Podcasts about ards

Long after acute infection has resolved, many survivors of severe COVID-19 experience persistent symptoms. Understanding the causes of long COVID and developing effective treatments pose a challenge for clinicians and researchers alike. In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Kyle B. Enfield, MD, speaks with Matthew Baldwin, MD, MS, about his article published in the March 2026 issue of Critical Care Explorations that examines post-acute sequelae of COVID-19 in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) survivors over a three-year period. One of the study's most notable findings is that approximately one in four study patients, many of whom were middle-aged and previously healthy, continued to meet criteria for long COVID three years after infection. This finding emphasizes the burden of chronic illness caused by COVID-19 infection and the need to focus research and treatment efforts on this population of ALI/ARDS survivors. Drs. Baldwin and Enfield discuss the relevance of inflammatory, thromboinflammatory, and endothelial biomarkers in understanding illness due to COVID-19. Surprisingly, the study found no association between long COVID symptoms and these biomarkers. Dr. Baldwin contextualizes this finding and encourages future studies to employ multiomics to better uncover the underlying mechanisms of these symptoms. The discussion emphasizes the patient-centered approach of the study, which examines functional outcomes as well as biomarkers. Dr. Baldwin encourages clinicians to validate the experiences of severe COVID-19 survivors and guide them towards the next step in their recovery as researchers continue to look for better therapies. Resources referenced in this episode: Baldwin M, Jones AE, McGroder CF, et al. Post-acute sequelae of COVID-19 persist over three years in acute lung injury/acute respiratory distress syndrome survivors but are not associated with persistent thromboinflammation or endothelial dysfunction. Crit Care Explor. 2026;8(3):e1390. Hodgson CL, Higgins AM, Bailey MJ, et al. Comparison of 6-month outcomes of survivors of COVID-19 versus non-COVID-19 critical illness. Am J Respir Crit Care Med. 2022;205(10):1159-1168. Herridge MS, Tansey CM, Matté A, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011;364(14):1293-1304. National Institutes of Health RECOVER Initiative. RECOVER: Researching COVID to Enhance Recovery. https://recovercovid.org Leisman DE, Mehta A, Thompson BT, et al. Alveolar, endothelial, and organ injury marker dynamics in severe COVID-19. Am J Respir Crit Care Med. 2022;205(5):507-519. Cervia-Hasler C, Brüningk SC, Hoch T, et al. Persistent complement dysregulation with signs of thromboinflammation in active long COVID. Science. 2024;383(6680). doi:10.1126/science.adg7942 Oelsner EC, Krishnaswamy A, Balte PP, et al. Collaborative cohort of cohorts for COVID-19 Research (C4R) Study: study design. Am J Epidemiol. 2022;191(7):1153-1173.

Haoss un kara laikā iespējamā laime. Par Tibetu, Ukrainu, Holivudu un pasauli, kas mainās. Raidījuma #1pret1 saruna ar aktieri un cilvēktiesību aktīvistu Ričardu Gīru. -- Chaos and the possibility of happiness in times of war. On Tibet, Ukraine, Hollywood and a changing world. A Latvian Television interview with actor and human rights activist Richard Gere.

Send us Fan MailOn the latest episode of Going Under: Anesthesia Answered, we walk through the reported details around Kyle Busch's surprising death and translate the headlines into a clear medical timeline from sinus symptoms to pneumonia, bacteremia, and sepsis. We also explain why “coughing blood” can be a sign of severe lung injury like ARDS, and what early treatment might have changed. Have a question for Dr. Brian Schmutzler? Submit them to any of the social media pages below or on his website at https://www.drbrianschmutzler.com/Facebook: https://www.facebook.com/drbrianschmutzlerInstagram: https://www.instagram.com/drbrianschmutzlerTikTok: https://www.tiktok.com/@drbrianschmutzler?lang=enProvider or Medical Student?? Subscribe to his Patreon Page to get exclusive content and access to Medical Blocks:https://www.patreon.com/user?u=89356957&utm_medium=clipboard_copy&utm_source=copyLink&utm_campaign=creatorshare_creator&utm_content=join_linkThanks to our show sponsor: Butterfly Networkhttps://store.butterflynetwork.com/us/en/?rsCode=BRIAN25Get $750 off the latest iQ3 at ButterflyNetwork.comSupport the show

Acute respiratory distress syndrome (ARDS) induced by COVID-19 was a leading cause of severe illness and death during the pandemic, driven by an intense innate immune response, hyperinflammation, and a decrease in lymphocytes. Mesenchymal stromal cells (MSCs) represent a potential therapeutic option for ARDS due to their ability to modulate the immune system and inflammation. Our guests report results from a Health Canada–regulated Phase I and Phase II trials evaluating freshly cultured umbilical cord–derived MSCs in patients with COVID-19-related ARDS, including assessments of safety, maximum feasible tolerated dose, and preliminary efficacy. Their work explores a therapeutic strategy to improve ARDS outcomes using MSCs, which will be important for optimizing and targeting future cellular therapies.GuestDuncan Stewart, MD, Ottawa Hospital Research Institute and University of Ottawa, CanadaElmira Safaie Qamsari, Ottawa Hospital Research Institute, CanadaHostJanet Rossant, Editor-in-Chief, Stem Cell Reports and The Gairdner FoundationSupporting DocumentsPaper link: Cellular immunotherapy for COVID-19-induced acute respiratory distress syndrome: Results of the CIRCA-19 phase 1 safety and phase 2 randomized controlled trials About Stem Cell ReportsStem Cell Reports is the open access, peer-reviewed journal of the International Society for Stem Cell Research (ISSCR) for communicating basic discoveries in stem cell research, in addition to translational and clinical studies. Stem Cell Reports focuses on original research with conceptual or practical advances that are of broad interest to stem cell biologists and clinicians. X: @StemCellReportsAbout ISSCRAcross more than 80 countries, the International Society for Stem Cell Research (@ISSCR) is the preeminent global, cross-disciplinary, science-based organization dedicated to advancing stem cell research and its translation to medicine.ISSCR StaffKeith Alm, Shuangshuang Du, Kym Kilbourne, Megan Koch, Jack Mosher, and Hunter Reed

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FNCS, FCCM, is joined by Aarti Sarwal, MD, FAAN, FNCS, RPNI, FCCM, and Brian L. Erstad, PharmD, FCCP, FASHP, MCCM, to discuss the 2026 guidelines for neuromuscular blockade in adult patients with acute respiratory distress syndrome. The guidelines, “Society of Critical Care Medicine Guidelines for the Administration of Neuromuscular Blockade in Adults With Acute Respiratory Distress Syndrome,” were published in the March issue of Critical Care Medicine. Drs. Sarwal and Erstad discuss how the evidence in two key trials, ACURASYS and PETAL-ROSE, has helped shape the recommendations provided in the SCCM guidelines. Despite how influential these trials were in shaping the recommendations, only conditional recommendations were made due to low or very low quality of evidence. The lack of evidence proved to be a driving factor in including a call to action in the guidelines. Future research priorities largely revolve around precision medicine and finding more patient-specific interventions to improve patient outcomes. Aarti Sarwal, MD, FAAN, FNCS, RPNI, FCCM, is a professor of neurology and the division chair of neurocritical care at Virginia Commonwealth University (VCU) School of Medicine in Richmond, Virginia, USA. She is also an associate editor of Critical Care Medicine, secretary of the American Society of Neuroimaging, and director of VCU-Wake Forest neuro-ultrasound courses. Brian L. Erstad, PharmD, FCCP, FASHP, MCCM, is a tenured professor and interim dean at the University of Arizona R. Ken Coit College of Pharmacy in Tucson, Arizona, USA. He is also a center investigator for the Center for Health Outcomes, a member of the BIO5 Institute and Comprehensive Center for Pain & Addiction and Pharmacoeconomics Research Center, and a codirector for the Arizona Clinical and Translational Research Graduate Certificate Program. Resources referenced in this podcast: Society of Critical Care Medicine Guidelines for the Administration of Neuromuscular Blockade in Adults With Acute Respiratory Distress Syndrome Early Neuromuscular Blockade in the Acute Respiratory Distress Syndrome Neuromuscular Blockers in Early Acute Respiratory Distress Syndrome

PerfWeb 110 – Day 2 examines clinical indications for extracorporeal membrane oxygenation (ECMO) and available cannulation options, focusing on evidence-based criteria for initiation in adult patients with refractory cardiac or respiratory failure. This session addresses decision-making in high-acuity scenarios where standard therapies fail, providing perfusionists with tools to assess suitability and select appropriate access strategies. By clarifying when ECMO offers benefit versus risk, the content supports safer implementation in programs managing acute decompensations. Learning Objectives: Identify key clinical conditions, such as severe ARDS or cardiogenic shock, where ECMO provides effective temporary support. Differentiate between venoarterial (VA) and venovenous (VV) ECMO configurations based on underlying pathophysiology. Evaluate patient-specific factors influencing ECMO candidacy, including contraindications and prognostic indicators. Describe common cannulation sites and techniques, including peripheral versus central approaches. Apply strategies to mitigate cannulation-related complications like limb ischemia or recirculation. Interpret hemodynamic and gas exchange parameters to guide initial ECMO setup and adjustments.

Broadcast from KSQD, Santa Cruz on 3-26-2026: li> Dr. Dawn announces a UCSF study recruiting participants for psilocybin therapy to help patients cope with chronic low back pain, requiring ages 25-70 with failed prior treatments. A caller preparing for bladder stone surgery asks about avoiding a repeat of severe post-anesthesia disorientation. Dr. Dawn recommends pharmacogenomic testing through 3x4 Genetics to identify slow acetylator status and other detoxification enzyme variants that can guide anesthesiologists toward better drug choices. A clinical trial found that 24 minutes of music with binaural beats—where slightly offset audio in each ear generates synchronized brainwaves—significantly reduced anxiety in medicated patients. Dr. Dawn encourages trying this accessible, low-risk intervention. Chronic noise exposure triggers oxidative stress, inflammation, and endothelial dysfunction, increasing cardiovascular disease risk. Data centers and server farms are emerging noise pollution sources, and Dr. Dawn recommends affordable noise-canceling headphones as a health investment. A Crohn's patient in Switzerland reports alarming neurological symptoms including speech arrest with preserved awareness and transient visual disturbances. He is having trouble finding any Functional Medicine trained physician and Dr. Dawn recommends emailing to info@ifm.org. Furthermore, Dr. Dawn suspects possible seizure activity from brain inflammation and recommends pursuing a sleep-deprived EEG and MRI through a neurology referral. MIT researchers discovered Interlectin-2, a protein that both strengthens the mucus barrier by cross-linking mucins and directly traps and kills pathogens like Salmonella and Shigella. Imbalanced levels may contribute to inflammatory bowel disease. Synthetic versions may be an effective treatment for inflammatory bowel disease. A 33-year-old man survived 48 hours without lungs after flu-triggered bacterial pneumonia caused ARDS and multiple organ failure. Surgeons removed both lungs treat septic shock while ECMO (extracorporeal oxygenation)sustained him until a successful double lung transplant. A meta-analysis of 43 studies involving millions of births found no evidence that acetaminophen use during pregnancy increases autism, ADHD, or intellectual disability risk, contradicting recent political claims. Green tea contains about 30% more L-theanine than black tea, with studies showing 200mg daily improves verbal fluency, sleep quality, and reduces anxiety. Decaffeinated green tea retains full theanine content. Pop star Robbie Williams developed scurvy while on GLP-1 weight loss drugs, highlighting that only 2 of 40+ major GLP-1 trials assessed vitamin intake. Dr. Dawn urges anyone on these medications to take a comprehensive multivitamin.

