the use of a large, externally generalizable population. As with all observational studies, however, residual confounding remains a methodological flaw, which the authors attempted to control for with advanced statistical techniques. All said, among patients hospitalized for COPD exacerbations, NIV seems to be a prudent initial choice for ventilatory support based on the results of this study.

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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44th Critical Care Congress On Demand Is Now Available

Now you can experience the stimulating educational content from the Society of Critical Care Medicine’s (SCCM) 44th Critical Care Congress as if you were there.

Congress On Demand provides access to the audio recordings and slides from hundreds of individual presentations drawn from the concurrent, joint and plenary educational sessions, as well as the symposia, at the 2015 Critical Care Congress in Phoenix, Arizona, USA. It is the next best thing from attending the live event. Once you’ve purchased Congress On Demand, you can access the materials as often as you like by logging into www.MySCCM.org.

Congress On Demand is available for purchase in the SCCM store. The subscription rate for SCCM members is just $295 ($385 for nonmembers).

Additionally, many of the pre-Congress courses are available for purchase. These include:

• 2015 Coding and Billing On Demand
• Acute Kidney Injury and Renal Replacement Therapies On Demand
• Advanced Practice Providers: Administration, Leadership and Outcomes On Demand
• Critical Care of the Patient with Liver Disease On Demand
• Critical Care Pharmacotherapy: Challenges and Controversies On Demand

Bring the Congress educational experience to your home or office.  Please contact SCCM Customer Service at +1 847 827-6888 with any questions.

If you attended this year’s Congress, your subscription to this service was included in your registration fee. If you were a registrant for a pre-Congress educational session, your Congress On Demand subscription includes complimentary access to that session. The materials can be accessed by logging into www.MySCCM.org with your customer ID and password.

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Stop CAUTI in the ICU

Catheter-associated urinary tract infections (CAUTIs) are the most common type of healthcare-associated infection. On the CUSP: Stop CAUTI in the ICU is a groundbreaking national initiative that uses the Comprehensive Unit-based Safety Program (CUSP) and evidence-based interventions to reduce CAUTI.

Learn about the clinical and cultural interventions of this initiative from national faculty experts during the American Hospital Association’s course, CUSP/CAUTI Boot Camp, which will be held prior to the Society of Critical Care Medicine’s 44th Critical Care Congress. Topics include CUSP, learning from defects, frequency of culturing, engaging patients and families, and real success stories from those implementing the work in their intensive care units.

CUSP/CAUTI Boot Camp will be held on January 16, 2015, from 8:30 a.m. to 5:00 p.m. at the Sheraton Phoenix Downtown Hotel in Phoenix, Arizona, USA. Register online by December 31, 2014, to secure your seat.

Complimentary registration is made possible by a grant from the Agency for Healthcare Research and Quality (AHRQ).

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No Cost, Online CME Activities from the 43rd Critical Care Congress

Several videos featuring the industry-supported sessions from the Society of Critical Care Medicine’s (SCCM) 2014 Critical Care Congress in San Francisco, California, USA, are available in the SCCM Store. Whether you missed the 2014 Congress or couldn’t make it to all the sessions of interest, you can still participate in the most popular events online at your convenience. Earn free continuing medical education (CME) credits by viewing any of the following webcasts and then applying for credit.

Can We Feed? Ensuring Optimal Early Enteral NutritionSupported by educational grants from Abbott Nutrition and Nestlé HealthCare Nutrition, Inc.

This offering identifies the development and initiation of early enteral nutrition therapy in the intensive care unit (ICU), compensatory enteral nutrition administration techniques, and strategies to reduce the incidence of aspiration and aspiration-related pneumonia in critically ill, tube-fed patients.

Feed Your Brain: It’s Not Just About Calories!Supported by an educational grant from Abbott Nutrition

In this session, expert faculty identify the basic concepts for optimal ICU nutritional support, examine pros and cons of pre- and probiotic use in the ICU and translate research findings into ICU management protocols.

Hemostatic Resuscitation and Acute Coagulopathy in the ICU – Supported by an educational grant from CSL Behring

This discussion focuses on the issues surrounding plasma and factor concentrates, as well as management of bleeding with the new anticoagulants.

Malnutrition: New International Etiology-Based DiagnosisSupported by an educational grant from Abbott Nutrition

The presenters discuss the integration of a cutting edge, international, etiology-based malnutrition diagnosis in the ICU, and outline characteristics of the diagnosis in the critically ill patient.

Noninvasive VentilationSupported by an educational grant from Covidien Puritan Bennett

This offering reviews the latest techniques in providing noninvasive ventilation and explores the efficacy of noninvasive ventilation in treating primary respiratory failure.

Pulmonary HypertensionSupported by an educational grant from Actelion Pharmaceuticals US, Inc.

Expert faculty describe basic management principles of patients with pulmonary hypertension, and look at developing a medication treatment plan for pulmonary hypertension.

