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March 19, 2015

Concise Critical Appraisal

Is Fluid Overload Associated with Mortality in Children?

Education

No Cost, Online CME Activities from the 43rd Critical Care Congress
2015 Editions of Current Concepts in Adult and Pediatric Critical Care Available
Webcast Aims to Increase Knowledge in Determining DNC
Registration Open for the Summer Critical Care Ultrasound Courses
Upcoming Webcast Will Explore Understanding of Brain Death

SCCM News

Video: ICU Survivor Discusses His Struggle with Delirium
Is Fluid Overload Associated with Mortality in Children?

Early fluid resuscitation remains an integral therapy in most critically ill children with sepsis.  However, as of late, an increasing body of literature (i.e., studies by Modem et al and Sutherland et al) has reported that fluid overload in critical illness may be associated with increasing mortality. Sinitsky and colleagues investigated the association of early fluid overload with respiratory parameters and mortality in a general pediatric intensive care unit (PICU) population.

The authors found that, in this general PICU population, fluid overload percent (%FO) at 48 hours was associated with oxygenation index at 48 hours and need for invasive ventilation in survivors. However, no association was detected between %FO and mortality.

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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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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2015 Editions of Current Concepts in Adult and Pediatric Critical Care Available

Each year, the Society of Critical Care Medicine’s (SCCM) popular Congress pre-courses, Current Concepts in Adult Critical Care and Current Concepts in Pediatric Critical Care, deliver the latest clinical information applicable to patients in the intensive care unit. These courses are now available On Demand and the companion textbooks are available in print and as eBooks.

Save over 10% by purchasing the Adult or Pediatric bundle, each containing the 2015 textbook and unlimited access to the On Demand course.

pi-lg-CCACC15BUNDThe 2015 version of Current Concepts in Adult Critical Care includes the topics:

  • Management of the “Almost Never Events”
  • Early Mobility
  • Antithrombolytics and Antiplatelet Therapy in the Intensive Care Unit
  • How to Start an Extracorporeal Membrane Oxygenation Program

Among the topics in the 2015 version of Current Concepts in Pediatric Critical Care pi-lg-CCPCC15BUNDare:

  • Diabetic Ketoacidosis and Cerebral Edema
  • Extracorporeal Membrane Oxygenation in High-Risk Populations
  • Managing Comfort in the Critically Ill Pediatric Patient
  • Donation After Cardiac Death

All of the Current Concepts resources are available for purchase in the SCCM store. If you have any questions, please contact SCCM Customer Service at +1 847 827-6888.

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Webcast Aims to Increase Knowledge in Determining DNC

Review the most up-to-date research and processes in determining death by neurological criteria (DNC) in the webcast, Death by Neurological Criteria: Diagnosis and Management, the latest offering from the Society of Critical Care Medicine’s (SCCM) Controversies in Critical Care series. This webcast aims to improve your confidence and knowledge in determining DNC.

Expert faculty, David Greer, MD, FAHA, FNCS, FAAN, FCCM, and Jose Javier Provencio, MD, FAAN, FNCS, FCCM, will examine the appropriate use of ancillary testing and discuss skills to successfully engage families and surrogates in conversation and decision making after DNC.

Learning Objectives

  • List the objective clinical tools needed to arrive at a DNC diagnosis and describe the management and organ support (hemodynamics, electrolytes, endocrine imbalances) for DNC patients
  • Articulate the indications and pros/cons for ancillary testing to support a DNC diagnosis
  • Explain techniques and authoritative and unambiguous terms used by experts to appropriately engage families and surrogates in the discussion of DNC, and recognize the related common cross-cultural, ethnic and religious sensitivities

This webcast will take place on Wednesday, March 25, 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 for members ($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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Registration Open for the Summer Critical Care Ultrasound Courses

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 skills during the Society of Critical Care Medicine’s (SCCM) Critical Care Ultrasound courses.

Obtain 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 and interactive presentations to reinforce key learning points. Extensive faculty coverage ensures a significant hands-on experience for each participant.

New this year, SCCM’s Advanced Critical Care Ultrasound course is also offered in a pediatric format.

In both the adult and pediatric one-day advanced 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 explore 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. Register today by visiting the ultrasound courses webpage.

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Upcoming Webcast Will Explore Understanding of Brain Death

Registration is now open for Understanding Brain Death: From Experts to Laypersons, a collaborative webcast from the Society of Critical Care Medicine’s (SCCM) Emergency Medicine Section and Project Dispatch. During this session, Isaac Tawil, MD, FCCM, Chair of the Emergency Medicine Section and Associate Professor of Emergency Medicine and Intensive Care at the University of New Mexico Health Sciences Center, and David Seder, MD, FCCM, Director of Neurocritical Care at Maine Medical Center, will explore the understanding of brain death by experts and the lay community and provide insight on how interactions with patients and families can contribute to patient-centered outcomes.

Learning Objectives

  • Review medical literature on understandings of brain death among clinicians and laypersons
  • Discuss interventions to improve the understanding and clinical evaluation of brain death
  • Review the guidelines and challenges of brain death determination
  • Discuss patient-centered outcomes

This 60-minute webcast will take place on Wednesday, April 8, 2015, at 2:00 p.m. Central Time.

Register online today using your Customer ID and password. Complimentary registration is made possible by a grant from the Agency for Healthcare Research and Quality (AHRQ).

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

This webcast was organized by SCCM’s Project Dispatch in collaboration with the Emergency Medicine Section. Project Dispatch focuses on the patient and family experience. The initiative highlights a number of patient-centered care approaches to encourage awareness and adoption at the bedside among SCCM’s members. This project is supported by grant number R18HS21940 from AHRQ. The content is solely the responsibility of the authors and does not necessarily represent the official views of AHRQ.

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Video: ICU Survivor Discusses His Struggle with Delirium

In this illuminating video, intensive care unit (ICU) survivor Anthony Russo provides an emotional and frank account of his ICU experience following his infection with the H1N1 virus. Anthony paints a vivid and heart-wrenching picture of his struggle with delirium and its long-term impact on his life. He also discusses the heroic efforts of the medical team at Sutter Health who oversaw his care.

After watching the video, you are encouraged to visit www.ICULiberation.org to learn about the upcoming grant-funded ICU learning collaborative and the fall simulation-based conference being offered by the Society of Critical Care Medicine at Vanderbilt University Medical Center. The ICU Liberation Initiative aims to engage clinicians in improving practice and patient outcomes related to pain, agitation and delirium. Consider how your ICU can become a part of this growing campaign.

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Accurately setting PEEP with transpulmonary pressure

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