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Critical Matters

Critical Matters

Sound Physicians

Podcast by Sound Physicians

  • 1 hour 5 minutes
    Revisiting Hospital Sepsis Programs

    Sepsis remains one of the leading causes of death and disability worldwide, making early recognition and coordinated care essential to improving patient outcomes.

    In honor of Sepsis Awareness Month, observed every September, we are revisiting an episode of Critical Matters featuring a conversation about hospital sepsis programs and the CDC Hospital Sepsis Program Core Elements.

    Originally debuting in 2023, Dr. Sergio Zanotti’s discussion with guest Hallie Prescott, MD, MSc, Associate Professor of Pulmonary and Critical Care Medicine at the University of Michigan, hits on evidence-based approaches to building effective sepsis initiatives and advancing quality care across healthcare organizations.

    Additional resources:

    CDC Hospital Program Sepsis Program Core Elements

    CDC Additional Sepsis Clinical Resources

    SCCM Surviving Sepsis Guidelines 2021

    Characterizing an implementation intervention in terms of behaviour change techniques and theory: the ‘Sepsis Six’ clinical care bundle. Steinmo S, et al. Implementation Science 2015

    Effect of a Multicomponent Sepsis Transition and Recovery Program on Mortality and Readmissions After Sepsis: The Improving Morbidity During Post-Acute Care Transitions for Sepsis Randomized Clinical Trial. Crit Care Medicine 2022

    Recent episodes of Critical Matters related to sepsis:

    Sepsis – Beyond the guidelines

    Surviving Sepsis Campaign 2026 Guidelines

    Capillary Refill Time (CRT)

    Books mentioned in this episode:

    The Autumn Ghost: How the Battle Against a Polio Epidemic Revolutionized Modern Medical Care. By Hannah Wunsch

    10 September 2026, 7:56 pm
  • 58 minutes 29 seconds
    Communication with mechanically ventilated patients

    For patients receiving mechanical ventilation, losing the ability to speak can be one of the most frightening and frustrating aspects of critical illness.

    In this episode of Critical Matters, Dr. Sergio Zanotti discusses the experience of being "voiceless" in the ICU and examines evidence-based strategies to improve communication between patients, families, and care teams.

    He is joined by Mary Beth Happ, PhD, RN, Nursing Distinguished Professor of Critical Care Research at The Ohio State University College of Nursing and a nationally recognized researcher whose work has transformed our understanding of communication during mechanical ventilation.

    Additional resources:

    Giving Voice: Nurse-Patient Communication in the Intensive Care Unit. Happ MB. American Journal of Critical Care 2021.

    Effect of a multi-level intervention on nurse-patient communication in the intensive care unit: results of the SPEACS trial. Happ MB, et al. Heart Lung 2014.

    The Patient Communication Support Guide (PCSG): Development and Pilot Field Testing of a Digital Clinical Guide for Patient Communication in ICU. Tate, JA, Happ MB, et al. Ann Am Thorac Soc 2026.

    Shin JW, Happ, MB., Tate, J. (2021). VidaTalk™ communication application “opened up” communication between nonvocal ICU patients and their family caregivers. Intensive and Critical Care Nursing, 66:103075. doi: 10.1016/j.iccn.2021.103075.

    Shin JW, Happ MB., Tate, J., Balas, MC., Dabelko-Schoney, H., Tan, A. (2025). Preliminary efficacy of an electronic VidaTalkTMcommunication application on family-patient communication and family psychological distress in the intensive care unit: A pilot study. Heart Lung, 70: 14-22. PMCID: PMC11846697.

    Books mentioned in this episode:

    Culpability: A Novel. By Bruce Holsinger

    27 August 2026, 7:00 am
  • 1 hour 3 minutes
    Communicating to Patients and Families about PICS

    Recovering after a stay in the intensive care unit (ICU) is a long and difficult process, and for some survivors, healing the body may only be a fraction of the journey.

    In recent years, attention has increasingly turned to the cognitive impact post-intensive care syndrome, or PICS, has on ICU patients. In this episode of Critical Matters, Dr. Sergio Zanotti explores how to communicate with patients and families about post-intensive care syndrome.

    He is joined by Dr. Carla M. Sevin, an Associate Professor of Medicine in the Division of Allergy, Pulmonary, and Critical Care Medicine at Vanderbilt University Medical Center (VUMC). Dr. Sevin also serves as Director of the Pulmonary Patient Care Center and Director of the ICU Recovery Center.

    Previous episodes of Critical Matters related to this topic:

    Post-Intensive Care Syndrome (PICAS)

    The Forgotten Patient

    Additional resources:

    Communicating to Patients and Families About Post-Intensive Care Syndrome. CHEST, 2025.