Translation Research in Cardiopulmonary Resuscitation – Supported by an educational grant from ZOLL Medical Corporation

This offering details how outcomes of sudden death have not changed since the introduction of cardiopulmonary resuscitation, and examines how many established standards of medical care are wrong or less than perfect.

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Registration Open for 2015 Adult Board Review Course

Registration is now open for the Society of Critical Care Medicine’s 2015 Adult Multiprofessional Critical Care Board Review Course (MCCBRC). Register online using your customer ID and password or contact SCCM Customer Service at +1 847 827-6888. The 2015 Adult MCCBRC will be held at the Fairmont Chicago, Millennium Park, August 11 to 15, 2015, in Chicago, Illinois, USA.

MCCBRC sets the standard in board preparation with a comprehensive review that prepares fellows and attending physicians for the certification and recertification examinations in critical care. Led by internationally recognized faculty, this 4.5-day course offers expert guidance on the core areas of critical care medicine. Whether you need to certify, recertify or simply review, MCCBRC provides an excellent update and thorough overview of the field.

As a registered participant, you will benefit from:

• Online access to practice questions
• A comprehensive course syllabus
• Networking opportunities with colleagues and world-renowned experts
• Post-course online access to MCCBRC On Demand, which features slides and recorded speaker audio from all sessions of the live course

For more information and to view the complete line of available board review products, visit www.sccm.org/adultboardreview.

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Webcast to Discuss Prone Positioning of ARDS Patients

Prone positioning in patients with acute respiratory distress syndrome (ARDS) has been shown to significantly improve oxygenation and prevent ventilator-induced lung injury. In the pro/con webcast, Should We Prone All ARDS Patients?, the latest offering from the Society of Critical Care Medicine’s (SCCM) Controversies in Critical Care series, the latest evidence on the benefits, limitations and alternatives of prone positioning of patients with ARDS will be presented by Claude Guérin, MD, PhD, and Antonio Pesenti, MD, PhD. Jean-Louis Vincent, MD, PhD, FCCM, will moderate the discussion.

Learning Objectives

• Describe the rationale for using the prone position
• Explain the evidence supporting the use of the prone position
• Implement a proning strategy in the intensive care unit
• Identify limitations and alternatives to prone positioning

This webcast will take place on Tuesday, February 10, 2015, at 1:00 p.m. Central Time. Participants will receive 1 hour of continuing education credit.

Register online today using your customer ID and password. The registration fee for this 60-minute webcast is $30 ($40 for nonmembers). For institutions seeking unlimited participation at a single location, a $200 group rate is available. Please contact SCCM Customer Service at +1 847 827-6888 for details.

The Controversies in Critical Care webcast series is intended to provide insight into topics in critical care medicine for which no clear consensus or unequivocal evidence is available to guide practice decisions.

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It’s Not Too Late to Attend the 44th Critical Care Congress

Although the Society of Critical Care Medicine’s (SCCM) 44th Critical Care Congress is right around the corner, it’s not too late to participate. Registration will be accepted on site at the Phoenix Convention Center. An SCCM staff member will be available to assist you at the SCCM Registration Desk, located in the Phoenix Convention Center on the Lower Level, outside Exhibit Hall 5-6, beginning Thursday, January 15, 2015, from 4:00 p.m. to 7:00 p.m.

Download the Congress App
Prepare for the 44th Critical Care Congress by downloading the Congress App to access the complete schedule of events, create your schedule, view the list of speakers, and much more. Point your mobile web browser to www.sccm.org/ccc44app to access this handy tool. Search “SCCM” in Google Play or the iTunes store.

Taking place in Phoenix, Arizona, USA, January 17 to 21, 2015, the 44th Critical Care Congress offers attendees innovative learning opportunities from a diverse set of thought leaders from around the world. For more information, visit www.sccm.org/Congress or contact SCCM Customer Service at +1 847 827-6888.

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David J. Martin Inducted as a Fellow of the Institute of Medicine of Chicago

David-Martin-SMALL-WEB-14022_605editCongratulations to Society of Critical Care Medicine (SCCM) Chief Executive Officer and Executive Vice-President, David J. Martin, CAE, who was recently inducted as a Fellow of the Institute of Medicine of Chicago (IOMC).

Martin is the first critical care association executive to be recognized with this prestigious honor, which acknowledges his meritorious professional contributions and his proven leadership in improving the health of the community.

Founded in 1915, IOMC is an independent organization of distinguished leaders in the health field who collaborate to improve the health of the public. Drawing upon the expertise of a diverse membership and other regional leaders, IOMC addresses critical health issues through a range of interdisciplinary approaches that include education, research, communication of trusted information, and community engagement.

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SCCM Forms the SCCM-Weil Research Trust

Meeting at the conclusion of its 44th Annual Critical Care Congress, the Society of Critical Care Medicine’s (SCCM) governing Council voted to create the SCCM-Weil Research Trust.

Seeded with $1 million transferred from SCCM’s reserves, earnings from investment of the trust’s assets will be used to fund research grants in perpetuity. Society members and others motivated to support the expansion of critical care research will be invited to contribute to the trust.

