SCCM Podcast

Central venous access remains foundational to the delivery of critical care, yet the techniques used for central line insertion have evolved minimally since the introduction of the Seldinger method more than 70 years ago. This relative stagnation persists despite increasing patient complexity and heightened expectations for procedural safety, efficiency, and reliability. This episode of the Society of Critical Care Medicine (SCCM) Podcast examines how procedural variability and fragmented workflows continue to contribute to risk during central venous catheter insertion in critically ill patients. It also considers the growing need to reassess long-standing approaches that may no longer align with the demands of contemporary ICU practice. Host Kyle B. Enfield, MD, speaks with Adnan Javed, MD, about emerging insertion techniques and integrated technologies designed to simplify procedural steps, reduce variability, and support more consistent performance at the bedside. Through a focused exploration of innovation in procedural design, this discussion highlights how streamlined, integrated approaches may enhance clinician performance, improve safety, and advance the standard of care in high-acuity environments. This episode provides a critical perspective on the future of central venous access and the role of innovation in transforming a commonly performed, yet high-stakes, procedure. This episode is sponsored by BD. Learning Objectives Describe how procedural complexity and workflow variability contribute to risk during central venous catheter insertion in critically ill patients Understand the potential of emerging insertion techniques and integrated, simplified approaches to improve procedural safety, consistency, and clinician performance   Resource referenced in this episode: Pronovost P, Needham D, Berenholtz S, et al. An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU. N Engl J Med. 2006;355(26):2725-2732. doi:10.1056/NEJMoa061115

Effective transitions of care are vital, particularly for children who have spent months in the neonatal intensive care unit (NICU). In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, speaks with Philip D. Cohen, MD, MSc, about his article, “Non-Emergent Neonatal ICU-to-PICU Transfers in the United States: Cross-Sectional Survey of Neonatologists and Pediatric Intensivists,” published in the May 2026 issue of Pediatric Critical Care Medicine. Drawing on responses from neonatologists and pediatric intensivists across the United States, Dr. Cohen examines the challenges associated with transferring patients from the NICU to the pediatric intensive care unit (PICU) for ongoing care. Although these transfers occur infrequently, with a median of only five to six non-emergent transfers annually per institution, they often involve children with prolonged hospitalizations, significant medical complexity, and deeply established relationships with NICU care teams. Survey findings suggest broad agreement among neonatologists and pediatric intensivists that standardized protocols are needed and that structured approaches improve the effectiveness of transfers. Key themes include multidisciplinary handoffs, earlier identification of transfer candidates, family-centered communication, and greater collaboration between NICU and PICU teams before and after transfer. Dr. Cohen also explores opportunities for implementation science to advance this work, emphasizing the importance of incorporating perspectives from parents and caregivers, nurses, and advanced practice providers. This discussion will educate and inspire pediatric critical care teams seeking to improve continuity of care through adaptable, evidence-informed frameworks. Resources referenced in this episode: Cohen PD, Boss RD, McKinney RL, Kudchadkar SR. Non-Emergent Neonatal ICU-to-PICU Transfers in the United States: Cross-Sectional Survey of Neonatologists and Pediatric Intensivists. Pediatr Crit Care Med. 2026;27(5):568-574. Cohen PD, Boss RD, Stockwell DC, et al. Perspectives on non-emergent neonatal intensive care unit to pediatric intensive care unit care transfers in the United States. World J Crit Care Med. 2024;13(4):97145.

Sepsis management has traditionally focused on timely antibiotic treatment, hemodynamic support, and source control, but emerging evidence suggests that outcomes may be shaped long before patients reach the ICU. In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, speaks with Sayed Abdulmotaleb Almoosawy, MBChB (Hons), about his article “The Association Between Socioeconomic Position and Mortality in Patients With Sepsis and Septic Shock—A Systematic Review and Meta-Analysis,” published in the April 2026 issue of Critical Care Medicine. Drawing on 13 observational studies that encompassed nearly 4 million patients, the analysis evaluates how factors such as insurance status, income, education, and neighborhood deprivation relate to short-term mortality outcomes. The findings reveal a consistent association between lower socioeconomic position and increased mortality, with lack of private insurance demonstrating the strongest signal—likely reflecting barriers to timely access to care and delayed presentation. This episode challenges clinicians and researchers alike to recognize the link between socioeconomic disadvantages and worse sepsis outcomes, highlighting the need to collect equity-relevant data and reduce gaps in care to improve survival for critically ill patients. Resources referenced in this episode: Almoosawy SA, Fernando SM, Rochwerg B, et al. The association between socioeconomic position and mortality in patients with sepsis and septic shock—a systematic review and meta-analysis. Crit Care Med. 2026;54(4):692-700. Prescott HC, Antonelli M, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Crit Care Med. 2026;54(4):725-812.

