#39 Beneath the Drape w/ Drs Alin Gragossian & Paul Wischmeyer
On this week's episode of Critical Care Time, Cyrus & Nick sit down with Dr. Alin Gragossian - intensivist, patient advocate, acclaimed blogger and heart transplant recipient and Dr. Paul Wischmeyer - a prior guest on CCT who is a world-renowned intensive care nutrition expert, tenured professor and no stranger to prolonged bouts with critical illness and life-threatening disease. These two incredible people share their stories and perspectives as physicians who have spent considerable time both behind the drape and beneath the drape: Being on the receiving end of countless procedures and life-saving interventions. They share with us their thoughts on where we are succeeding as a healthcare team, and where we can strive to improve at the bedside. Join us as we embark on this emotional and thoughtful journey with Alin & Paul. We hope you will listen to their stories and come away with a new appreciation for the patient experience and how privileged we are to care for the patients we care for.
#38 Palliative Care in Critical Illness: Intentional & Compassionate Palliation with Dr. Anand Iyer, MD
On this week's episode of Critical Care Time, Cyrus & Nick are honored to be joined by palliative care expert, Dr. Anand Iyer. Together they explore the intricacies of palliation in the ICU, exploring the challenge and nuances of addressing this critical element of care amongst the sickest patients in the hospital. How do you begin these discussions? How do you ensure your patients and families feel heard? How do you help them realize palliation is part of the care process and not that you are giving up on a loved one? What terms should we avoid using? We cover all of this and more with Dr. Iyer so make sure to give this episode a listen and leave us some feedback!
#37 Acute Respiratory Distress Syndrome
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!!
#36 Inotropes
Get excited for a new episode jam packed-episode with Critical Care goodness! Nick & Cyrus deconstruct, demystify and unpack Inotropes. These medications are essential in the world of critical care when we have to manage cardiogenic shock. What are the different inotropes? How can you decide which one is right for your patient? And... what's the difference between an Inotropic and an Ionotropic agent? You'll learn all this and so much more on this week's episode of Critical Care Time: The Podcast for Everyone Who Cares for the Critically Ill!
#35 Pulmonary Embolism: Part III
Cyrus and Nick revisit one of their favorite topics: Pulmonary Embolism! In this episode - a follow up to our two-parter from season 1 - we sit down with Dr. Rick Channick of UCLA to talk about his approach to PE management with a focus on catheter directed therapies & PE response teams. This episode is packed full of expert insights and practical clinical pearls. Give it a listen and let us know what you think!
#34 Anatomically Difficult Airway Part 2
In this week's episode of Critical Care Time, Cyrus & Nick close out their discussion (for now anyway!) on difficult airways! Here we build upon episode 33 by working through some scenarios we've seen where we've needed to implement some of the strategies previously discussed. We close out by covering 10 pitfalls and pearls when it comes to anatomically difficult airways. As always, give us a listen and let us know what you think!
#33 Anatomically Difficult Airway Part 1
On this week’s episode of Critical Care Time, Nick & Cyrus return to talk about airway management in the ICU. In season 1 we focused on the physiologically difficult airway. Now we will begin to unravel the anatomically difficult airway. Today we will break things down by covering foundational concepts, discussing some of the physical and cognitive tools you can use to address an airway, and basically set the stage for part II where we will go through some case studies and leave you with our pitfall and pearls for anatomically difficult airways. This episode is packed with clinical pearls that will empower you to take on even the spiciest of airways!
#32 Three Wishes with Dr. Thanh Neville
On this week’s episode of Critical Care Time, Nick & Cyrus have the honor of hosting Dr. Thanh Neville, MD, MSHS (X @thanh_neville) the director of the 3 Wishes Program out of UCLA. In this moving discussion we explore the importance of dying with dignity when curative intent is no longer a realistic option. We dovetail this with an impassioned exploration Dr. Neville’s incredible work with 3WP which relies on modest funding and the power of humanism to grant priceless gifts - Wishes, if you will - to dying patients and their loved ones in their 11th hour. Please give us a listen and let us know what you think!
#31 Tele-Critical Care Drs. Bill Beninati and David Guidry
Tele-health is blowing up in 2024 and that is as true for critical care as it is for other fields of medicine! On this episode of Critical Care Time, Nick and Cyrus interview Drs. Bill Beninati and David Guidry: Two experts in the world of tele critical care. We cover all the in’s and out’s of delivering critical care service from afar with a focus on implementation, logistics, benefits and challenges. Give this a listen and let us know what you think!
#30 Hypoxemia Masterclass
Join Nick and Cyrus as they teach a master class on hypoxemia for everyone and anyone who is ICU adjacent! We discuss why oxygen is so crucial, share some very interesting animal physiology and - perhaps most importantly- discuss the 6 causes of hypoxemia you MUST know… and what you can do about them! Take a listen, let us know what you think, and leave us a review!
#29 Pleural Disease Part 3: Hemothorax & Bronchoplueral Fistulas
On this episode we continue our discussion of pleural disease with a focus on hemothorax & management of bronchopleural fistulas. Small tube or large tube? When do you call in the reinforcements? What about endobronchial valves for persistent air leaks? Learn the answers to these questions - and so much more with Dr. Mike Sobieszczyk our expert interventionalist!
