Couverture de SoCCC Pre-Rounds: Bite-Sized Critical Care Cardiology Topics Delivered By Experts

SoCCC Pre-Rounds: Bite-Sized Critical Care Cardiology Topics Delivered By Experts

SoCCC Pre-Rounds: Bite-Sized Critical Care Cardiology Topics Delivered By Experts

De : Dr. Balim Senman Dr. Elliott Miller Dr. Simon Parlow Dr. Anthony Carnicelli
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 SoCCC Pre-Rounds is your go-to for quick, high-yield insights in critical care cardiology, hosted by members of the Society of Critical Care Cardiology (SoCCC). With only 160 specialists in the U.S., mentorship is rare. This podcast bridges the gap with bite-sized episodes featuring clinical pearls, expert tips, and real-world answers on topics like cardiogenic shock, ECMO, and resuscitation. Perfect for pre-rounds, night shifts, or leveling up anytime. Listen in. Level up. Join the SoCCC community.Dr. Balim Senman, Dr. Elliott Miller, Dr. Simon Parlow, Dr. Anthony Carnicelli Hygiène et vie saine Maladie et pathologies physiques
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    • ECPR: From Cannulation to Prognostication with Dr. Jason Bartos

      ECPR: From Cannulation to Prognostication with Dr. Jason Bartos
      Dec 5 2025
      Should we be using ECMO during cardiac arrest? In this episode of SoCCC Pre-Rounds, Dr. Balim Senman sits down with Dr. Jason Bartos, interventional and critical care cardiologist at the University of Minnesota and one of the nation’s leading voices on extracorporeal cardiopulmonary resuscitation (ECPR). Together, they break down when and why to consider ECMO in cardiac arrest, the patient selection puzzle, and what truly impacts outcomes in the field.Dr. Bartos shares pearls from the ARREST trial and offers hard-won insights into what it takes to build an ECPR program that saves lives from timing and volume to sedation, TTM, and neuroprognostication. Whether you’re a trainee encountering ECPR for the first time or a team leader building a resuscitation program, this episode delivers essential guidance grounded in real-world experience.Key TakeawaysECPR = ECMO during or shortly after cardiac arrest; best for patients with witnessed arrest and refractory shockable rhythmsAvoid ECPR in patients with poor baseline function, irreversible comorbidities, or prohibitive vascular anatomyOutcomes depend on systems: high-volume centers, early activation, and streamlined protocols improve survivalDon’t oversedate; sedation is not required for ECMO; prioritize comfort and cannula safetyUse 37°C TTM with aggressive fever prevention; ECMO allows precise temperature controlNeuroprognostication takes time; wait beyond 72 hours, and don’t withdraw care too early some patients recover even after 30 daysIn This Episode[00:00] Introduction[00:45] Episode introduction & guest welcome[01:25] What is ECPR?[02:14] Rationale and data behind ECPR[03:13] Key ECPR trials and outcomes[08:56] ECPR patient selection & center volume[10:15] Selection criteria details[13:06] Absolute and relative contraindications[15:11] In-hospital ECPR activation & information gathering[16:21] Standardizing in-hospital ECPR response[18:22] Timing and team mobilization for ECR[19:56] Post-ECMO management: sedation & temperature[21:40] Sedation practices on ECMO[23:28] Temperature management evolution[25:29] Neuroprognostication after ECPR[29:13] Early predictors of poor neurological outcomeNotable Quotes[01:34] "ECPR is extracorporeal cardiopulmonary resuscitation. It's the use of ECMO for patients with cardiac arrest." — Dr. Jason Bartos[25:40] "The danger to the patients in the ICU post-arrest is us. We really have the task of trying to determine and predict and inform family members of how their loved one is going to do in this worst circumstance of their life." — Dr. Jason Bartos[25:29] "Neuroprognostication is near and dear to my heart, partly because I think it's honestly the most important thing we do in the ICU for any post-arrest patient, but particularly for this population." — Dr. Jason BartosDr. Jason BartosDr. Jason Bartos is an interventional and critical care cardiologist at the University of Minnesota. He leads one of the nation’s highest-volume ECPR programs and is a founding member of the Center for Resuscitation Medicine. He is nationally recognized for his leadership in post-arrest care, real-world ECMO implementation, and advancing cardiac arrest science.Resources and LinksBecome a member of the Community: https://www.soccc.org/subscribeDr. Jason Bartoshttps://med.umn.edu/bio/jason-bartoshttps://www.linkedin.com/in/jason-bartos-b6898441Dr. Balim Senmanhttps://www.linkedin.com/in/balim-senman-7561436b/https://x.com/BalimSenmanMDhttps://www.soccc.org/Supported By:This episode is made possible by unrestricted support from Zoll LifeVest — thanks for keeping high-impact education free for our community.DisclaimerThis podcast is not medical advice, just candid, practical discussions about what your hosts do every day in the CICU. Always consult your supervising team and current guidelines before applying any interventions.
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      32 min
    • The Hidden Heart Crisis: Managing Right Ventricular Failure with Dr. Ryan Tedford

      The Hidden Heart Crisis: Managing Right Ventricular Failure with Dr. Ryan Tedford
      Nov 7 2025
      In this episode, Dr. Anthony Carnicelli sits down with Dr. Ryan Tedford, a top expert on right ventricular (RV) failure, to break down everything you need to know about this tricky condition. RV failure happens when the right side of the heart struggles to pump properly, messing with blood flow through the lungs and raising pressure in the veins. It shows up in a bunch of serious illnesses like pulmonary hypertension, left heart failure, and sepsis.Dr. Tedford walks us through how to spot RV failure using key measurements from right heart catheterization, like right atrial pressure and the pulmonary artery pulsatility index (PAPi).He also shares a simple, practical approach to managing RV failure: avoid overloading the heart with fluids, lower the pressure, the right heart has to pump against with pulmonary vasodilators, and boost its strength with inotropes like dobutamine. And when things get really serious, mechanical support might be needed. The good news? The right ventricle is pretty resilient, and with the right care, patients can bounce back.Key TakeawaysRV failure is a clinical syndrome due to dysfunction in any part of the right heart circulatory system, not just the RV itself.Don't skip hemodynamics: Right heart cath data is essential to distinguish RV from LV failure and guide therapy.Afterload reduction strategies include managing left-sided filling pressures and careful ventilator settings (avoid high PEEP and hyperinflation).The RV is more resilient than we think with the right therapy, recovery is often possible, even in severe cases.In This Episode[00:00] Introduction[01:39] Defining right ventricular failure[02:14] Importance of the right heart in critical care[03:57] Role of hemodynamic evaluation[04:12] Key hemodynamic metrics for RV failure[05:19] Echo vs. hemodynamics in RV failure[08:01] Treatment strategies: preload, afterload, and contractility[10:04] Avoiding hypotension and ischemia[11:16] Stepwise vs. immediate mechanical support[12:07] Prognosis and recovery of RV failure[13:50] Closing remarks and takeawaysNotable Quotes[02:02] "Although the RV is one of the biggest and perhaps most important components of the right heart circulatory system, actually any part of the right heart circulatory system can contribute to overall right heart failure." — Dr. Ryan Tedford[02:43] "If you go back, you know, 30 years or 80 years, in fact, the right heart has been largely ignored." — Dr. Ryan Tedford[04:04] "A comprehensive hemodynamic evaluation is really key. And I would say you really can't get it right without the right heart catheterization." — Dr. Ryan TedfordDr. Ryan TedfordDr. Tedford is a Professor of Medicine/Cardiology and holds the Dr. Peter C. Gazes Endowed Chair in Heart Failure at the Medical University of South Carolina (MUSC). He directs the Advanced Heart Failure and Transplant Fellowship and serves as the section head of heart failure and medical director of cardiac transplantation. An internationally recognized researcher with over 200 publications, his work focuses on right ventricular function, pulmonary hypertension, and hemodynamics.Resources and LinksBecome a member of the Community: https://www.soccc.org/subscribeDr. Ryan Tedfordhttps://www.linkedin.com/in/ryan-tedford-7163aa6/Dr. Anthony Carnicellihttps://www.soccc.org/https://www.linkedin.com/in/anthony-carnicelli-926a0b88/Mentioned Pragmatic approach to temporary mechanical circulatory support in acute right ventricular failure by Dr. Anthony CarnicelliSupported By:This episode is made possible by unrestricted support from Zoll LifeVest — thanks for keeping high-impact education free for our community.DisclaimerThis podcast is not medical advice, just candid, practical discussions about what your hosts do every day in the CICU. Always consult your supervising team and current guidelines before applying any interventions.
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      15 min
    • Post-Cath Instability: Rapid Evaluation and Management in the ICU