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.

Propofol remains a cornerstone sedative for mechanically ventilated critically ill patients and is supported by PADIS guidelines and favored for its rapid onset, titratability, and limited side effects. However, its use in hemodynamically unstable patients remains a persistent clinical dilemma. In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Kyle Enfield, MD, is joined by Scott Benken, PharmD, MHPE, BCCCP, and Nathan Smischney, MD, MS, to explore the risks, benefits, and evolving evidence surrounding propofol use in this high-risk population.     The discussion examines the physiologic basis of propofol-associated hypotension and how that can manifest in different patients, such as those with sepsis and septic shock. Patient selection and real-time assessment of hemodynamic trends are essential. Additional considerations include the recognition of and monitoring for propofol infusion syndrome, a rare but life-threatening complication.     The episode also explores alternative drugs such as dexmedetomidine and ketamine, highlighting the benefits and risks of each. Emerging strategies are discussed, including a ketamine-propofol combination called ketafol and its utility in balancing sedation and hemodynamic stability.  Listeners will gain expert insights into propofol use in the ICU and a deeper understanding of patient-centered approaches to sedation.    Resources referenced in this episode:   Lewis K, Balas MC, Stollings JL, et al. A focused update to the clinical practice guidelines for the prevention and management of pain, anxiety, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med. 2025;53(3):e711-e727.  Russotto V, Myatra SN, Laffey JG, et al. Intubation practices and adverse peri-intubation events in critically ill patients from 29 countries. JAMA. 2021;325(12):1164-1172.  Boncyk C, Devlin JW, Faisal H, et al. INhaled Sedation versus Propofol in REspiratory failure in the Intensive Care Unit (INSPiRE-ICU1): protocol for a randomised, controlled trial. BMJ Open. 2024;14(10):e086946.  O’Gara B, Serra AL, Englert JA, et al. Inhaled sedation versus propofol in respiratory failure in the ICU (INSPiRE-ICU2): study protocol for a multicenter randomized controlled trial. Trials. 2025;26(1):114. 

Older adults consist of approximately half of the patients in the ICU, with that number expected to grow in the coming decades. In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn N. Bulloch, PharmD, BCPS, FCCM, is joined by Bram Rochwerg, MD, MSc(Epi), FRCPC, FCCM, and Lauren E. Ferrante, MD, MHS, to discusses new guidelines on caring for older adults in the ICU and the difficulties in finding research that focuses on those patients. The guidelines, “Society of Critical Care Medicine Guidelines on Caring for Older Adults in the ICU,” will be published in an upcoming issue of Critical Care Medicine. The panel details the process and methodology behind the guidelines, the dearth of studies focusing on older patients in the ICU, and the difficulty of finding studies that enroll older adults who are on multiple medications. The guidelines offer two conditional recommendations and offer priorities for aging-friendly research topics to help provide stronger guidance in the future. Bram Rochwerg, MD, MSc(Epi), FRCPC, FCCM, is an associate professor, intensivist, and researcher based at McMaster University in Hamilton, Ontario, Canada, who focuses on intravenous fluid use in sepsis, the role of corticosteroids in acute hypoxemic respiratory failure, and clinical practice guideline methodology. Lauren E. Ferrante, MD, MHS, is an associate professor of medicine in the section of pulmonary, critical care, and sleep medicine at the Yale School of Medicine; director of the operations core of the Yale Claude D. Pepper Older Americans Independence Center; and an attending physician in the medical intensive care unit at Yale-New Haven Hospital in New Haven, Connecticut, USA. Resources referenced in this podcast: Society of Critical Care Medicine Guidelines on Caring for Older Adults in the ICU Compassionate and Evidence-Based Care (session from the 2026 Critical Care Congress) Congress Digital Geriatric Knowledge Education Group Thought Leader: Why the 4Ms Approach to Critical Care Improves Quality (session from the 2025 Critical Care Congress)

