In this episode, Dr. Zanotti discusses the science of hope. He's joined by Dr. Stephen Trzeciak, a physician-scientist, the Edward D. Viner Endowed Chief of Medicine at Cooper University Health Care, and Professor and Chair of Medicine at Cooper Medical School of Rowan University in Camden, New Jersey. Dr. Trzeciak is a practicing intensivist and a clinical researcher with more than 100 publications in the scientific literature. In addition, he is co-author of two excellent books: Wonder Drug: 7 Scientifically Proven Ways That Serving Others Is the Best Medicine for Yourself (2022) and Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference (2019).
Additional resources:
Recovery Expectations and Long-term Prognosis of Patients with Coronary Heart Disease Barefoot JC, et al. JAMA Internal Medicine 2011: https://pubmed.ncbi.nlm.nih.gov/21357800/
Optimism and Rehospitalization After Coronary Artery Bypass Graft Surgery. Scheler MF, et al. JAMA Int Med 1999: https://pubmed.ncbi.nlm.nih.gov/10219928/
The median is not the message. By Jay Gould: https://journalofethics.ama-assn.org/sites/joedb/files/2018-05/mnar1-1301.pdf
Books mentioned in this episode:
Man’s Search for Meaning. By Viktor E. Frankl: https://bit.ly/3SqsNyt
Wonder Drug: 7 Scientifically Proven Ways That Serving Others Is the Best Medicine for Yourself. By Stephen Trzeciak and Anthony Mazzarelli: https://bit.ly/4kiyA5q
Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference. By Stephen Trzeciak and Anthony Mazzarelli: https://bit.ly/43ul5IE
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58:51
Mechanical Ventilation for Severe Asthma
In this episode, Dr. Sergio Zanotti focuses on the nuances of mechanical ventilation in patients with severe asthma. Previously, he explored the medical management of acute asthma exacerbations. Today, he takes a deeper dive into ventilatory strategies tailored to this high-risk population. He's joined by Dr. Emily Damuth, a dual-trained emergency medicine and critical care physician. Dr. Damuth is an Assistant Professor of Medicine and Emergency Medicine at Cooper Medical School of Rowan University and practices clinically in both the Emergency Department and Intensive Care Unit at Cooper University Hospital in Camden, New Jersey. She is also an Assistant Program Director for the Critical Care Medicine Fellowship and is actively involved in the ECMO program. A passionate educator, she teaches mechanical ventilation through lectures and simulation and has received multiple teaching awards for her contributions to medical education.
Additional resources:
Links:
Management of Life-Threatening Asthma. O. Garner, et al. CHEST 2022; https://pubmed.ncbi.nlm.nih.gov/35218742/
Extracorporeal Membrane Oxygenation for Refractory Asthma Exacerbations With Respiratory Failure. J. Zakrajsek, et al. CHEST 2023: https://pubmed.ncbi.nlm.nih.gov/36191634/
Ventilator Graphics and Respiratory Mechanics in the Patient With Obstructive Lung Disease. R. Dhand. Respiratory Care 2005: https://pubmed.ncbi.nlm.nih.gov/15691394/
Books mentioned in this episode:
Seabiscuit: An American Legend. By Laura Hillenbrand: https://bit.ly/3EY24pJ
Pisto: The Life of Pete Maravich. By Mark Kriegel: https://bit.ly/3GIarq6
Good Inside: A Practical Guide to Resilient Parenting Prioritizing Connection Over Correction. By Becky Kennedy: https://bit.ly/4iSTnes
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1:15:00
PADIS Guidelines Update
In this episode, Dr. Zanotti discussed the Society of Critical Care Medicine “Focused Update on the Clinical Guidelines for the Prevention and Management of Pain, Anxiety. Agitation/Sedation. Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU." This is also known as the PADIS Guidelines. He is joined by Joanna L. Stollings, PharmD, a Board-Certified Pharmacotherapy Specialist and a Board-Certified Critical Care Pharmacotherapy Specialist. Joanna is the Medical Intensive Care Unit (MICU) Clinical Pharmacy Specialist at the Vanderbilt University Medical Center. She also served as vice chair for the PADIS Guideline Focused Update and co-authored the guidelines.