Welcome back to the tasty morsels of critical care podcast. Today we look at something we do fairly frequently in ICU, especially in the post COVID era: prone positioning or to use its preferred technical term: adult tummy time. This has been around for a long time but was uncommonly done in the pre COVID days and was always a talking point when it did happen. But then 2020 came and you’d spend significant portions of the day proning and supinating patients in the unit. Fair to say it’s something we should have a keen understanding of. Firstly we’ll talk about the physiology and potential mechanism of benefit behind proning. This comes from the proning chapter in Tobin’s mechanical ventilation textbook. Written by none other than the late, great Gattanoni. He argues that there are 3 mechanisms by which proning affects ventilation and oxygenation changes in inflation redistribution of ventilation redistribution of perfusion A lot of this comes from Gattanoni’s early work where they managed to do a whole bunch of CT scans on critically people with ARDS in both the supine and the prone position. Yes you heard that right they did the CT scan prone. The typical CT scan for many ARDS patients is a basal dorsal distribution of disease. One would think that flipping the patient might redistribute this atelectasis to the ventral surface. But what seems to happen is more of a homogenisation of the lung with an overall improved inflation of the lung tissue. No longer are you just hyperinflating the baby lung and doing nothing for the atelectatic lung. This should lead to better recruitment, better perfusion/ventilation matching, better oxygenation and in turn better clinical outcomes. There are some suggestions it may also aid secretion clearance which in a paralysed supine patient is obviously a problem. Proning (as we shall we see) does seem to improve outcomes but the precise mechanism is unclear. Improved oxygenation seems plausible but it may also be a reduction in VILI by having a more homogenous lung that is less prone to injury of the baby lung. Guerin (lead PROSEVA author) wrote a nice review article in 2020 highlighting that proning can make chest wall compliance worse. The anterior ventral wall is normally more mobile than the dorsal chest wall. When prone the ventral bit is now wedged and immobile against the bed hence the fall in chest wall compliance. However lung compliance is probably improved and now that the chest wall is moving less it’s probably increased diaphragmatic movement that recruits the bases. Overall compliance should improve. We turn now to the evidence base for proning our patients. This, like many critical care interventions, this  has a little bit of a narrative to it with some early trials lacking benefit followed by the paradigmatic trial that shapes practice. What follows is a brief summary of some of the important studies and is neither intended nor considered to be comprehensive. Back in the early noughties there were a flurry of RCTs looking at prone positioning in ARDS. The late and great Gattanoi was of course involved in some. The “dose” of proning was variable with sometimes only short periods like 6 hours being used. Results were variable and a 2011 meta analysis of 7 RCTs did not show a definitive mortality benefit but did suggest that those with the sicker lungs had a benefit Enter PROSEVA. A name, that if you’re going into an ICU viva, is probably something that you should keep in your head. This was 26 centres in France who were already experienced with proning. They took people with severe ARDS and randomised them to 16 hrs a day of proning vs no proning. They used mortality at 28 days as a primary outcome and they were looking for a 15% absolute reduction in mortality (which is pretty huge). It was, for obvious reasons, an open label trial. They enrolled 450 patients and found a 32% vs a 16% mortality favoring proning. It’s possible this trial found a benefit due to the dose – they proned for much longer than many of the other trials. It’s worth having some problems related to proning in your back pocket to pull out. The list of potential contraindications was initially quite long pre-COVID but it turns out that when your back is up against the wall we all became a little bolder with our proning. While you can prone the vast majority of patients it’s not going to be possible in those with unstable spinal injuries. One would think that abdominal surgery or advanced pregnancy might be a problem but you can usually work round this with some discussion with your surgeons. The main downsides (beyond the hassle factor) are related to safety. The facial oedema and skin injuries are not insignificant and no matter how careful you are some people just aren’t a great shape for proning. There is a chance that the ET tube can kink or dislodge either on the proning or on the head turns so you need to have a good plan in your head how to confirm this and get someone flipped back if they need it. Reading Tobin Chapter 49 Deranged Physiology  Prone Position and Mechanical Ventilation Guerin, C. et al. Prone Positioning in Severe Acute Respiratory Distress Syndrome. New England Journal of Medicine 368, 2159–2168 (2013). Guérin, C. et al. Prone position in ARDS patients: why, when, how and for whom. Intens Care Med 46, 2385–2396 (2020).

Passage: John 1:35-51 Date: 15 March 2026 Speaker: Andrew Gill Summary: In today's message, we explore how Jesus began his mission with ordinary people in everyday places, like Andrew and Philip, who simply invited others to meet Him. This demonstrates that sharing our faith doesn't require perfection or expertise; it's about enthusiasm and authenticity. As we discover what we've found in Christ, we are called to share that joy with those around us, encouraging them to “come and see.” Links: Church Website Watch on YouTube Contact Us

Transfers don't have to feel like controlled chaos. We break down how to move a critically ill patient from the OR to the ICU with confidence by pairing structured handoffs with disciplined infection prevention—so information moves seamlessly while pathogens hit a dead end.We start by revisiting the ICU's influence on anesthesia practice through the story of ARDS and lung-protective ventilation. The shift to 6 ml/kg ideal body weight didn't just save lungs in the unit; it reshaped intraoperative strategy to reduce ventilator-induced injury for surgical patients. From there, we zoom into the human factors of handoffs: why complex, time-sensitive details—hemodynamics, antimicrobials, ventilator settings, imaging, and goals of care—so often fall through the cracks, and how IPASS, OR-to-ICU structured handoffs, and explicit role assignments align teams. Then we tackle pathogen transmission where it thrives: device-rich environments and high-touch surfaces. We unpack how environmental reservoirs and biofilms turn bed rails and anesthesia machine into unseen vectors, and why consistent, high-frequency hand hygiene is the most powerful countermeasure. Clear targets make habits stick: at least four sanitizer uses per hour in the ICU and eight per hour in the OR, coupled with strict isolation adherence and diligent decontamination. By the end, you'll have a tight, transferable playbook: adopt lung-protective settings across care areas, script handoffs with shared tools and timed calls, measure sanitizer touches, and treat the environment as a clinical variable. If this conversation helps your team cut errors or infections, share it with a colleague, subscribe for future episodes, and leave a review with one change you'll make this week.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/297-from-or-to-icu-how-checklists-and-clean-hands-save-lives/© 2026, The Anesthesia Patient Safety Foundation

ARDS is one of the more complex syndromes we manage in critical care. More than just pulmonary edema, we are battling stiff lungs, refractory hypoxemia, rising pressures, and frequently making decisions that can either protect the lung or make things worse.In this episode, I'm joined by respiratory therapist Melody Bishop for a deep dive into ARDS ventilator management through the lens of physiology, evidence, and real bedside practice. We break down what's actually happening in the lung, why some long-held practices have fallen out of favor, and how nurses and RTs can work together to make more precise, lung-protective decisions.If ARDS has ever felt like guesswork, this episode will help it make sense.Topics discussed in this episode:What ARDS looks like at the alveolar level and why surfactant loss changes everythingHow inflammation leads to stiff lungs, poor compliance, and refractory hypoxemiaWhy lung-protective ventilation is about avoiding harm, not chasing perfect numbersMoving beyond tidal volume: how driving pressure reframes vent managementHow RTs use compliance trends to judge whether lungs are improving or failingPEEP selection: why tables are a guide, not the final answerThe physiology behind proning and why it's one of the few ARDS interventions that saves livesWhy recruitment maneuvers fell out of favor (and what works instead)What nurses should be watching on the ventilator to catch deterioration earlyConnect with Melody and download her free book:https://melodybishoprt.com/Mentioned in this episode:Rapid Response Academy Winter 2026 Cohorthttps://www.rapidresponseandrescue.com/rraCONNECT

Authors Herng Lee Tan, MSc, and Judith Ju Ming Wong, MBBCh, BAO, and editorialist Vicent Modesto i Alapont, MD, PhD, join CHEST® Critical Care Podcast Moderator Dan Fein, MD, to discuss their research into the impact of mechanical power normalized to predicted body weight on outcomes in pediatric ARDS.  This episode is part of a new series exploring articles published in our open access journal CHEST Critical Care.  DOI: 10.1016/j.chstcc.2025.100162 Disclaimer: The purpose of this activity is to expand the reach of CHEST content through awareness, critique, and discussion. All articles have undergone peer review for methodologic rigor and audience relevance. Any views asserted are those of the speakers and are not endorsed by CHEST. Listeners should be aware that speakers' opinions may vary and are advised to read the full corresponding journal article(s) for complete context. This content should not be used as a basis for medical advice or treatment, nor should it substitute the judgment used by clinicians in the practice of evidence-based medicine.  