What has changed in the updated 2026 Surviving Sepsis Campaign (SSC) guidelines for children? In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Elizabeth H. Mack, MD, MS, FCCM, speaks with pediatric SSC guideline cochairs Scott L. Weiss, MD, MSCE, FCCM, and Pierre Tissieres, MD, DSc, about the latest guideline recommendations for the care of children with sepsis and septic shock. The updated guidelines emphasize the early identification of sepsis, an evolution to a more targeted way of treatment, and a more practical approach to guideline implementation. Other aspects of the previous guidelines, such as lactate measurements, continuous reassessment, and the role of point-of-care monitoring, were reinforced in the 2026 guidelines. The guidelines, “Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026,” were released in the April issue of Pediatric Critical Care Medicine. Key updates and new areas of emphasis include:   A more nuanced approach to sepsis screening and early recognition  New guidance on supplemental oxygen, including limiting hyperoxia and using more conservative oxygenation targets in children with septic shock  New patient, intervention, comparison, outcome questions related to immune dysregulation, highlighting an important area for future research  New attention to post-sepsis morbidity  Greater emphasis on long-term follow-up and risk assessment for children who survive sepsis Scott L. Weiss, MD, MSCE, FCCM, is division chief of critical care and vice-chair of research at Nemours Children’s Hospital (DuPont)-Delaware and professor of pediatrics and pathology and genomic medicine at the Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA. Pierre Tissieres, MD, DSc, is a professor of pediatrics and head of Pediatric ICU and Neonatal Medicine at Paris South University Hospitals in Paris, France. This podcast is sponsored by Vantive.  At Vantive, our mission to extend lives and expand possibilities starts with a commitment to continuous learning. We are committed to partnering with the medical community to support vital organ therapy innovation grounded in clinical evidence and focused on improving patient outcomes. The recent publication on endotoxic septic shock centers on an evidence-based approach to address clinical challenges in critical care and beyond as highlighted in our press release. Resources referenced in this podcast:  Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026  Executive Summary of Society of Critical Care Medicine 2026 Guidelines on the Care and Management of Pediatric and Neonatal Intensive Care Patients at the End of Life  International Consensus Criteria for Pediatric Sepsis and Septic Shock

What has changed in the new 2026 Surviving Sepsis Campaign (SSC) guidelines for adults? In this episode of the Society of Critical Care Medicine (SCCM) Podcast, Kyle B. Enfield, MD, is joined by guideline cochairs Massimo Antonelli, MD, and Hallie C. Prescott, MD, MSc, FCCM, for a practical discussion on the biggest updates in the care of adults with sepsis and septic shock, from appropriate care during transport to the hospital to balancing timely antibiotics with antimicrobial stewardship. The panel also discusses hemodynamic resuscitation, vasopressor selection, global implementation, and the growing recognition that sepsis care does not end at hospital discharge. The guidelines, “Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026,” were released in the April issue of Critical Care Medicine. The episode highlights:   How the panel graded the evidence  New sepsis terminology to address variabilities in how different professions, environments, or cultures refer to specific features of sepsis  How the guidelines are shaped to support clinicians practicing in a wide range of care settings, including resource-limited settings Dr. Antonelli is a professor of anesthesiology and intensive care medicine at Università Cattolica del Sacro Cuore in Rome, Italy, and director of the general intensive care unit at Policlinico A. Gemelli University Hospital. Dr. Prescott is a professor of pulmonary and critical care medicine at the University of Michigan, Ann Arbor, Michigan, USA, and a staff physician at the Ann Arbor Veterans Affairs Healthcare System. This podcast is sponsored by Vantive. At Vantive, our mission to extend lives and expand possibilities starts with the commitment to continuous learning. We are committed to partnering with the medical community to support vital organ therapy innovation grounded in clinical evidence and focused on improving patient outcomes. The recent publication on endotoxic septic shock centers on an evidence-based approach to address clinical challenges in critical care and beyond as highlighted in our press release. Resources referenced in this podcast:  Executive Summary: Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026  Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026  Restriction of Intravenous Fluid in ICU Patients with Septic Shock  Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension