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.