🧭 REBEL Rundown 🗝️ Key Points 💉 Hydrocortisone Saves Lives:The 2023 Cape Cod Trial (NEJM) showed a clear mortality benefit and reduced need for intubation in severe CAP patients treated with hydrocortisone.📊 Guidelines Are Catching Up:The SCCM (2024) and ERS now recommend steroids for severe CAP, while ATS/IDSA updates are still pending.🔥 Redefining “Severe”:Patients requiring high FiO₂ (>50%), noninvasive or mechanical ventilation, or PSI >130 meet criteria for steroid therapy — even outside the ICU.🍬 Main Risk = Hyperglycemia:Elevated glucose was the most consistent adverse effect, but rates of GI bleed and secondary infection were not increased.🧭 Early, Targeted Use Matters:Start hydrocortisone within 24 hours of identifying severity — especially in patients with high CRP (>150) or strong inflammatory response. Click here for Direct Download of the Podcast. 📝 Introduction Corticosteroids have long sparked debate in the treatment of bacterial pneumonia — once viewed with skepticism, now increasingly supported by high-quality evidence. In this episode, Dr. Alex Chapa joins the REBEL Core Cast team to explore how the 2023 Cape Cod Trial (NEJM) reshaped practice and guideline recommendations for severe community-acquired pneumonia (CAP). 📖 Historical Context & Long-Standing Skepticism For decades, the use of steroids in pneumonia was controversial.Early Use: Steroids entered practice in the 1940s and 50s for autoimmune inflammation, but there was immediate hesitation regarding secondary superinfections.Mixed Data: From the 1980s to the 2000s, small studies emerged on severe pneumonia and ARDS, but the data was inconsistent. Different trials used varying definitions of “severe” pneumonia and different C-reactive protein (CRP) cutoffs, making the data “spread” and easy to “cherry pick” to support or deny a benefit.Past Guidelines: This uncertainty was reflected in official guidelines:2007 (ATS/IDSA): The American Thoracic Society and the Infectious Diseases Society of America did not address the topic due to insufficient data.2019 (ATS/IDSA): Pre-COVID, the guidelines recommended against using corticosteroids in severe CAP. They acknowledged no benefit for non-severe pneumonia, but the data for severe pneumonia was considered too weak to endorse.Pre-Trial Consensus: Prior to 2023, the consensus was to avoid steroids in non-severe pneumonia, while severe pneumonia remained a “gray area” with no treatment showing a clear mortality difference. 📜 The Landmark Cape Cod Trial (NEJM 2023) The Cape Cod trial, published in the New England Journal of Medicine in 2023, reignited the discussion by providing robust, positive data.Trial Design: Phase 3, multi-center, double-blind, randomized, controlled trial.Intervention: 800 patients randomized to two groups, Hydrocortisone as a continuous infusion (200mg/day) versus a placebo infusion.Taper: On day 4, clinicians would decide whether to continue the infusion or begin a taper based on clinical response.Population: Patients with severe CAP, defined by meeting at least one of the following criteria:Pneumonia Severity Index (PSI) > 130.O2 by FiO2 ratio < 300.Need for mechanical or non-invasive ventilation (with PEEP ≥ 5).Need for high FiO2 (>50%) via non-rebreather or heated high flow.Primary Outcomes: Death for any cause 6.2% (hydrocortisone) vs 11.9% (placebo)Secondary outcomes:Death from any cause at 90 days 9.3% (hydrocortisone) vs 14.7% (placebo)Endotracheal intubation 18% (hydrocortisone) vs 29% (placebo)Hospital-acquired infections 9.8% (hydrocortisone) vs 11.1% (placebo)Gastrointestinal bleeding 2.3% (hydrocortisone) vs 3.3% (placebo)Vasopressor initiation by day 28 15.3% (hydrocortisone) vs 25.0% (placebo)Key Findings: The trial demonstrated superiority for hydrocortisone 📋 Updated Guidelines & Current Practice The Cape Cod trial, along with subsequent meta-analyses, has begun to change official recommendations.Society of Critical Care Medicine (SCCM): In 2024, an SCCM expert panel, reviewing the Cape Cod trial and 18 others, strongly recommended corticosteroids for severe CAP. They concluded that steroids reduce mortality and the need for mechanical ventilation.Meta-Analysis (Smit et al.): A 2024 meta-analysis in Lancet Respiratory confirmed the 30-day mortality benefit.European Respiratory Society (ERS): The ERS has issued a recommendation to use steroids for severe pneumonia but still urges caution regarding side effects.ATS/IDSA: As of the podcast recording, the ATS/IDSA had not yet updated their 2019 guidelines. 🛠️ Practical Application for Clinicians Defining “Severe” CAP: The key is to identify patients who qualify as “severe”. This can be done using:Scoring Tools: The PSI is the best validated tool for mortality but is cumbersome. Simpler tools like CURB-65 or SMART-COP are practical and acceptable for defining severity. 2023 meta-analysis from by Zaki et al showed both work well, but CURB-65 has better mortality prediction early on.Cape Cod Criteria: Any patient meeting the trial’s inclusion criteria (e.g., high-flow O2, non-invasive ventilation) qualifies, regardless of location (ED, floor, or ICU).Biomarkers: While not required, a CRP level was used in many studies. A CRP > 150 (Cape Cod) or > 204 (Smit meta-analysis) strongly indicates severe inflammation that would benefit from steroids.Clinical Judgment: A patient who looks “sick,” has “soft” blood pressure, or has dense infiltrates and high oxygen needs (e.g., >50% FiO2 on high flow) is a candidate.Adverse Effects:Hyperglycemia: This was the most significant risk identified, with rates between 6-12%. This is a primary concern, especially in patient populations with high BMI.GI Bleed & Secondary Infection: Fears of these side effects, which contributed to historical skepticism, were not borne out in the Cape Cod trial. The data does not support being overly concerned.Other Side Effects: Mood changes, delirium, insomnia, and agitation in the elderly are known side effects of steroids that were not specifically addressed in the trial but remain clinical concerns. 🔄 Clinical Pathway for Steroids in Severe CAP Unanswered Questions & Future Research Possible remaining questions:Biomarkers: Can we find a more precise CRP level to distinguish moderate from severe disease? Could other markers like ferritin or IL-6 be used? Dosing & Tapering: How much immunomodulation is needed, and when is it truly safe to taper?Gender Differences: Early data suggests females may respond better to steroids and experience fewer side effects. The question of female patients with severe CAP require less corticosteroids needs further exploration. 👉 Clinical Bottom Line The current literature, spearheaded by the Cape Cod trial, now supports the use of corticosteroids in severe community-acquired pneumonia. The best evidence currently points to hydrocortisone, started early (within 24 hours) after severity is identified using a validated tool. While hyperglycemia is a risk, the previous fears of GI bleeding and secondary infections were not substantiated in recent, rigorous trials. 📚 References Chapa-Rodriguez A, Abou-Elmagd T, O’Rear C, Narechania S. Do patients with severe community-acquired bacterial pneumonia benefit from systemic corticosteroids?. Cleve Clin J Med. 2025;92(10):600-604. PMID: 41033846Dequin PF, Meziani F, Quenot JP, et al. Hydrocortisone in Severe Community-Acquired Pneumonia. N Engl J Med. 2023;388(21):1931-1941. PMID: 36942789Chaudhuri D, Nei AM, Rochwerg B, et al. 2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia. Crit Care Med. 2024;52(5):e219-e233. PMID: 38240492 Post Peer Reviewed By: Marco Propersi, DO (Twitter/X: @Marco_propersi), and Mark Ramzy, DO (X: @MRamzyDO) 👤 Show Notes Alex Chapa, MD PGY 5 Pulmonary Critical Care Fellow Cape Fear Valley Medical Center Fayetteville NC 🔎 Your Deep-Dive Starts Here REBEL Core Cast 149: Review of Corticosteroids in Community-Acquired Pneumonia Corticosteroids have long sparked debate in the treatment of bacterial ... Thoracic and Respiratory Read More The post REBEL Core Cast 149: Review of Corticosteroids in Community-Acquired Pneumonia appeared first on REBEL EM - Emergency Medicine Blog.

A year after Storm Éowyn wreaked havoc across Ireland David Maxwell visits the gardens at Mount Stewart on the Ards peninsula where thousands of trees were lost. He meets volunteers planting oak and pine trees which will form a new shelter belt for the garden in the decades to come. At the other end of the garden, the Winterwatch team have been broadcasting the programme from Northern Ireland for the first time. Chris Packham explains the vast range of habitats that exist around this historic garden. Also on the programme, a visit to the National Botanic Gardens in Dublin and questions on muddy lawns, growing olives outdoors and what to do with a stem of rose hips that has unexpectedly rooted. Contact the programme on gardenerscorner@bbc.co.uk

We discuss the diagnosis and management of SCAPE in the ED. Hosts: Naz Sarpoulaki, MD, MPH Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/SCAPEv2.mp3 Download Leave a Comment Tags: Acute Pulmonary Edema, Critical Care Show Notes Core EM Modular CME Course Maximize your commute with the new Core EM Modular CME Course, featuring the most essential content distilled from our top-rated podcast episodes. This course offers 12 audio-based modules packed with pearls! Information and link below.  Course Highlights: Credit: 12.5 AMA PRA Category 1 Credits™ Curriculum: Comprehensive coverage of Core Emergency Medicine,  with 12 modules spanning from Critical Care to Pediatrics. Cost: Free for NYU Learners $250 for Non-NYU Learners Click Here to Register and Begin Module 1 The Clinical Case Presentation: 60-year-old male with a history of HTN and asthma. EMS Findings: Severe respiratory distress, SpO₂ in the 60s on NRB, HR 120, BP 230/180. Exam: Diaphoretic, diffuse crackles, warm extremities, pitting edema, and significant fatigue/work of breathing. Pre-hospital meds: NRB, Duonebs, Dexamethasone, and IM Epinephrine (under the assumption of severe asthma/anaphylaxis). Differential Diagnosis for the Hypoxic/Tachypneic Patient Pulmonary: Asthma/COPD, Pneumonia, ARDS, PE, Pneumothorax, Pulmonary Edema, ILD, Anaphylaxis. Cardiac: CHF, ACS, Tamponade. Systemic: Anemia, Acidosis. Neuro: Neuromuscular weakness. What is SCAPE? Sympathetic Crashing Acute Pulmonary Edema (SCAPE) is characterized by a sudden, massive sympathetic surge leading to intense vasoconstriction and a precipitous rise in afterload. Pathophysiology: Unlike HFrEF, these patients are often euvolemic or even hypovolemic. The primary issue is fluid maldistribution (fluid shifting from the vasculature into the lungs) due to extreme afterload. Bedside Diagnosis: POCUS vs. CXR POCUS is the gold standard for rapid bedside diagnosis. Lung Ultrasound: Look for diffuse B-lines (≥3 in ≥2 bilateral zones). Cardiac: Assess LV function and check for pericardial effusion. Why not CXR? A meta-analysis shows LUS has a sensitivity of ~88% and specificity of ~90%, whereas CXR sensitivity is only ~73%. Importantly, up to 20% of patients with decompensated HF will have a normal CXR. Management Strategy 1. NIPPV (CPAP or BiPAP) Start NIPPV immediately to reduce preload/afterload and recruit alveoli. Settings: CPAP 5–8 cm H₂O or BiPAP 10/5 cm H₂O. Escalate EPAP quickly but keep pressures to avoid gastric insufflation. Evidence: NIPPV reduces mortality (NNT 17) and intubation rates (NNT 13). 2. High-Dose Nitroglycerin The goal is to drop SBP to < 140–160 mmHg within minutes. No IV Access: 3–5 SL tabs (0.4 mg each) simultaneously. IV Bolus: 500–1000 mcg over 2 minutes. IV Infusion: Start at 100–200 mcg/min; titrate up rapidly (doses > 800 mcg/min may be required). Safety: ACEP policy supports high-dose NTG as both safe and effective for hypertensive HF. Use a dedicated line/short tubing to prevent adsorption issues. 3. Refractory Hypertension If SBP remains > 160 mmHg despite NIPPV and aggressive NTG, add a second vasodilator: Clevidipine: Ultra-short-acting calcium channel blocker (titratable and rapid). Nicardipine: Effective alternative for rapid BP control. Enalaprilat: Consider if the above are unavailable. Troubleshooting & Pitfalls The “Mask Intolerant” Patient Hypoxia is the primary driver of agitation. NIPPV is the best sedative. * Pharmacology: If needed, use small doses of benzodiazepines (Midazolam 0.5–1 mg IV). AVOID Morphine: Data suggests higher rates of adverse events, invasive ventilation, and mortality. A 2022 RCT was halted early due to harm in the morphine arm (43% adverse events vs. 18% with midazolam). The Role of Diuretics In SCAPE, diuretics are not first-line. The problem is redistribution, not volume excess. Diuretics will not help in the first 15–30 minutes and may worsen kidney function in a (relatively) hypovolemic patient. Delay Diuretics until the patient is stabilized and clear systemic volume overload (edema, weight gain) is confirmed. Disposition Admission: Typically requires CCU/ICU for ongoing NIPPV and titration of vasoactive infusions. Weaning: As BP normalizes and work of breathing improves, infusions and NIPPV can be gradually tapered. Take-Home Points Recognize SCAPE: Hyperacute dyspnea + severe HTN. Trust your POCUS (B-lines) over a “clear” CXR. NIPPV Immediately: Don’t wait. It saves lives and prevents tubes. High-Dose NTG: Use boluses to “catch up” to the sympathetic surge. Don’t fear the dose. Avoid Morphine: Use small doses of benzos if the patient is struggling with the mask. Lasix Later: Prioritize afterload reduction over diuresis in the hyperacute phase. Read More