Additional resources:
Society of Critical Care Medicine Focused Update on the Clinical Guidelines for the Prevention and Management of Pain, Anxiety. Agitation/Sedation. Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. PADIS 2025 Update: https://pubmed.ncbi.nlm.nih.gov/39982143/
Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. PADIS 2018 Guidelines: https://pubmed.ncbi.nlm.nih.gov/30113379/
Link to a previous episode of Critical Matters discussing the PADIS 2018 Guidelines: https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=635606964
Landing page for the Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center: https://www.icudelirium.org/
Books mentioned in this episode:
The Prophet. By Kahlil Gibran: https://bit.ly/4lA2Jhx
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46:16
TEE in Cardiac Arrest
In this episode, Dr. Sergion Zanotti discusses TEE in cardiac arrest and shock. Critical care clinicians commonly utilize transthoracic echocardiography in the ICU as part of their point-of-care-ultrasonography (POCUS) toolkit. However, there is a growing push to train intensivists in using transesophageal echocardiography (TEE) for cardiac arrest and peri-arrest situations in the ICU. Our guest is Dr. Sara Nikravan, a cardiothoracic anesthesia critical care physician with training in advanced perioperative echocardiography. Dr. Nikravan is an Associate Professor of Cardiothoracic Anesthesiology and Critical Care Medicine at the University of Washington Medical School and practices at the UW Medical Center. She is recognized as an expert and master educator in Critical Care, Perioperative echocardiography, and Point of Care Ultrasound. She has authored numerous peer-reviewed papers and is the guidelines co-chair of the Society of Critical Care Medicine Guidelines on Adult Critical Care Ultrasonography: Focused Update 2024, recently published in Critical Care Medicine.
Additional links:
Society of Critical Care Medicine Guidelines on Adult Critical Care Ultrasonography: Focused Update 2024, Crit Care Med 2025: https://pubmed.ncbi.nlm.nih.gov/39982182/
Focused Transesophageal Echocardiography During Cardiac Arrest Resuscitation: JACC Review Topic of the Week. JACC 2020: https://pubmed.ncbi.nlm.nih.gov/32762909/
Landing page for the Resuscitative TEE Project website: https://www.resuscitativetee.com/
Books mentioned in this episode:
The Prophet. By Kahlil Gibran: https://www.amazon.com/dp/998247037X?psc=1&smid=ATVPDKIKX0DER&ref_=chk_typ_imgToDp
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1:01:20
AI in Critical Care
In this episode, Dr. Sergio Zanotti explores one of medicine's fastest-evolving frontiers: artificial intelligence (AI). From predictive analytics to decision-support tools, AI is beginning to influence how we deliver critical care — but what does that actually mean for frontline clinicians? Dr. Zanotti is joined by Dr. Sharad Patel, a critical care physician with additional board certification in nephrology and Echocardiography. He is a Critical Care Intensivist at Cooper University Health Care, the assistant program Director for the Internal Medicine Residency Program, and an Assistant Professor of Medicine at Cooper Medical School of Rowan University. Dr. Patel is deeply interested in applying artificial intelligence and technology at the bedside.
Additional resources:
Landing page for New England Journal of Medicine – AI in Medicine section. A multitude of articles and resources on the topic: https://www.nejm.org/ai-in-medicine
Attention Is All You Need. A Vaswani et al. NIPS 2017: https://proceedings.neurips.cc/paper_files/paper/2017/file/3f5ee243547dee91fbd053c1c4a845aa-Paper.pdf
Artificial Intelligence Courses Online: https://www.coursera.org/courses?query=artificial%20intelligence
UDEMY landing page for AI courses. https://www.udemy.com/AI
Books mentioned in this episode:
Meditations. By Marcus Aurelius (Author), Gregory Hayes (Translator): https://amzn.to/4iLvfLA
Thinking Fast and Slow. By Daniel Kahneman: https://bit.ly/4c6pANu
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