      Post-Cath Instability: Rapid Evaluation and Management in the ICU
      Oct 3 2025
      What do you do when a patient returns from the cath lab hypotensive and unstable? In this episode of SoCCC Pre-Rounds, critical care cardiologists Dr. Ann Gage and Dr. Zach Il'Giovine join host Dr. Elliott Miller to break down the management of post-catheterization hypotensive emergencies. This conversation delves into rapid assessment, differential diagnosis, and life-saving interventions in the acute care setting.The experts emphasize the importance of taking a moment to gather context before rushing to the bedside. Was it a PCI, EP study, or structural intervention? This pause allows for a more focused differential diagnosis, covering complications such as vascular issues (groin hematoma, retroperitoneal bleed), cardiac tamponade, and acute stent thrombosis. A standout takeaway: manual pressure is your first-line tool for managing bleeding, and don’t hesitate to call the proceduralist early. They also highlight when to order a CT scan (pro-tip: non-contrast first) and the principles behind massive transfusion protocols.This episode offers actionable insights for handling hypotensive emergencies with confidence and precision. Key TakeawaysBuild a differential based on the cath details: arterial, venous, pericardial?Retroperitoneal bleed is high on the list for sudden post-cath hypertension.First move: Is the patient in extremis? If yes, act. If not, think.Groin pain or back pain? Start with pressure and basic labs.For massive bleeds: use balanced transfusions and proper IV access.Most important treatment for groin bleeds? Manual pressure.In This Episode[00:00] Introduction[00:56] Meet the guests: Dr. Ann Gage and Zach Il'Giovine[02:09] Gathering info before seeing post-cath patient[03:46] Building the differential diagnosis[08:13] Physical exam and bedside assessment[09:57] Hemodynamic assessment and initial workup[16:00] Massive hemorrhage and transfusion protocols[17:05] Procedural complications and communication[19:55] Manual pressure crucial for groin bleeds[21:11] Conclusion and take-home messagesNotable Quotes[04:06] "I was told once by a medicine resident that if you were a good resident, you would have two or three things on your differential, but if you were great, you would appear at the bedside with at least 10 things on your differential." — Dr. Ann[00:13:55] "Nothing really makes me madder than coming in the morning and seeing that the residents gave contrast to ten people, when if you've got a hemodynamically significant bleed, you do not need contrast." — Dr. Elliott[00:20:53] "On more than one occasion, manual pressure has saved lives." — Dr. Zach Dr. Ann GageDr. Ann Gage is a critical care and interventional cardiologist at Centennial Heart in Nashville. She bridges the cath lab and CICU with expertise in both patient care and procedural nuance.Dr. Zach Il'GiovineDr. Zach Il'Giovine is a heart failure and critical care cardiologist at Centennial Heart. He focuses on managing complex ICU patients, procedural complications, and bridging multidisciplinary care.Resources and LinksBecome a member of the Community: https://www.soccc.org/subscribeDr. Ann Gage https://centennialheart.com/https://www.linkedin.com/in/ann-gage-b7036831https://x.com/anngagemd?lang=enDr. Zach IlGiovinehttps://centennialheart.com/https://www.linkedin.com/in/zachary-il-giovinehttps://x.com/zilgiovinemd?lang=enDr. Elliott Millerhttps://x.com/ElliottMillerMDhttps://www.soccc.org/Supported By:This episode is made possible by unrestricted support from Zoll LifeVest — thanks for keeping high-impact education free for our community.DisclaimerThis podcast is not medical advice, just candid, practical discussions about what your hosts do every day in the CICU. Always consult your supervising team and current guidelines before applying any interventions.
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      22 min
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