🧭 REBEL Rundown 🗝️ Key Points 💨 Peak vs. Plateau Pressures: PIP reflects total airway resistance and compliance, while Pplat isolates alveolar compliance—elevations in both suggest decreased lung compliance (e.g., ARDS, pulmonary edema, pneumothorax).🧱 PEEP Protects Alveoli: Maintains alveolar recruitment and prevents collapse; typical range 5–8 cmH₂O, but higher levels may benefit moderate–severe ARDS.️ Driving Pressure (ΔP = Pplat − PEEP): Lower ΔP reduces atelectrauma and improves outcomes; optimize by adjusting PEEP thoughtfully.💥 Prevent VILI: Keep Pplat < 30 cmH₂O, use low tidal volumes (6 mL/kg IBW), and monitor for barotrauma, volutrauma, atelectrauma, and biotrauma.📚 Evidence-Based Practice: ARDSNet and subsequent trials confirm that lung-protective ventilation—low Vt, limited pressures, and individualized PEEP—improves survival in ARDS. Click here for Direct Download of the Podcast. 📝 Introduction This episode reviews essential ventilator pressures and how to interpret them during ICU rounds. 🚀 Under Pressure Peak Inspiratory Pressure (PIP)Definition: Total pressure required to deliver a breath.Reflects: Airway resistance + lung/chest wall compliance.Common Causes of ↑ PIP:Mucus pluggingBiting the endotracheal tubeKinked tubing or bronchospasmPlateau Pressure (Pplat)Definition: Alveolar pressure measured after an inspiratory hold.Reflects: Lung compliance (stiffness of lung tissue).When Both PIP & Pplat Are Elevated:→ Indicates poor compliance (e.g., ARDS, pulmonary edema, pneumothorax).Positive End-Expiratory Pressure (PEEP)Definition: Pressure remaining in airways at end-expiration to prevent alveolar collapse.Typical Range: 5–8 cmH₂O but needs to titrated to meet patient requirements Notes:Provides physiologic “glottic” PEEP in intubated patients.Using high PEEP strategy shows mortality benefit only in moderate–severe ARDS in meta-analysis.Driving Pressure (ΔP)Definition: ΔP = Pplat − PEEP.Reflects: Pressure needed to keep alveoli open during the respiratory cycle.Goal: Lower ΔP → less atelectrauma & improved outcomes.Optimize: Increase PEEP to reduce ΔP and alveolar cycling. 📖 Interpreting High PIP/High Pplat ↑ PIP & ↑ PplatInterpretation: ↓ ComplianceCommon Causes: ARDS, pulmonary edema, pleural effusion, pneumothorax↑ PIP & Normal/Low PplatInterpretation: ↑ Airway ResistanceCommon Causes: Mucus plug, bronchospasm, tube obstruction or biting 🤕 Ventilator-Associated Lung Injury (VILI) Barotrauma:Mechanism: Excessive airway pressure damages alveoli.Prevention: Keep Pplat < 30 cmH₂O.Volutrauma:Mechanism: Overdistension from excessive tidal volumes.Prevention: Use low tidal volume ventilation (6 mL/kg ideal body weight).ARDSNet trial: 6 mL/kg → lower mortality compared to 12 mL/kg.Ideal Body Weight: Based on height and sex, not actual weight.Typical patient: Tidal Volume: 6–8 mL/kg IBWARDS: Tidal Volume: 4–6 mL/kg IBWAtelectrauma:Mechanism: Repeated opening/collapse of unstable alveoli.Prevention: Optimize PEEP to keep alveoli open and reduce driving pressure.Biotrauma:Mechanism: Inflammatory cascade (↑ IL-6, TNF-α) from mechanical injury.Effect: Can trigger systemic inflammation & multiorgan dysfunction.Prevention: Minimize all other forms of VILI. Post Peer Reviewed By: Marco Propersi, DO (Twitter/X: @Marco_propersi), and Mark Ramzy, DO (X: @MRamzyDO) 👤 Show Notes Joel Rios Rodriguez, MD PGY 3 Internal Medicine Resident Cape Fear Valley Internal Medicine Residency Program Fayetteville NC Aspiring Pulmonary Critical Care Fellow 🔎 Your Deep-Dive Starts Here REBEL Core Cast – Pediatric Respiratory Emergencies: Beyond Viral Season Welcome to the Rebel Core Content Blog, where we delve ... Pediatrics Read More REBEL Core Cast 143.0–Ventilators Part 3: Oxygenation & Ventilation — Mastering the Balance on the Ventilator When you take the airway, you take the wheel and ... Thoracic and Respiratory Read More REBEL Core Cast 142.0–Ventilators Part 2: Simplifying Mechanical Ventilation – Most Common Ventilator Modes Mechanical ventilation can feel overwhelming, especially when faced with a ... Thoracic and Respiratory Read More REBEL Core Cast 141.0–Ventilators Part 1: Simplifying Mechanical Ventilation — Types of Breathes For many medical residents, the ICU can feel like stepping ... Thoracic and Respiratory Read More REBEL Core Cast 140.0: The Power and Limitations of Intraosseous Lines in Emergency Medicine The sicker the patient, the more likely an IO line ... Procedures and Skills Read More REBEL Core Cast 139.0: Pneumothorax Decompression On this episode of the Rebel Core Cast, Swami takes ... Procedures and Skills Read More The post REBEL Core Cast 147.0–Ventilators Part 5: Key Mechanical Ventilator Pressures & Definitions Made Simple appeared first on REBEL EM - Emergency Medicine Blog.

🧭 REBEL Rundown 🗝️ Key Points ❌ Don’t chase perfect numbers: Adequate and safe is often better than “perfect but harmful.”💨 Oxygenation levers: Start with FiO₂ and PEEP, but remember MAP is the true driver.🫁 Ventilation levers: Adjust RR and TV, tailored to underlying physiology.🚫 Watch your obstructive patients: Sometimes less RR is more. Click here for Direct Download of the Podcast. 📝 Introduction Ventilator management can feel overwhelming—there are so many knobs to turn, numbers to watch, and changes to make. But before adjusting any settings, it’s crucial to understand why the patient is in distress in the first place, because the right strategy depends on the underlying cause. In this episode, we’ll walk through three different cases to see how the approach changes depending on the problem at hand. ️ The 4 Main Ventilator Settings Tidal Volume (Vt) 🌬️ Amount of air delivered with each breath Typically set based on ideal body weight (6–8 mL/kg for lung protection) Respiratory Rate (RR) ⏱️ Number of breaths delivered per minute Adjusted to control minute ventilation and manage CO₂ FiO₂ (Fraction of Inspired Oxygen) ⛽ Percentage of oxygen delivered Adjusted to maintain adequate oxygenation (goal SpO₂ 92–96%, PaO₂ 55–80 mmHg). PEEP (Positive End-Expiratory Pressure) 🎈 Pressure maintained in the lungs at the end of exhalation to prevent alveolar collapse and improve oxygenation 🧮 Modes of Ventilation AC/VC (Assist Control – Volume Control)How it Works: Delivers a set tidal volume with each breath (whether patient- or machine-triggered).When It’s Used / Pros: Most common initial mode; guarantees minute ventilation; good for patients with variable effort.Limitations / Cons: May cause patient–ventilator dyssynchrony if set volumes don’t match patient’s demand.AC/PC (Assist Control – Pressure Control)How it Works: Delivers a set inspiratory pressure for each breath; tidal volume varies depending on lung compliance/resistance.When It’s Used / Pros: Useful in ARDS (lung-protective strategy), limits peak airway pressures.Limitations / Cons: Tidal volume not guaranteed; must closely monitor volumes and minute ventilation.PRVC (Pressure-Regulated Volume Control)How it Works: Hybrid: set target tidal volume, ventilator adjusts inspiratory pressure breath-to-breath to achieve it (within limits).When It’s Used / Pros: Common default mode on newer vents; combines benefits of VC (guaranteed volume) + PC (pressure limitation).Limitations / Cons: Can increase pressures if compliance worsens.SIMV (Synchronized Intermittent Mandatory Ventilation)How it Works: Delivers set breaths, but allows spontaneous patient breaths in between (without guaranteed volume).When It’s Used / Pros: Used for weaning; allows patient effort.Limitations / Cons: Risk of increased work of breathing if spontaneous breaths are inadequate.PSV (Pressure Support Ventilation)How it Works: Every breath is patient-initiated; ventilator provides preset pressure support to overcome airway resistance.When It’s Used / Pros: Weaning trials; patients with intact drive who just need assistance.Limitations / Cons: Not a full-support mode; not for unstable patients without spontaneous drive. ♟️ Ventilation Strategies Airway ProtectionLow GCS, seizure, strokeLoss of gag/cough reflexHigh aspiration risk (vomiting, GI bleed, poor mental status)Hypoxemic Respiratory FailureSevere pneumoniaARDSPulmonary edemaInhalation injuryVentilatory (Hypercapnic) Failure / Increased Ventilation DemandSevere metabolic acidosis (DKA, sepsis, renal failure) → need high minute ventilationCOPD, asthma (if decompensating)Neuromuscular weakness (myasthenia, Guillain–Barré, spinal cord injury)Airway Obstruction / Anticipated Loss of AirwayTumor, anaphylaxis, angioedemaFacial or airway traumaPre-op / anticipated deterioration Post Peer Reviewed By: Marco Propersi, DO (Twitter/X: @Marco_propersi), and Mark Ramzy, DO (X: @MRamzyDO) 👤 Show Notes Priyanka Ramesh, MD PGY 1 Internal Medicine Resident Cape Fear Valley Internal Medicine Residency Program Fayetteville NC Aspiring Pulmonary Critical Care Fellow 🔎 Your Deep-Dive Starts Here REBEL Core Cast – Pediatric Respiratory Emergencies: Beyond Viral Season Welcome to the Rebel Core Content Blog, where we delve ... Pediatrics Read More REBEL Core Cast 143.0–Ventilators Part 3: Oxygenation & Ventilation — Mastering the Balance on the Ventilator When you take the airway, you take the wheel and ... Thoracic and Respiratory Read More REBEL Core Cast 142.0–Ventilators Part 2: Simplifying Mechanical Ventilation – Most Common Ventilator Modes Mechanical ventilation can feel overwhelming, especially when faced with a ... Thoracic and Respiratory Read More REBEL Core Cast 141.0–Ventilators Part 1: Simplifying Mechanical Ventilation — Types of Breathes For many medical residents, the ICU can feel like stepping ... Thoracic and Respiratory Read More REBEL Core Cast 140.0: The Power and Limitations of Intraosseous Lines in Emergency Medicine The sicker the patient, the more likely an IO line ... Procedures and Skills Read More REBEL Core Cast 139.0: Pneumothorax Decompression On this episode of the Rebel Core Cast, Swami takes ... Procedures and Skills Read More The post REBEL Core Cast 146.0–Ventilators Part 4: Setting up the Ventilator appeared first on REBEL EM - Emergency Medicine Blog.

Guys even though Darren was really unwell, he came in a we did the Podcast...Thats how much he loves you guys! I mean I hate every single last one of you but Darren loves you!!Just kidding I love you too! Its a toxic love/hate relationship!Darrens 2026 tour is ON SALE NOW -https://432presents.seetickets.com/artist/darren-connell/965895?fbclid=IwdGRleAOH3rxleHRuA2FlbQExAHNydGMGYXBwX2lkCjY2Mjg1NjgzNzkIY2FsbHNpdGUCMjUAAR40c8GOyl-gcVtwcUUJj_e98-NWbvrVkvTUis8txoJD34wtUcjdxd4MVaC3xg_aem_DgBq7dBrZRwS_HX2RxMTTgThis Podcast is Brought to you by: Quick Stop NutritionYour One stop shop for everything sports nutrition and vitaminsGet 30% off with code: WHALE30https://quickstopnutrition.com/ Hosted on Acast. See acast.com/privacy for more information.

