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GENERAL CRITICAL CARE
Live PERT Discussion in the Management of Pulmonary Embolism Cases
01:15:31

Live PERT Discussion in the Management of Pulmonary Embolism Cases

This webinar will provide an in-depth exploration of the management of pulmonary embolism in the intensive care unit. It is designed to provide medical professionals with the tools and knowledge they need to effectively diagnose and manage pulmonary embolism cases. The session will cover topics such as risk assessment, diagnostic strategies, and current treatment options, including both medical and interventional approaches. dditionally, the webinar will highlight best practices for patient monitoring and management, as well as strategies and will discuss the value of a pulmomany embolism rapid response team (PERT). During this educational session, attendees will learn about the latest diagnostic techniques, current best practices for treatment and management, and strategies for overcoming challenges and complications. This webinar will feature expert speakers who will share their experience and insights, as well as interactive case studies and practical tools that attendees can use in their own practice. The ultimate goal of this webinar is to empower medical professionals to confidently diagnose and manage pulmonary embolism cases, leading to better patient outcomes. Speakers: Terry Fortin, MD, MS: Associate professor of medicine and director of pulmonary vascular disease center, Duke university. Nabil Abouchala, MD, FCCP: Associate professor of medicine, University of Albama. Pulmonary and critical care consultant. Talal Dahhan, MD, MMEL, MHA, FACP, FCCP: Assitant professor of medicine, Duke University. Program director, critical care fellowship program.
ChatGPT's Role in the Physician's Toolbox
01:22:10
Current Insights in ICU Nutrition
01:05:45

Current Insights in ICU Nutrition

Nutrition support plays a crucial role in the care of critically ill patients. This review aims to shed light on the latest findings regarding critical care nutrition, with a particular emphasis on the complex relationship between critical illness, the gastrointestinal tract, and nutrition support. The review also examines the available evidence concerning the optimal administration route, type, dosage, and timing of nutrition in this patient population. By exploring these key aspects, we can gain a better understanding of how to effectively provide nutrition support in critical care settings. While indirect calorimetry is the recommended method for measuring energy expenditure, predictive equations are commonly used in practice. However, these equations have limitations as they often lack accuracy when applied to individual patients. Current evidence supports the early initiation of enteral nutrition (EN) in most patients, with a gradual increase in the daily dose during the first week of critical illness. Patients with severe shock may benefit from delayed EN. Recent trials suggest that parenteral nutrition is comparable to EN in terms of effectiveness and may be considered if adequate EN is not achieved within the first week. Although a higher protein dose is recommended, the optimal timing for its administration remains uncertain. Routine use of immuno-nutrition in critically ill patients is not recommended. Patients receiving artificial nutrition should be closely monitored for metabolic abnormalities. Further well-designed studies with sufficient sample sizes are needed to address many remaining unanswered questions in this field. Dr. Abouchala joined UAB as an Assistant Professor of Medicine in Pulmonary and Critical Care Medicine in July 2021. He has also currently held the position of Associate Professor of Medicine at the University of North Dakota, School of Medicine & Health Sciences, since October 2019, where he previously held the position of the Medical Director of the Medical & Surgical ICU, and Program Director of the Critical Care Fellowship. Before his time at UAB, Dr. Abouchala worked as Assistant Professor of Medicine at the University of Tennessee in Memphis, where he also completed his residency and fellowship training in pulmonary and critical care medicine. Dr. Abouchala completed his initial medical training at Aleppo Medical School in 1983.
TTM for Cardiac Arrest: Shockable Rhythms, Non-Shockable Rhythms, and Hypothermia
27:59

TTM for Cardiac Arrest: Shockable Rhythms, Non-Shockable Rhythms, and Hypothermia

In this video, we explore the use of targeted temperature management (TTM) in patients with cardiac arrest, including those with shockable and non-shockable rhythms, and the role of hypothermia in improving outcomes. We review the early trials that led to the development of TTM guidelines and discuss the results of recent multicenter randomized controlled trials, including TTM-1 and TTM-2. We also examine the results of trials such as HYPERION and Wolfrum et al that evaluated TTM in non-shockable rhythms. Key takeaways: TTM has been found to increase survival with good neurologic outcome in patients presenting with an out of hospital cardiac arrest (OHCA) with shockable rhythms The American Heart Association (AHA) and the International Liaison Committee on Resuscitation (ILCOR) 2015 guidelines recommend maintaining temperatures between 32°C and 36°C in the immediate post-arrest period TTM to 33°C was not associated with a statistically significant improvement in mortality, composite of death or poor neurologic function, or total complications compared to 36°C in TTM-1 trial TTM-2 trial found no difference in the primary outcome of mortality or secondary outcome of neurologic function at six months between 32°C and 37.5°C, and demonstrated that 32°C was associated with an increased risk of arrhythmias resulting in hemodynamic compromise HYPERION trial concluded a statistically significant increase in survival with good neurologic outcome in 33°C compared to 37°C for OHCA and in-hospital cardiac arrest patients (IHCA) with no difference in death at 90 days across the groups TTM can limit complications associated with shivering and cardiac arrhythmias Don't forget to like, subscribe, and share this video for more informative content about TTM and cardiac arrest. #TTM #cardiacarrest #hypothermia #shockablerhythms #nonshockablerhythms #OHCA #IHCA #neurologicoutcome #mortality #arrhythmias #AHA #ILCOR
Insights on Post Cardiac Arrest Care Management: Controversies, Risks, and Therapies
51:53

Insights on Post Cardiac Arrest Care Management: Controversies, Risks, and Therapies

Jennifer Spadgenske. a clinical pharmacist, shares her expert insights on targeted temperature management (TTM) after cardiac arrest, the risks associated with TTM, and the detriment of shivering in patients post cardiac arrest. She will describe the pharmacological therapies for the management of shivering in patients undergoing TTM therapy and assess the mean arterial pressure goals for a patient post cardiac arrest. Video Content: Jennifer will start by explaining the controversy surrounding TTM in patients post cardiac arrest. She will discuss the current guidelines and research on this topic and provide her expert opinion on the optimal temperature range to use for cooling. Next, Jennifer will discuss the risks of TTM and the detriment of shivering. She will share her insights on the potential complications associated with TTM, such as infections, electrolyte imbalances, and cardiac arrhythmias. Additionally, she will explain how shivering can negate the beneficial effects of TTM and discuss strategies for managing this side effect. Jennifer will then describe the pharmacological therapies for the management of shivering in patients undergoing TTM therapy. She will discuss the advantages and disadvantages of each therapy and provide her recommendations for their use based on her clinical experience. Finally, Jennifer will assess the mean arterial pressure goals for a patient post cardiac arrest. She will discuss the current guidelines and recommendations for mean arterial pressure goals in post cardiac arrest patients and provide her expert insights on how to achieve these goals. 🩺 Video Content: 00:00 - Introduction 02:28 - Controversy Surrounding TTM in Post Cardiac Arrest Patients 23:30 - Risks of TTM and the Detriment of Shivering 35:50 - Pharmacological Therapies for Shivering Management 38:21 - Mean Arterial Pressure Goals in Post Cardiac Arrest Patients 44:54 - Conclusion 45:14: Questions and Answers 📣 Hashtags: #PostCardiacArrestCare #TTM #ShiveringManagement #MeanArterialPressure #PharmacologicalTherapies #Healthcare #MedicalEducation #ExpertInsights #ClinicalPharmacist
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