    Post-Intensive Care Syndrome Awareness and Communication: Surveys of ICU Providers and Patients. CHEST, 2026.

    The Heroism of Incremental Care. Atul Gawande. The New Yorker, 2017.

    Critical Illness, Brain Dysfunction. And Survivorship (CIBS) Center.

    CAIRO- Critical and Acute Illness Recovery Organization.

    Books mentioned in this episode:

    The Diving Bell and the Butterfly: A Memoir of Life in Death. By Jean Dominique-Bauby

    The Correspondent: A Novel. By Virginia Evans.

    The Wall. By Marlen Haushofer

    13 August 2026, 7:00 am
  • 1 hour 7 minutes
    Nutrition Therapy in the ICU

    When it comes to critical illness, nutrition isn't just supportive care—it can be a key part of the treatment plan.

    In this episode, Dr. Sergio Zanotti sits down with Dr. Jayshil Patel to discuss nutrition therapy for critically ill adults and the growing evidence behind enteral nutrition's role in improving outcomes.

    Dr. Patel is a pulmonary and critical care physician in the Division of Pulmonary at the Medical College of Wisconsin whose research focuses on how enteral nutrition influences outcomes in critical care settings.

    Additional resources:

    • Nutrition Therapy in Critically Ill Adults. J. Patel, S McCLave. NEJM 2026.
    • Trial of the Route of Early Nutritional Support in Critically Ill Adults. CALORIES Trial. NEJM 2015.
    • Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2). LANCET 2018.

    Books mentioned in this episode:

    • The Road to Character. By David Brooks.
    30 July 2026, 7:00 am
  • 53 minutes 53 seconds
    Sepsis - Beyond the guidelines

    In a recent episode, Dr. Sergio Zanotti discussed the 2026 iteration of the Surviving Sepsis Guidelines. In this episode, the discussion continues, focusing on important aspects beyond clinical guidelines. He is joined by Dr. Andre Kalil, a physician specializing in critical care and infectious diseases. Dr. Kalil is a Professor in the Division of Infectious Diseases and Director of Transplant Infectious Diseases at the University of Nebraska Medical Center (UNMC). Dr. Kalil is a prolific author and has participated in several IDSA/SCCM Clinical Guidelines and has written extensively on critical care and infectious disease topics.

    Additional resources:

    Surviving sepsis campaign 2026 guidelines | Critical Matters

    Sepsis. M Singer, et al. The Lancet 2026.

    Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Crit Care Medicine 2026.

    Subphenotypes and phenotypes to resolve sepsis heterogeneity: hype or hope? Andre Kalil, et al. Intensive Care Med 2025.

    Early Goal-Directed Therapy for Sepsis: A Novel Solution for Discordant Survival Outcomes in Clinical Trials. Andre Kalil, et al. Crit Care Med 2017.

    Books mentioned in this episode:

    Curious: The Desire to Know and Why Your Life Depends on It. By Ian Leslie.

    9 July 2026, 7:00 am
  • 50 minutes 56 seconds
    The Fearless ICU, revisited

    This episode was originally posted Feb. 24, 2022.

    The last 24 months have pushed ICU teams around the world to their limits. As we move forward, we need to heal and rebuild our critical care teams. Healthcare more than ever will require ICU teams to perform at the highest levels and to continuously innovate to deliver high-value care to the sickest of the sick. In this episode, Dr. Sergio Zanotti discusses the elements of The Fearless ICU. He is joined by Amy Edmondson (@AmyCEdmondson), the Novartis Professor of Leadership and Management at the Harvard Business School. For the last two decades, she has studied the elements of high-performing teams in complex environments.

    Additional Resources:

    Faculty page for Amy Edmondson. A great jumping point to her vast body of work.

    How to turn a group of strangers into a team. TED Talk by Amy Edmondson

    The Fearless Organization. By Amy Edmondson.

    What Google Learned in its Quest to Build the Perfect Team. New York Times.

    Implementing New Practices: An Empirical Study of Organizational Learning in Hospital Intensive Care Units. A. Edmondson et al. Management Science 2007.

    Books Mentioned in this Episode:

    Get Rid of the Performance Review! By Samuel Culbert.

    Mindset. By Carol Dweck.

    25 June 2026, 6:10 pm
  • 53 minutes 15 seconds
    Caring for older adults in the ICU

    In this episode, Dr. Sergio Zanotti discusses the care of older adults in the ICU. He is joined by Dr. Lauren Ferrante, a pulmonary critical care physician in the medical intensive care unit at Yale New Haven Hospital. She is an Associate Professor of Medicine at the Yale School of Medicine and serves as Director, Operations Core, at the Yale Claude D. Pepper Older Americans Independence Center. Dr. Ferrante is the lead author of the recently published “Society of Critical Care Medicine Guidelines on Caring for Older Adults in the ICU."