This week Patsy and Ashes are discussing Ben Richards from the 1982 book, 1987 and 2025 films The Running Man! They discuss how he changes in each adaptation, and what makes each one unique. They also discuss the differing motivations and impact each version has on each other. They also have last episode's battle results, a NEW battle, and an explanation regarding why it's illegal to own sperm whale teeth. All this and more on this week's episode! Find out more at https://throwdown-thursday.pinecast.co Send us your feedback online: https://pinecast.com/feedback/throwdown-thursday/4d82c879-57ad-4022-a429-d4bca1614606

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 HandbookAmazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/47qJZe1⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Affiliate Link)My Store: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Use "podcast" to save 10%)Citations:Weir EK, López-Barneo J, Buckler KJ, Archer SL. Acute oxygen-sensing mechanisms. N Engl J Med. 2005 Nov 10;353(19):2042-55. doi: 10.1056/NEJMra050002. PMID: 16282179; PMCID: PMC2803102.Weir EK, Olschewski A. Role of ion channels in acute and chronic responses of the pulmonary vasculature to hypoxia. Cardiovasc Res. 2006 Sep 1;71(4):630-41. doi: 10.1016/j.cardiores.2006.04.014. Epub 2006 Apr 27. PMID: 16828723.Lumb AB, Slinger P. Hypoxic pulmonary vasoconstriction: physiology and anesthetic implications. Anesthesiology. 2015 Apr;122(4):932-46. doi: 10.1097/ALN.0000000000000569. PMID: 25587641.Timour G, Fréderic V, Olivier S, Shango DN. Nicardipine-induced acute respiratory failure: Case report and literature review. Clin Case Rep. 2023 May 1;11(5):e7186. doi: 10.1002/ccr3.7186. PMID: 37143457; PMCID: PMC10151601.McMurtry IF, Davidson AB, Reeves JT, Grover RF. Inhibition of hypoxic pulmonary vasoconstriction by calcium antagonists in isolated rat lungs. Circ Res. 1976 Feb;38(2):99-104. doi: 10.1161/01.RES.38.2.99. PMID: 1245025.Simonneau G, Escourrou P, Duroux P, Lockhart A. Inhibition of hypoxic pulmonary vasoconstriction by nifedipine. N Engl J Med. 1981 Jun 25;304(26):1582-5. doi: 10.1056/NEJM198106253042606. PMID: 7231503.Kennedy T, Summer W. Inhibition of hypoxic pulmonary vasoconstriction by nifedipine. Am J Cardiol. 1982 Oct;50(4):864-8. doi: 10.1016/0002-9149(82)91246-2. PMID: 7124646.Chrétien B, Decros JB, Suard F, Dolladille C, Fischer MO, Alexandre J, Descamps R. Hypoxia Associated With Dihydropyridine Calcium Channel Inhibitors: A Pharmacovigilance Study in VigiBase. Clin Pharmacol Ther. 2023 Sep;114(3):686-692. doi: 10.1002/cpt.2970. Epub 2023 Jun 29. PMID: 37309986.Burghuber OC. Nifedipine attenuates acute hypoxic pulmonary vasoconstriction in patients with chronic obstructive pulmonary disease. Respiration. 1987;52(2):86-93. doi: 10.1159/000195309. PMID: 3671896.Suard F, Mombrun M, Fischer MO, Hanouz JL, Decros JB, Derville S, Gakuba C, Al Issa G, Menard C, Chretien B, Descamps R. Oxygenation Effects of Antihypertensive Agents in Intensive Care: A Prospective Comparative Study of Nicardipine and Urapidil. Clin Pharmacol Ther. 2025 Mar;117(3):742-748. doi: 10.1002/cpt.3509. Epub 2024 Nov 27. PMID: 39604146.

Positioned for Healing: Comprehensive Care in Prone PositioningSUMMARY: This episode explores prone positioning as a critical intervention for patients with acute respiratory distress syndrome (ARDS) and severe respiratory conditions such as COVID-19. With insights from an experienced critical care clinician and educator, the discussion covers the science, history, and practical application of this life-saving technique, including the development of safe implementation tools and protocols. Listeners will learn about the physiological benefits of prone positioning, key clinical indicators and contraindications, interdisciplinary collaboration, and innovations that enhance patient and provider safety. This episode provides actionable knowledge for healthcare professionals to improve patient outcomes, reduce complications, and integrate evidence-based practices into critical care settings. ---Nurses may be able to complete an accredited CE activity featuring content from this podcast and earn CE hours provided from Elite Learning by Colibri Healthcare. For more information, click hereAlready an Elite Member? Login hereLearn more about CE Podcasts from Elite Learning by Colibri HealthcareView Episode TranscriptView this podcast course on Elite LearningSeries: Positioned for Healing: Comprehensive Care in Prone Positioning

In this World Shared Practice Forum podcast, Dr. Robinder Khemani, co-author of the PALICC-2 guidelines, discusses the real-world application of pediatric ARDS management strategies. Through a case-based conversation, Dr. Khemani shares nuanced insights on intubation timing, ventilator settings, neuromuscular blockade, and rescue therapies, including ECMO. He also introduces the REDvent trial, a novel approach to lung and diaphragm protective ventilation. This content is ideal for clinicians, respiratory therapists, and healthcare educators seeking to deepen their understanding of evidence-informed, physiology-driven care in pediatric acute respiratory distress syndrome. LEARNING OBJECTIVES - Analyze the clinical decision-making process for intubation in pediatric ARDS - Apply PEEP titration techniques to assess lung recruitability in patients with PARDS - Evaluate the role of neuromuscular blockade in maintaining lung protective ventilation - Identify appropriate advanced rescue therapies based on PARDS phenotypes - Explore the principles and outcomes of the REDvent trial in ventilator management AUTHORS Robinder "Roby" Khemani, MD, MsCI Professor of Pediatrics, Vice Chair of Research University of Southern California, Department of Anesthesiology and Critical Care Medicine Children's Hospital Los Angeles Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: October 28, 2025. ARTICLE REFERENCED Khemani RG, Bhalla A, Hotz JC, et al. Randomized Trial of Lung and Diaphragm Protective Ventilation in Children. NEJM Evid. 2025;4(6):EVIDoa2400360. doi:10.1056/EVIDoa2400360 TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/at/47wbxnvxtcpvv54p48gc2v/202510_WSP_Khemani_Transcript.pdf Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Khemani RG, Burns JP. Practical Strategies for Management of Patients with Pediatric ARDS. 10/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/practical-strategies-for-management-of-patients-with-pediatric-ards-by-r-khemani-openpediatrics.

BUFFALO, NY — September 4, 2025 — A new #research perspective was #published in Volume 17, Issue 8 of Aging (Aging-US) on August 16, 2025, titled “Age-related diseases as a testbed for anti-aging therapeutics: the case of idiopathic pulmonary fibrosis.” In this research perspective, Alex Zhavoronkov, Dominika Wilczok, Feng Ren, and Fedor Galkin, from Insilico Medicine, Buck Institute for Research on Aging, and Duke University, propose a new method to evaluate age-related diseases based on how closely they align with the biological processes of aging. Their analysis shows that idiopathic pulmonary fibrosis (IPF), a progressive lung condition, is one of the diseases most strongly associated with aging. This makes IPF a promising model for testing new anti-aging therapies with the potential to treat multiple age-related conditions. “This perspective explores how aging-related diseases (ARDs) can serve as experimental platforms for discovering new geroprotective interventions.” While many age-related diseases are used as models for aging research, not all accurately reflect the biology of aging. To address this, the authors developed a scoring system that measures how closely a disease is connected to the key hallmarks of aging, such as inflammation, genetic instability, and impaired cellular repair. Using this system, they evaluated 13 common age-related diseases and found that IPF had a particularly high overlap with aging biology. IPF is a chronic disease that causes scarring in the lungs and a rapid decline in lung function. In contrast to the gradual loss of function seen in normal aging, IPF progresses more than five times faster. The authors highlight that IPF shares nearly all of the biological features associated with aging. These similarities make IPF a strong candidate for studying aging and testing therapies that target its underlying causes. The authors also discuss different therapies currently being developed for IPF that are also designed to address aging itself. These include drugs that clear senescent cells, activate telomerase to maintain chromosome health, or repair damaged signaling between cells. Some of these treatments, such as senolytic combinations and AI-discovered compounds like rentosertib, are already showing early promise in preclinical or clinical trials. In addition, the authors point out that IPF's fast progression and clearly measurable outcomes offer an advantage for clinical testing. If a therapy proves effective in IPF, it may also be useful for other conditions that share similar aging-related mechanisms, including diabetes, arthritis, and heart disease. This approach could accelerate drug development and reduce costs by focusing on therapies that target shared biological pathways. Overall, this perspective supports a shift in pharmaceutical research toward treating aging as an underlying cause of many chronic diseases. By positioning IPF as a model for aging-related drug development, the authors propose a strategic pathway for testing and expanding anti-aging therapies across a wide range of health conditions. DOI - https://doi.org/10.18632/aging.206301 Corresponding author - Alex Zhavoronkov – alex@insilico.com Video short - https://www.youtube.com/watch?v=p5ur7itzvSI Subscribe for free publication alerts from Aging - https://www.aging-us.com/subscribe-to-toc-alerts To learn more about the journal, please visit our website at https://www.Aging-US.com​​ and connect with us on social media at: Facebook - https://www.facebook.com/AgingUS/ X - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/@AgingJournal LinkedIn - https://www.linkedin.com/company/aging/ Bluesky - https://bsky.app/profile/aging-us.bsky.social Pinterest - https://www.pinterest.com/AgingUS/ Spotify - https://open.spotify.com/show/1X4HQQgegjReaf6Mozn6Mc MEDIA@IMPACTJOURNALS.COM

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Elizabeth H. Mack, MD, MS, FCCM, speaks with Anil Sachdev, MD, FICCM, of the Institute of Child Health, Sir Ganga Ram Hospital in New Delhi, India about his team's study, “Transpulmonary Pressure-Guided Mechanical Ventilation in Severe Acute Respiratory Distress Syndrome in the PICU: Single-Center Retrospective Study in North India, 2018–2021,” published in the March 2025 issue of Pediatric Critical Care Medicine. Dr. Sachdev explains the development and implementation at his institution of a protocol for transpulmonary pressure (TPP) monitoring in pediatric patients with severe acute respiratory distress syndrome. His team compared outcomes of patients receiving TPP-guided ventilation with those receiving conventional mechanical ventilation. Study findings suggested that TPP monitoring enabled the use of higher positive end-expiratory pressure with greater clinician confidence, resulting in improved oxygenation. Study limitations included small sample size and challenges of equipment availability, cost, and obtaining parental consent. The study was conducted in part during the COVID-19 pandemic, which further constrained resources and study participation. The discussion concludes with Dr. Sachdev's insights into practical challenges of TPP monitoring, including inserting delicate esophageal catheters in infants and young children and the necessity of correct catheter position for accurate readings. Resources referenced in this episode: Transpulmonary Pressure-Guided Mechanical Ventilation in Severe Acute Respiratory Distress Syndrome in the PICU: Single-Center Retrospective Study in North India, 2018–2021 (Sachdev A, et al. Pediatr Crit Care Med. 2025;26:e354-e363).