#28 Pleural Disease Part 2: Empyema & Hemothorax
On this episode of Critical Care Time, Nick & Cyrus revisit the pleural space! We had SO much great content we opted to split the episode into two parts. We also figured it would be nice to get an interventionalists take on this and we thus recruited Dr. Mike Sobieszczyk to help navigate this complex topic! Here we discuss things like hepatic hydrothorax, indwelling pleural catheters and all things parapneumonic effusion. Check it out and leave us a review! If you missed our first episode on pleural disease, head on back to episode 10 and get caught up. If you like what you heard here, make sure to come back in 2 weeks for the second part!
#27 Season 1 Listener Mailbag
Join Cyrus and Nick as they review listener questions and feedback from season one of Critical Care Time! Where did we goof up? Where did we hit the "Mark"? Give this episode a listen as we investigate a potpourri of clinically relevant topics courtesy of YOU - our incredible audience whom we are so thankful for.
#26 Breaking News: PREOXI Study Published
Extra Extra - Read All About It!! It is our pleasure to bring to you - hot off the presses - the results from the PREOXI Trial which looks at whether or not preoxygenation with non-invasive positive pressure ventilation results in better peri-intubation outcomes versus non-pressurized preoxygenation strategies. Joining us is the primary author on this paper, Dr. Kevin Gibbs, MD of Wake Forest University School of Medicine. Practice changing? Practice affirming? Does it even matter?! Check out our interview with Dr. Gibbs and see what you think! Leave us a comment and let us know if this is going to impact your practice in the ICU and beyond!
#25 Diuresis & Negative Fluid Balance
Diuretics are essential tools used by clinicians to manage volume status in ambulatory patients and in the critically ill… but are we using them correctly? Join Nick & Cyrus as they explore principles of fluid balance and teach a masterclass on how to approach diuresis in the critically ill patient. You won’t want to miss this high-yield episode discussing an evergreen topic in the world of critical care medicine!
#24 Thrombocytopenia in Critical Illness
Thrombocytopenia is a puzzling, yet common problem in the ambulatory setting, on the wards and in critically ill patients! Having an understanding of why it happens, why it matters, and what we should do about it, is of paramount importance. Given that patient care is first and foremost for us at Critical Care Time, we’ve teamed up - once again - with hematologist extraordinaire Matthew Rendo (X: RendOncology) to help us develop a pragmatic approach to managing the patient with thrombocytopenia. Please give it a listen and let us know what you think!
#23 Resuscitative TEE with Dr. Ross Prager
On Critical Care Time we are - of course - HUGE fans of POCUS. On this episode, Nick and Cyrus take this love for POCUS to the next level with our discussion on Resuscitative Transesophageal Echocardiography (Resus-TEE) with Canadian intensivist, Dr. Ross Prager (@ross_prager) a Resus-TEE expert aficionado! On this show, we discuss the basics of Resus-TEE including indications, pitfalls and pearls, the practicality of implementing this modality at your hospital and some of the medico-legal considerations. We had a ton of fun recording his with Ross and hope you enjoy listening to it!
#22 Bronchoscopy Emergencies w/ PulmPEEPs
(blurb)Like that time the Jetsons met the Flintstones or the more recent colab between Lululemon and Peloton, join us for an epic pairing between Critical Care Time hosts Cyrus & Nick and the PulmPEEPS - Drs. Dave Furfaro and Kristina Montemayor. On this show we use a case based approach to answer the question: How can a bronchoscope save your @$$ in the ICU and beyond? We take a practical look at airway bleeds, trach emergencies and so much more with our friends from PulmPEEPs!
#21 Feeding in Critical Illness w/ Dr. Paul Wischmeyer
On this MEGAsode of Critical Care Time, Cyrus & Nick are joined by world-renowned expert in ICU nutrition, Dr. Paul Wischmeyer (X: Paul_Wischmeyer & IG: paul_wischmeyermd) to discuss all things ICU nutrition. This episode is highly fortified with practice changing pearls from soup to nuts! In addition to getting to know who Paul is and why he does what he does, we demystify metabolic carts, talk about protein needs and metabolism in the critically ill, discuss steroids and other supplements - all while dispelling some major ICU myths regarding gastric residuals, TPN and more. Grab a healthy snack, sit back and get ready to enjoy some remarkable content in an oft overlooked field in medicine!
#20 CRRT w/ Dr. Kevin Chung
On this week’s episode of Critical Care Time, Nick and Cyrus discuss continuous renal replacement (or kidney replacement) therapy and acute kidney injury with master intensivist and extra corporeal aficionado, Dr. Kevin Chung. Dr. Chung is a retired colonel in the United States Army, the principal force behind an intensivist-run renal replacement program in San Antonio, and is currently the Chief Medical Officer for our season one sponsor, Seastar Medical.
In this episode, we discuss an approach to acute kidney injury, demystify elements of continuous renal replacement therapy, and then discuss various applications to include blood purification technology in 2024.