SCCM Podcast

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

There is enormous heterogeneity in clinical outcomes and severity of septic shock, with some patients needing only supportive care in the ICU and others progressing to multiorgan system failure and death. How can clinicians identify patients at higher risk of death?

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn Bulloch, PharmD, BCPS, FCCM, is joined by John A. Kellum, MD, FCCM, to discuss high endotoxin activity as a possible endotype for septic shock. Dr. Kellum’s article, “Organ Failure, Endotoxin Activity, and Mortality in Septic Shock,” was published in the September 2025 compendium of Critical Care Explorations. Dr. Kellum is a professor and director of the Center for Critical Care Nephrology, as well as vice chair for the Department of Critical Care Medicine, at the University of Pittsburgh in Pittsburgh, Pennsylvania, USA.

The study used a novel biomarker called the endotoxin activity assay (EAA) to detect endotoxin in the blood. While the EAA is not good at identifying patients who are at risk for sepsis, Dr. Kellum said that, when combined with organ failure, it identifies patients at high risk for endotoxic septic shock. In the study, these patients had a mortality rate of 60%.

Neither the EAA nor the anti-endotoxin therapy is readily available. And, although endotoxic septic shock is rare, occurring in only a quarter of patients with septic shock, Dr. Kellum hopes that, through precision medicine, segmenting this population into treatable subgroups may allow better diagnostics and opportunities to develop or repurpose therapies in the future. This episode is sponsored by Prenosis.

Resources referenced in this episode:

Organ Failure, Endotoxin Activity, and Mortality in Septic Shock (Molinari  L, et al. Crit Care Explor. 2025;7:e1308)

Derivation, Validation, and Potential Treatment Implications of Novel Clinical Phenotypes for Sepsis (Seymour CW, et al. JAMA. 2019;321:2003-2017)

Safety and Efficacy of Polymyxin B Hemoperfusion (PMX) for Endotoxemic Septic Shock in a Randomized, Open-Label Study (TIGRIS) (ClinicalTrials.gov. ID NCT03901807. Last update posted January 9, 2026)

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Maureen Madden, DNP, RN, CPNP-AC, CCRN, FCCM, speaks with Javier Varela, MD, MSc, about his study, “Acute Bronchiolitis in Infants on Invasive Mechanical Ventilation: Physiology Study of Airway Closure,” published in the September 2025 issue of Pediatric Critical Care Medicine. The study revealed new insights into airway pathophysiology in infants with severe bronchiolitis who require mechanical ventilation, a population that comprises a substantial portion of winter pediatric intensive care unit (PICU) admissions worldwide. Dr. Varela is an intensivist in the PICU in the Department of Pediatrics at Clínica Alemana de Santiago, in Santiago, Chile.

Differing ventilatory strategies and the heterogeneous phenotypes of bronchiolitis motivated Dr. Varela’s team to investigate airway closure, which was detected in seven of the 12 patients included in the study. Airway opening pressure frequently exceeded the set positive end-expiratory pressure (PEEP) levels—highlighting a potential gap in traditional ventilator management. Dr. Varela explains that respiratory mechanics, particularly driving pressure and respiratory system compliance, can be misinterpreted when airway opening pressure is not considered.

Study limitations included bacterial coinfection in nearly half the patients and the constraints of a single-center design, but Dr. Varela said that these factors did not appear to alter the physiologic observations.

Although more research is needed before making clinical recommendations, the study established a foundational understanding of airway closure in patients with bronchiolitis and underscores the need for future work on personalized ventilation strategies, PEEP titration, and the potential heterogeneity of airway behavior in this population.

Resources referenced in this episode:

Acute Bronchiolitis in Infants on Invasive Mechanical Ventilation: Physiology Study of Airway Closure (Varela J, et al. Pediatr Crit Care Med. 2025;26:e1096-e1104)

Airway Closure in Acute Respiratory Distress Syndrome: An Underestimated and Misinterpreted Phenomenon (Chen L, et al. Am J Respir Crit Care Med. 2018;197:132-136)