A severely ill Flu A patient, fully intubated, and fighting for every breath requires the AMPED team for transport for possible ECMO. Under even the best of circumstances, this type of patient requires extensive care and presents many challenges. But what happens when extreme weather causes problems with the team's equipment, making care even more challenging? Find out how our team dealt with and overcame these challenges to help ensure our patient's recovery and survival.   Interested in obtaining CE credit for this episode? Visit OnlineAscend.com to learn more. Listeners can purchase individual episode credits or subscribe to the Critical Care Review Bundle and gain access to all episode CE Credits.    We are joined by:   Matt Johnson, NRP Flight Paramedic     Anna Schmick, BSN, RN, CFRN Flight Nurse    Click here to download this episode today! As always thanks for listening and fly safe! Hawnwan Moy MD FACEP FAEMS John Wilmas MD FACEP FAEMS Nyssa Hattaway, BA, BSN, RN, CEN, CPEN, CFRN

The JournalFeed podcast for the week of July 7-11, 2025.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday Spoon Feed:Targeting the 5th percentile mean blood pressure in pediatric septic shock resulted in similar 28-day mortality as targeting the 50th percentile - while reducing vasopressor use, side effects, and complications like ARDS.Friday Spoon Feed:This study shows that ketamine alone is a safe choice for pediatric sedation in the ED, with serious adverse events (AE) occurring rarely, primarily in older children or when opioids are coadministered.

In this episode, Julie, Suzanne, and Stephanie answer the listeners' questions regarding acute respiratory distress syndrome (ARDS) and Cardiomyopathy. These 2 diagnoses can appear with similar symptoms. The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Critical Care Obstetrics Academy: https://www.clinicalconceptsinob.com/Follow us: Instagram: https://www.instagram.com/criticalcareob/Dr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Ma...

Dr. Harish Kinni, a triple-board-certified emergency medicine and critical care physician and assistant professor at the Mayo Clinic, provides an overview of the fundamentals of ventilator care for emergency department professionals. We will review key modes that we should know, the variables to set, how to adjust them for your patient's needs, and provide troubleshooting tips and tricks for when things suddenly go awry. This is sure to be one of the most helpful chapters of Always on EM, but don't let it take your breath away! CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS Swart P, Nijbroek SGLH, Paulus F, Neto AS, Schultz MJ. Sex Differences in Use of Low Tidal Volume Ventilation in COVID-19-Insights From the PRoVENT-COVID Study. Front Med (Lausanne). 2022 Jan 3;8:780005. doi: 10.3389/fmed.2021.780005. PMID: 35300177; PMCID: PMC8923734. McNicholas BA, Madotto F, Pham T, Rezoagli E, Masterson CH, Horie S, Bellani G, Brochard L, Laffey JG; LUNG SAFE Investigators and the ESICM Trials Group. Demographics, management and outcome of females and males with acute respiratory distress syndrome in the LUNG SAFE prospective cohort study. Eur Respir J. 2019 Oct 17;54(4):1900609. doi: 10.1183/13993003.00609-2019. PMID: 31346004. Swart P, Deliberato RO, Johnson AEW, Pollard TJ, Bulgarelli L, Pelosi P, de Abreu MG, Schultz MJ, Neto AS. Impact of sex on use of low tidal volume ventilation in invasively ventilated ICU patients-A mediation analysis using two observational cohorts. PLoS One. 2021 Jul 14;16(7):e0253933. doi: 10.1371/journal.pone.0253933. PMID: 34260619; PMCID: PMC8279424. Evans, Laura1; Rhodes, Andrew2; Alhazzani, Waleed3; Antonelli, Massimo4; Coopersmith, Craig M.5; French, Craig6; Machado, Flávia R.7; Mcintyre, Lauralyn8; Ostermann, Marlies9; Prescott, Hallie C.10; Schorr, Christa11; Simpson, Steven12; Wiersinga, W. Joost13; Alshamsi, Fayez14; Angus, Derek C.15; Arabi, Yaseen16; Azevedo, Luciano17; Beale, Richard18; Beilman, Gregory19; Belley-Cote, Emilie20; Burry, Lisa21; Cecconi, Maurizio22; Centofanti, John23; Coz Yataco, Angel24; De Waele, Jan25; Dellinger, R. Phillip26; Doi, Kent27; Du, Bin28; Estenssoro, Elisa29; Ferrer, Ricard30; Gomersall, Charles31; Hodgson, Carol32; Hylander Møller, Morten33; Iwashyna, Theodore34; Jacob, Shevin35; Kleinpell, Ruth36; Klompas, Michael37; Koh, Younsuck38; Kumar, Anand39; Kwizera, Arthur40; Lobo, Suzana41; Masur, Henry42; McGloughlin, Steven43; Mehta, Sangeeta44; Mehta, Yatin45; Mer, Mervyn46; Nunnally, Mark47; Oczkowski, Simon48; Osborn, Tiffany49; Papathanassoglou, Elizabeth50; Perner, Anders51; Puskarich, Michael52; Roberts, Jason53; Schweickert, William54; Seckel, Maureen55; Sevransky, Jonathan56; Sprung, Charles L.57; Welte, Tobias58; Zimmerman, Janice59; Levy, Mitchell60. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Critical Care Medicine 49(11):p e1063-e1143, November 2021. | DOI: 10.1097/CCM.0000000000005337  Fan E, Del Sorbo L, Goligher EC, Hodgson CL, Munshi L, Walkey AJ, Adhikari NKJ, Amato MBP, Branson R, Brower RG, Ferguson ND, Gajic O, Gattinoni L, Hess D, Mancebo J, Meade MO, McAuley DF, Pesenti A, Ranieri VM, Rubenfeld GD, Rubin E, Seckel M, Slutsky AS, Talmor D, Thompson BT, Wunsch H, Uleryk E, Brozek J, Brochard LJ; American Thoracic Society, European Society of Intensive Care Medicine, and Society of Critical Care Medicine. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med. 2017 May 1;195(9):1253-1263. doi: 10.1164/rccm.201703-0548ST. Erratum in: Am J Respir Crit Care Med. 2017 Jun 1;195(11):1540. doi: 10.1164/rccm.19511erratum. PMID: 28459336. Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, Oczkowski S, Levy MM, Derde L, Dzierba A, Du B, Aboodi M, Wunsch H, Cecconi M, Koh Y, Chertow DS, Maitland K, Alshamsi F, Belley-Cote E, Greco M, Laundy M, Morgan JS, Kesecioglu J, McGeer A, Mermel L, Mammen MJ, Alexander PE, Arrington A, Centofanti JE, Citerio G, Baw B, Memish ZA, Hammond N, Hayden FG, Evans L, Rhodes A. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Crit Care Med. 2020 Jun;48(6):e440-e469. doi: 10.1097/CCM.0000000000004363. PMID: 32224769; PMCID: PMC7176264. Wang W, Scharfstein D, Wang C, Daniels C, Needham D, Brower R, NHLBI ARDS Clinical Network. Estimating the Causal Effect of Low Tidal Volume Ventilation on Survival in Patients with Acute Lung Injury. J R Stat Soc Ser C Appl Stat. 2011. PMC: PMC3197806 Brower RG, Thompson BT, NIH/NHLBI/ARDSNetwork. Tidal volumes in acute respiratory distress syndrome--one size does not fit all. Crit Care Med. 2006. Hager DN, Krishman JA, Hayden D, Brower RG, ARDSNet NIH / NHLBI. Tidal Volume Reduction in Patients with acute Lung Injury When Plateau Pressures Are Not High. Am J Resp Crit Care Med. 2005. Rubenfeld GD, Cooper C, Carter G, Thompson BT, Hudson LD. Barriers to providing lung protective ventilation to patients with acute lung injury. Crit Care Med. 2004. Chatburn RL, El-Khatib M, Mireles-Cabodevila E. A taxonomy for mechanical ventilation: 10 fundamental maxims. Respir Care. 2014 Nov;59(11):1747-63. doi: 10.4187/respcare.03057. Epub 2014 Aug 12. PMID: 25118309. Guo L, Wang W, Zhao N, Guo L, Chi C, Hou W, Wu A, Tong H, Wang Y, Wang C, Li E. Mechanical ventilation strategies for intensive care unit patients without acute lung injury or acute respiratory distress syndrome: a systematic review and network meta-analysis. Crit Care. 2016 Jul 22;20(1):226. doi: 10.1186/s13054-016-1396-0. PMID: 27448995; PMCID: PMC4957383. Rice TW, Wheeler AP, Bernard GR, Hayden DL, Schoenfeld DA, Ware LB, NIH NHLBI ARDS Network. Comparison of the Sp02/FI02 Ratio and the PaO 2/FI02 in Patients with Acute Lung Injury or ARDS. Chest. 2007. Zhang G, Burla MJ, Caesar BB, Falank CR, Kyros P, Zucco VC, Strumilowska A, Cullinane DC, Sheppard FR. Emergency Department SpO2/FiO2 Ratios Correlate with Mechanical Ventilation and Intensive Care Unit Requirements in COVID-19 Patients. West J Emerg Med. 2024 May;25(3):325-331. doi: 10.5811/westjem.17975. PMID: 38801037; PMCID: PMC11112664.   WANT TO WORK AT MAYO? EM Physicians: https://jobs.mayoclinic.org/emergencymedicine EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs   Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs

Today, we're virtually visiting the University of Virginia for another Fellows' Case Files. This is a fantastic case that covers ARDS, the infectious work up of an immunosuppressed patient, and the evaluation of undifferentiated shock. Please let us know what … Continue reading →

Lung-protective ventilation (LPV), characterized by low tidal volumes and appropriate PEEP, is a cornerstone in managing patients with acute respiratory distress syndrome (ARDS). However, its application in patients with severe acute brain injury raises concerns. The potential for lung protective ventilation to increase intracranial pressure due to hypercapnia and elevated PEEP levels necessitates a closer examination of its safety and efficacy in this unique patient population.