“This investment allows us to double the amount of funding SCCM is giving out in grants to those researching ways to improve the care we provide to our patients,” Society President Craig M. Coopersmith, MD, FCCM, said. “It demonstrates our commitment to being part of the discovery and innovation needed to help secure future advances in the ICU.”

Explaining the motivation of SCCM’s leadership, Dr. Coopersmith added, “Our research seeks to help patients in the future, but has foundations in our past. The Society’s founder, Dr. Max Harry Weil, was a true visionary who committed his entire life to the pillars of academic life – patient care, discovery and innovation, and education. In addition to founding SCCM, Dr. Weil had a lifelong focus on performing patient-oriented research. The naming of this trust for Dr. Weil honors his legacy, and is a transformative step for our organization.”

The first grant from the SCCM-Weil Trust will be awarded in 2016 at the 45th Critical Care Congress in Orlando using the same criteria, rules and selection processes that govern the previously established Vision Grant program.

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New LearnICU.org Resources Available

New LearnICU.org resources are available, including a Critical Care Protocol Toolkit, developed by the Clinical Pharmacy and Pharmacology Section.

This new resource is meant to assist members of the critical care team with identifying clinical problems and developing, implementing and sustaining success in the provision of critical care services through the use of protocols, which can be defined as “standard set(s) of tasks that define precisely how classes of patients should be managed or treated.”

You are also encouraged to check out the latest Society of Critical Care Medicine eCommunity posts and join the discussion.

Choosing Wisely® and Nutrition in the ICU

Should the Choosing Wisely® recommendations be used as quality benchmarks for intensive care unit care?

Normothermia Protocols

Can anyone share lessons learned from implementing order sets that apply a protocolized approach to fever control in patients recovering from stroke and aneurysmal subarachnoid hemorrhage (aSAH)?

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SCCM’s 44th Critical Care Congress a Resounding Success

Thank you all for making the Society of Critical Care Medicine’s (SCCM) 44th Critical Care Congress in Phoenix, Arizona, USA, a great success! The 2015 Congress provided more than 6,000 critical care clinicians from around the world with unique opportunities to network with leadership in critical care and experience enlightened and innovative learning experiences.

Videos from key Congress sessions, including plenary sessions and the Presidential Address from Craig M. Coopersmith, MD, FCCM, are now available. You can also access bonus video interviews conducted with thought leaders in the field.

In addition, our iCritical Care podcast hosts had the opportunity to interview numerous Congress speakers and prominent members of the critical care community. Listen to these podcasts, including a sit-down with Dr. Coopersmith.

You are also encouraged to check out new articles released by JAMA and Critical Care Medicine during a late-breaker session at the 2015 Congress:

“Protocolized Sedation vs. Usual Care in Pediatric Patients Mechanically Ventilated for Acute Respiratory Failure”

• Accompanying Editorial

“Chlorhexidine Bathing and Health Care-Associated Infections: A Randomized Clinical Trial”

• Accompanying Editorial

“The Impact of Hospital and Intensive Care Unit Organizational Factors on Outcome in Critically Ill Patients: Results from the EPIC II Study”

“The Epidemiology of Chronic Critical Illness in the United States”

See you next year, February 20 to 24, 2016, in Orlando, Florida, USA, for SCCM’s 45th Critical Care Congress!

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International Liaison Committee on Resuscitation Seeking Input

The International Liaison Committee on Resuscitation (ILCOR) seeks to finalize systematic evidence evaluations for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC), relevant to the critical care community. ILCOR is using an online public commenting process (www.ilcor.org) and seeks important input from general members of the Society of Critical Care Medicine. The American Heart Association, in collaboration with ILCOR, is seeking public comment about scientific evidence evaluation questions that will be used to develop the 2015 guidelines, anticipated to be published on October 15, 2015.

Over 80 clinical and education questions and draft recommendations on a variety of resuscitation topics are now posted for review on ILCOR’s Scientific Evidence Evaluation and Review System at ILCOR.org/SEERS. More will be posted in the coming days. Public comments will be accepted through February 28. Each question posted focuses on a specific resuscitation topic and includes scientific evidence from relevant, peer-reviewed journals.

A number of topics are of high interest to the critical care community, including:

• Induced Hypothermia and Targeted Temperature Management
• Oxygen Dose after Return of Circulation
• Percutaneous Coronary Intervention after Return of Circulation
• Prognostication after Cardiac Arrest when Therapeutic Hypothermia Has Been Implemented

ILCOR’s Consensus on Science with Treatment Recommendations (CoSTR) is scheduled for online publication in the journal Circulation on October 15, 2015. Based in part on CoSTR, the 2015 AHA Guidelines for CPR and ECC will be published on the same date.

As key stakeholders in critical care and resuscitation, ILCOR encourages you and your peers to visit ILCOR.org/SEERS and to participate in the CoSTR public comment process.

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Dinner Symposium: Addressing the Rising Threat of Candidemia in the ICU: Mortality, Resistance and Cost Management through Rapid Species Identification

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