Learning Objectives:By the end of this series, listeners should be able to discuss:The physiologic rationale supporting the use of airway pressure release ventilation (APRV) in ARDS. The patient populations most likely to benefit from APRV.Key published evidence that informs our use of APRV in critical care.An expert approach to managing a patient with APRV.Next steps in research that will direct our understanding of the use of APRV in pediatric critical care.About our Guest: Dr. Palen Mallory is an assistant professor of pediatrics at Duke University and a pediatric intensivist at Duke Children's Hospital. She completed medical school at Virginia Commonwealth University, a pediatric residency at Emory University, and a critical care fellowship at Vanderbilt University. She is interested in respiratory care research, including ECMO, respiratory failure, and ARDS.Selected References:Mallory, P., & Cheifetz, I. (2020). A comprehensive review of the use and understanding of airway pressure release ventilation. Expert Review of Respiratory Medicine, 14(3), 307–315. https://doi.org/10.1080/17476348.2020.1708719Frawley, P. M., & Habashi, N. M. (2004). Airway pressure release ventilation and pediatrics: Theory and practice. Critical Care Nursing Clinics of North America, 16(3 SPEC. ISS.), 337–348. https://doi.org/10.1016/J.CCELL.2004.04.003Fredericks, A. S., Bunker, M. P., Gliga, L. A., Ebeling, C. G., Ringqvist, J. R. B., Heravi, H., Manley, J., Valladares, J., & Romito, B. T. (2020). Airway Pressure Release Ventilation: A Review of the Evidence, Theoretical Benefits, and Alternative Titration Strategies. Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine, 14. https://doi.org/10.1177/1179548420903297APRV Guideline - EMCrit Project. (n.d.). Retrieved March 30, 2025, from https://emcrit.org/squirt/aprv/Andrews P, Shiber J, Madden M, Nieman GF, Camporota L, Habashi NM. Myths and Misconceptions of Airway Pressure Release Ventilation: Getting Past the Noise and on to the Signal. Front Physiol. 2022 Jul 25;13:928562. doi: 10.3389/fphys.2022.928562. PMID: 35957Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Learning Objectives:By the end of this series, listeners should be able to discuss:The physiologic rationale supporting the use of airway pressure release ventilation (APRV) in ARDS. The patient populations most likely to benefit from APRV.Key published evidence that informs our use of APRV in critical care.An expert approach to managing a patient with APRV.Next steps in research that will direct our understanding of the use of APRV in pediatric critical care.About our Guest: Dr. Palen Mallory is an assistant professor of pediatrics at Duke University and a pediatric intensivist at Duke Children's Hospital. She completed medical school at Virginia Commonwealth University, a pediatric residency at Emory University, and a critical care fellowship at Vanderbilt University. She is interested in respiratory care research, including ECMO, respiratory failure, and ARDS.Selected References:Mallory, P., & Cheifetz, I. (2020). A comprehensive review of the use and understanding of airway pressure release ventilation. Expert Review of Respiratory Medicine, 14(3), 307–315. https://doi.org/10.1080/17476348.2020.1708719Frawley, P. M., & Habashi, N. M. (2004). Airway pressure release ventilation and pediatrics: Theory and practice. Critical Care Nursing Clinics of North America, 16(3 SPEC. ISS.), 337–348. https://doi.org/10.1016/J.CCELL.2004.04.003Fredericks, A. S., Bunker, M. P., Gliga, L. A., Ebeling, C. G., Ringqvist, J. R. B., Heravi, H., Manley, J., Valladares, J., & Romito, B. T. (2020). Airway Pressure Release Ventilation: A Review of the Evidence, Theoretical Benefits, and Alternative Titration Strategies. Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine, 14. https://doi.org/10.1177/1179548420903297APRV Guideline - EMCrit Project. (n.d.). Retrieved March 30, 2025, from https://emcrit.org/squirt/aprv/Andrews P, Shiber J, Madden M, Nieman GF, Camporota L, Habashi NM. Myths and Misconceptions of Airway Pressure Release Ventilation: Getting Past the Noise and on to the Signal. Front Physiol. 2022 Jul 25;13:928562. doi: 10.3389/fphys.2022.928562. PMID: 35957Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Welcome to the The Confab, the term derives from "confidential talk", which was commonly used in the Prohibition Era for meetings and conversations that took place in the smoky, rule-breaking speakeasies of that time.The informal, privacy focused and clandestine nature of Ungovernable Misfits lends itself to these discussions. So, grab a seat and a stiff drink from the concealed bar, listen and revel in the conversation.In this episode, Max chats to K about performance enhancements. Covering diet, supplements and pharmaceutical interventions and how you can own the keys to your health and make a beast out of yourself.IMPORTANT LINKS https://freesamourai.comhttps://p2prights.org/donate.htmlhttps://ungovernablemisfits.comVALUE FOR VALUEThanks for listening you Ungovernable Misfits, we appreciate your continued support and hope you enjoy the shows.You can support this episode using your time, talent or treasure.TIME:- create fountain clips for the show- create a meetup- help boost the signal on social mediaTALENT:- create ungovernable misfit inspired art, animation or music- design or implement some software that can make the podcast better- use whatever talents you have to make a contribution to the show!TREASURE:- BOOST IT OR STREAM SATS on the Podcasting 2.0 apps @ https://podcastapps.com- DONATE via Paynym @ https://paynym.rs/+misfit- DONATE via Monero @ https://xmrchat.com/ugmf- BUY SOME STICKERS @ https://www.ungovernablemisfits.com/shop/FOUNDATIONhttps://foundation.xyz/ungovernableFoundation builds Bitcoin-centric tools that empower you to reclaim your digital sovereignty.As a sovereign computing company, Foundation is the antithesis of today's tech conglomerates. Returning to cypherpunk principles, they build open source technology that “can't be evil”.Thank you Foundation Devices for sponsoring the show!Use code: Ungovernable for $10 off of your purchaseCAKE WALLEThttps://cakewallet.comCake Wallet is an open-source, non-custodial wallet available on Android, iOS, macOS, and Linux.Features:- Built-in Exchange: Swap easily between Bitcoin and Monero.- User-Friendly: Simple interface for all users.Monero Users:- Batch Transactions: Send multiple payments at once.- Faster Syncing: Optimized syncing via specified restore heights- Proxy Support: Enhance privacy with proxy node options.Bitcoin Users:- Coin Control: Manage your transactions effectively.- Silent Payments: Static bitcoin addresses- Batch Transactions: Streamline your payment process.Thank you Cake Wallet for sponsoring the show!(00:00:00) INTRO(00:02:08) THANK YOU FOUNDATION(00:02:52) THANK YOU CAKE WALLET(00:03:55) BOOSTS(00:06:28) Welcome Back (00:13:38) Disclaimer(00:15:00) Diet Basics(00:26:00) Jib Jab(00:26:47) Inflammation(00:30:53) Fibre(00:35:23) Cancer(00:38:02) Autophagy(00:40:55) Vitamins & Minerals(00:46:07) Training(00:49:07) Growth Hormone(00:50:13) Dig Bick(00:52:50) Needles or Tablets(01:00:53) Test is Best(01:08:14) PCT & HCG(01:12:50) DIY or Big Pharma(01:19:08) The Benefits(01:19:44) Healing Potions(01:22:00) Final Thoughts

He's the ultimate rock 'n' roll frontman, but Justin Hawkins from The Darkness also possesses a penchant for performance cars, and like his catsuits, he likes them to be exotic and flamboyant! This is a brilliant episode as Jason and Dave take a walk down Justin's memory lane of motors, and talk about his future days on track, now that he's passed his ARDS racing licence!

In this forward-looking episode of the SCCM Podcast, Daniel F. McAuley, MD, explores how the clinical and research communities are rethinking acute respiratory distress syndrome (ARDS), shifting from a one-size-fits-all model to a focus on identifying and targeting modifiable traits. Building on his Thought Leader Session at the 2024 Critical Care Congress, Dr. McAuley unpacks the major thematic shift toward precision medicine in critical care. Instead of treating ARDS as a single, homogenous condition, researchers are increasingly identifying biologically distinct subgroups—especially hyper- and hypoinflammatory phenotypes—that may respond differently to therapies. These insights are fueling a new generation of trials that aim to prospectively apply this knowledge to treatment strategies. Central to this evolution is the Precision medicine Adaptive platform Network Trial in Hypoaemic acutE respiratory failure (PANTHER), of which Dr. McAuley is a team member. PANTHER is a Bayesian adaptive platform randomized clinical trial studying novel interventions to improve outcomes for patients with acute hypoxemic respiratory failure. Designed to be adaptive and biomarker informed, PANTHER will test therapies such as simvastatin and baricitinib, based on real-time phenotyping of patients with ARDS. Throughout the episode, Dr. McAuley reflects on how advances in machine learning and biomarker identification are making precision treatment more feasible. He discusses the importance of maintaining evidence-based supportive care, such as lung-protective ventilation and prone positioning, while integrating new targeted therapies. Discover the latest investigations into potential therapeutic agents—including mesenchymal stromal cells, statins, and extracorporeal carbon dioxide removal—as Dr. McAuley aims to translate early findings into tangible improvements in patient outcomes. This episode offers critical insights into the changing landscape of ARDS research and patient care, as Dr. McAuley articulates a hopeful vision for the future—one in which targeted, individualized treatments can improve outcomes for patients with one of critical care's most challenging conditions. Dr. McAuley is a consultant and professor in intensive care medicine in the regional intensive care unit at the Royal Victoria Hospital and Queen's University of Belfast. He is program director for the  Medical Research Council/National Institute for Health and Care Research (MRC/NIHR) Efficacy and Mechanism Evaluation Program and scientific director for programs in NIHR.   Access Dr. McAuley's Congress Thought Leader Session, ARDS: From Treating a Syndrome to Identifying Modifiable Traits here.

On this week's episode of Critical Care Time, we revisit ARDS... sort of! We are joined again by Dr. Whittney Warren & for the first time by Denitza Blagev for a dynamic discussion on ARDS imitators: Things that looks like ARDS but aren't technically ARDS - or are they? It's a bit of a confusing landscape as you'll see, where the lines are blurred and things get a bit murky. We'll unpack diagnoses like EVALI, DAH, AIP and more in the context of ARDS and help you guys come up with a framework for the "ARDS" patient who doesn't seem to respond to the tried and true approaches we discussed earlier this year on our ARDS Epic-sode!. As always, give it a listen and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

Welcome to another exciting episode of PICU Doc on Call! Today, we're diving deep into the world of pediatric critical care with our expert hosts, Dr. Rahul Damania, Dr. Pradip Kamat, and Dr. Monica Gray. Get ready to unravel the mysteries of the oxygen extraction ratio (O2ER) and its pivotal role in managing pediatric acute respiratory distress syndrome (ARDS) and multi-organ dysfunction.Picture this: a seven-year-old girl battling severe pneumonia that spirals into ARDS and septic shock. Our hosts walk you through this gripping case, shedding light on calculating O2ER and why central venous oxygen saturation (ScvO2) is a game-changer. They'll share their top strategies for optimizing oxygen delivery and cutting down on oxygen demand.But that's not all! This episode is all about the holistic approach to managing critically ill pediatric patients. Tune in to discover how these insights can lead to better outcomes for our youngest and most vulnerable patients. Don't miss out on this vital conversation!Show Highlights:Clinical significance of the oxygen extraction ratio (O2ER) in pediatric critical careImportance of understanding oxygen delivery and consumption in critically ill patientsCalculation and interpretation of O2ER and its relationship to central venous oxygen saturation (ScvO2)Physiological concepts related to oxygenation, including intrapulmonary shunting and ventilation-perfusion mismatchManagement strategies for increasing oxygen delivery and reducing oxygen demand in ARDS and septic shockInterventions such as blood transfusions, sedation, and optimization of cardiac outputImplications of lactic acidosis and anaerobic metabolism in the context of inadequate oxygen deliveryHolistic approach to patient management, focusing on both numerical values and overall metabolic needsWe welcome you to share your feedback, subscribe & place a review on our podcast! Please visit our website picudoconcall.org.References:Fuhrman B.P. & Zimmerman J.J. (Eds.). Pediatric Critical Care, 6th ed. Elsevier; 2021. (Key concepts of oxygen delivery, consumption, and extraction in shock states are discussed in Chapter 13) .Nichols D.G. (Ed.). Roger's Textbook of Pediatric Intensive Care, 5th ed. Wolters Kluwer; 2016. (Comprehensive review of oxygen transport and utilization in critically ill children, including ARDS and shock).Lucking S.E., Williams T.M., Chaten F.C., et al. Dependence of oxygen consumption on oxygen delivery in children with hyperdynamic septic shock and low oxygen extraction. Crit Care Med. 1990;18(12):1316–1319. doi:10.1097/00003246-199012000-00002.Ronco J.J., Fenwick J.C., Tweeddale M.G., et al. Pathologic dependence of oxygen consumption on oxygen delivery in acute respiratory failure. Chest. 1990;98(6):1463–1466. doi:10.1378/chest.98.6.1463 .Carcillo J.A., Davis A.L., Zaritsky A. Clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock. Crit Care Med. 2002;30(6):1365–1378. (ACCM guidelines emphasizing ScvO₂ targets in shock) .Emeriaud G, López-Fernández YM, Iyer NP, et al; PALICC-2 Group; PALISI Network. Executive summary of the second international guidelines for the diagnosis and management of pediatric ARDS (PALICC-2). Pediatr Crit Care Med. 2023;24(2):143–168. doi:10.1097/PCC.0000000000003147.

Editor's Summary by JAMA Deputy Editors Linda Brubaker, MD, and Preeti Malani, MD, MSJ, for articles published from March 15-21, 2025.

ARDS, which is characterized by hypoxemic respiratory failure and inflammatory injury to the lungs, has a mortality rate of 30% to 40%. Balasubramanian Venkatesh, MD, of the George Institute for Global Health joins JAMA Deputy Editor Kristin Walter, MD, MS, to discuss the effects of inhaled sedation with sevoflurane for patients with moderate to severe ARDS. Related Content: Sevoflurane Sedation in Acute Respiratory Distress Syndrome Inhaled Sedation in Acute Respiratory Distress Syndrome

What happens when a doctor becomes the patient—facing a near-death experience that changes everything?In this episode of Shifting Dimensions, Jummie sits down with Dr. Michael Hession, a physician whose life took an unexpected turn when he found himself fighting for survival. After developing severe pneumonia that spiraled into acute respiratory distress syndrome (ARDS), Dr. Hession was at death's door. And in that moment, something incredible happened—he had a near-death experience.He describes seeing a luminous figure, hearing the words, "Michael, it is not your time. You must go back. There is much to do." When he woke up, he wasn't just battling to heal physically—he was trying to make sense of what had just happened on a much deeper level.In this conversation, Dr. Hession opens up about what it was like to suddenly be on the other side of the hospital bed, how the experience transformed his understanding of medicine, and the role that empathy, prayer, and human connection play in healing. He also shares insights from his book, Physician Heal Thyself: Nearly Dead and the Journey Back to Health, where he explores what it truly means to recover—not just in body, but in mind and spirit.This episode is an emotional and eye-opening look at life, death, and the mysteries in between.What You'll Hear in This Episode:

Refractory hypoxemia in the intubated patient is one of the scariest situations any emergency physician can face. In this episode of EMRA*Cast, Drs. Peter Lorenz and Steven Haywood discuss a stepwise approach to managing this worst-case scenario.

In this episode, we review the high-yield topic of⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠Acute Respiratory Distress Syndrome (ARDS)⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Respiratory section.Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets

Today we have a mini-episode / clinical pearl. We previously discussed the PROSEVA trial and the evidence for prone positioning in ARDS. In that trial, patients with elevated intracranial pressure (ICP) were excluded. We are joined now by Dr. Jon … Continue reading →

We are headed out to Portland, Oregon today to speak with Listener Sammy about her first Dopey Challenge from a couple of weeks ago down at Walt Disney World! Sammy was a member of USA Fencing who wanted to take on a new challenge, and found that in runDisney! We discuss her planning 4 costumes for 4 days (and the logistics of getting them all to Walt Disney World), organizing a group of 14, most of whom were not running the races, some great meals (and easy-to-get ARDs) for Marathon Weekend, and more! We also preview Sammy's thoughts on this weekend's upcoming Disneyland Half-Marathon events, as she will be headed there as well! We hope you can continue the conversation with us this week in the Be Our Guest Podcast Clubhouse at www.beourguestpodcast.com/clubhouse! Thank you so much for your support of our podcast! Become a Patron of the show at www.Patreon.com/BeOurGuestPodcast.  Also, please follow the show on Twitter @BeOurGuestMike and on Facebook at www.facebook.com/beourguestpodcast.   Thanks to our friends at The Magic For Less Travel for sponsoring today's podcast!

If you thought ARDS was a long episode... get ready for a marathon! This week on Critical Care Time, Cyrus and Nick take on the unenviable task of trying to cover everything you need to know about cardiogenic shock - at least in broad strokes - in ONE episode! That's right, this is your one-stop-shop for all things cardiogenic shock. While we will have some deep dives on RV and LV failure, as well as ECMO and other mechanical circulatory support options - this episode has a little bit of it all to wet your whistle and then some! We deconstruct the epidemiology of cardiogenic shock, do a deep dive on the SCAI classes of cardiogenic shock, talk pathophysiology (duh!) and then move on to treatment considerations - both medical and mechanical - followed finally by some cases to cement all the learning. We know this is a long one so feel free to listen/watch in chunks. However you decide to enjoy it, we are certain you will walk away from it ready to conquer the next CGS case you come across! Once you've finished this epic - leave us a review and let us know how we did! Hosted on Acast. See acast.com/privacy for more information.

Today, pediatric intensivists Dr. Pradip Kamat and Dr. Rahul Damania discuss a complex case of a 12-year-old girl who suffered a seizure and unresponsiveness due to a subarachnoid hemorrhage from a ruptured aneurysm. They explore the multi-system effects of traumatic brain injury (TBI) and intracranial hemorrhage, focusing on non-neurologic organ dysfunction. They'll also highlight the impact on cardiovascular, respiratory, renal, and hepatic systems, emphasizing the importance of understanding these interactions for better patient management. Tune in to hear relevant studies and management strategies to improve outcomes in pediatric TBI cases.In This Episode:Clinical case of a 12-year-old girl with seizure and unresponsiveness due to subarachnoid hemorrhage from a ruptured aneurysmManagement of non-neurologic organ dysfunction in traumatic brain injury (TBI) and intracranial hemorrhageMulti-system effects of brain injuries, including cardiovascular, respiratory, renal, and hepatic complicationsImportance of recognizing non-neurologic organ dysfunction in pediatric patientsEpidemiology and prevalence of non-neurologic organ dysfunction in patients with aneurysms or subarachnoid hemorrhageMechanisms of organ dysfunction following brain injury, including inflammatory responses and cytokine releaseManagement strategies for cardiovascular complications in TBI patients.Discussion of respiratory complications, such as acute lung injury and ARDS, in the context of TBIRenal and hepatic dysfunction associated with traumatic brain injury and their managementEmphasis on the need for a comprehensive understanding of organ interactions to improve patient outcomes in pediatric critical careConclusionIn summary, the episode underscores the complex interplay between brain injury and multi-system organ dysfunction. The hosts emphasize the need for a comprehensive understanding of these interactions to improve patient outcomes in pediatric TBI cases. They advocate for a team-based approach to management, focusing on individual patient physiology and the delicate balance required to address the challenges posed by non-neurologic organ dysfunction.Connect With Us!We hope you found value in this case-based discussion. Please share your feedback, subscribe, and leave a review on our podcast. For more resources, visit our website at PICUoncall.org.Thank you for joining us, and stay tuned for our next episode!

On this week's episode, Cyrus & Nick tackle one of their biggest challenges yet: Acute Respiratory Distress Syndrome, more commonly known as ARDS.***WARNING*** this is no shorty! We cover all things ARDS from pathophysiology, diagnosis, treatments and things NOT to do. Dare we say, this is the definitive FOAM-ARDS experience for anyone and everyone who cares for people suffering from ARDS. Give it a listen and as always, send us your feedback!! Hosted on Acast. See acast.com/privacy for more information.

In this episode, we review the high-yield topic of ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Acute Respiratory Distress Syndrome (ARDS) ⁠⁠⁠⁠⁠⁠⁠⁠from the Pulmonary section at ⁠⁠⁠⁠⁠⁠Medbullets.com⁠⁠⁠⁠⁠⁠ Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets

Unexploded Bomb: Where the COVID-19 Vaccine Deaths Are Really Hiding. Epoch Times. Part 1- Evidence: How CDC Buried Vaccine Death Data https://www.theepochtimes.com/epochtv/evidence-how-cdc-buried-vaccine-death-data-5575113 Frontline Health   Views 88.8K • Jan-27-2024 Today on Frontline Health we interview John Beaudoin, an electrical engineer and author of “The Real CdC.” On January 18, 2022, Cassidy, a seven-year-old girl died from COVID-19 complications in Massachusetts. Her story was broadcast on local networks. Beaudoin saw it too, but he had questions. “I'm thinking, for everything I know about the data, there's no way a seven-year-old girl died from COVID,” he said. Beaudoin ran eight public records requests. “I ran them through other people so that the state wouldn't deny me,” he said. That's how he was able to obtain the entire death certificate database of Massachusetts with no redactions, from the year 2015 through 2022. At the time, he says it was a total of 420,000 records. Cassidy's cause of death was in there too. Her death certificate vaguely listed “complications of coronavirus-19 viral infection.” “Okay, well, what kind of complications? Why didn't they list anything like pneumonia [or] ARDS?” he said. “Why is there nothing else listed? Did she have a heart attack? How does somebody die from COVID with no other symptoms?” Beaudoin decided to turn to the Vaccine Adverse Event Reporting System (VAERS). After running a few requests, he came upon one record that could have belonged to Cassidy. “The report was made on January 15th, that's a couple days, two or three days before she died.” This particular VAERS record describes a 7-year-old girl vomiting for 8-10 hours after her first COVID-19 vaccine injection. After her second injection, she had severe abdominal pain, 103 degree fever and no bowel movement for three days. If this VAERS record actually belongs to Cassidy, then her cause of death should have been listed as a vaccine. “I want to know, is that the same girl? The state won't tell me so I'm suing the governor of the state, the public health commissioner, chief medical examiner and four individual medical examiners.” But Cassidy's case “was the tip of the iceberg,” says Beaudoin. He has uncovered many more questionable death certificates in the Massachusetts death database that have not attributed “vaccine” as the cause of death when there was evidence of severe vaccine reaction. “It's not willful ignorance,” Beaudoin said. “This is intentional withholding of information from the public that would save the lives of the public.” Follow Dan on

FREE! 8 Steps to Becoming a CRNA: https://www.cspaedu.com/3m9jgffpJoin us for this enlightening episode of the CSPA Podcast as Dr. Jeremy Heiner, an esteemed educator with over 16 years of experience, dives deep into the complexities of Acute Respiratory Distress Syndrome (ARDS). Unpacking the evolution, pathophysiology, and modern treatment approaches of ARDS, today's special guest episode offers invaluable insights for ICU nurses and nurse anesthesia providers.Whether you're a seasoned practitioner or a nursing student eager to expand your critical care knowledge, this episode is packed with essential information that will enhance your understanding and skills in managing ARDS. Tune in for a masterclass in respiratory care and gain practical knowledge that could be crucial in your next shift in the ICU.Thousands of nurses have gained CRNA school acceptance with CRNA School Prep Academy. Join today for access to all of the tools proven to accelerate your CRNA success! Click here:https://cspaedu.com/joinGet CRNA School insights sent straight to your inbox! Join the CSPA email list: https://www.cspaedu.com/podcast-email Join the Free Facebook Community here! https://www.facebook.com/groups/crnaschoolprepacademyfreeBook a mock interview, resume or personal statement critique, transcript review and more: www.teachrn.comDr. Heiner has an extensive background in clinical anesthesia and is the co-author of several textbooks including Emergency Management in Anesthesia and Critical Care (EMAC), Critical Events in Anesthesia, & Nurse Anesthesia, the main textbook used by a majority of Nurse Anesthesia Programs. Learn More about The Nurse Anesthesia: https://thenurseanesthesia.com/