    Additional resources:

    Society of Critical Care Medicine Guidelines on Care for Older Adults in the ICU. Crit Care Medicine 2026

    Society of Critical Care Medicine Guidelines on Care for Older Adults in the ICU. Implementation Toolkit

    American Geriatric Society Beers Criteria (Pocket Guide)

    Books mentioned in this episode:

    The Correspondent. By Virginia Evans

    11 June 2026, 7:00 am
  • 40 minutes 52 seconds
    Rethinking arterial lines

    In this episode, Dr. Sergio Zanotti discusses arterial catheters in shock through the lens of the recently published EVERDAC trial. He is joined by Dr. Gregoire Muller, a critical care physician in the Department of Intensive Care Medicine and Resuscitation at the University Hospital Center of Orléans, Orléans, France. Dr. Muller is an accomplished clinician and researcher. He is the principal investigator/lead author of the EVERDAC clinical trial published in the New England Journal of Medicine.

    Additional resources:

    Deferring Arterial Catheterization in Critically Ill Patients with Shock. EVERDAC Trial. New Engl J Med 2025.

    Arterial lines in the ICU: A call for rigorous controlled trials. CHEST 2014.

    Hemodynamic monitoring in shock and implications for management. International Consensus Conference, Paris, France 2006. Intensive Care Med 2007.

    Noninvasive BP monitoring in the critically ill: time to abandon the arterial catheter? CHEST 2018. 

    Books mentioned in this episode:

    Getting Things Done: The Art of Stress-Free Productivity. By David Allen.

    28 May 2026, 7:00 am
  • 57 minutes 26 seconds
    Invasive Candidiasis

    In this, Dr. Sergio Zanotti discusses the management of invasive candidiasis in critically ill patients. Invasive candidiasis is frequent in critically ill patients and is associated with high mortality and morbidity. He is joined by Dr. Max Adelman, a practicing critical care and infectious disease physician at Houston Methodist Hospital. Dr. Adelman is an Assistant Professor of Medicine at Weill Cornell Medical College. Dr. Adelman’s clinical interests include bacteremia, hospital-acquired infections, immunocompromised hosts, multidrug-resistant organisms, and septic shock.

    Additional Resources:

    Invasive candidiasis in critically ill patients: Fundamental concepts and future directions. Perez MA, Hoffman WJ, Perez JC, and Adelman MH. CHEST 2026.

    Empirical Micafungin Treatment and Survival Without Invasive Fungal Infection in Adults With ICU-Acquired Sepsis, Candida Colonization, and Multiple Organ Failure: The EMPIRICUS Randomized Clinical Trial. JAMA 2016.

    Global guideline for the diagnosis and management of candidiasis: an initiative of the ECMM in cooperation with ISHAM and ASM. THE LANCET- Infectious Diseases 2025.

    Books and Music mentioned in this episode:

    Four Thousand Weeks: Time Management for Mortals. By Oliver Bukerman.

    Lonesome Drifter. By Charlie Crockett.

    14 May 2026, 7:00 am
  • 1 hour 11 minutes
    Surviving sepsis campaign 2026 guidelines

    In this episode, Dr. Zanotti discusses the Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. He is joined by Dr. Hallie Prescot and Dr. Bram Rochwerg. Dr. Hallie Prescott is an Associate Professor in Pulmonary & Critical Care Medicine at the University of Michigan and a staff physician at the Ann Arbor Veterans Affairs Healthcare System. She serves as co-chair of the international Surviving Sepsis Campaign Guidelines. Dr. Bram Rochwerg is an associate professor and critical care physician at McMaster University in Hamilton, Ontario, Canada. He is co-vice-chair of the Surviving Sepsis Campaign Adult Guidelines.

    Additional Resources:

    Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Crit Care Medicine 2026

    Executive Summary: Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Crit Care Medicine 2026

    SCCM Point-of-Care (POC) APP:

    https://play.google.com/store/apps/details?id=org.sccm.mobl&hl=en

    https://apps.apple.com/us/app/sccm-poc/id1079591546

    Books and music mentioned in this episode:

    William Osler: A Life in Medicine. By Michael Bliss

    Blood Poison: The Untold Story of Sepsis. By Parsa Shahinpoor

    Album: Bloodline Artist: Mon Rovia

    23 April 2026, 7:00 am
  • 55 minutes 24 seconds
    Management of Impella Emergencies

    In this episode, Dr. Sergio Zanotti discusses emergency management and resuscitation of patients with left-sided Impella support. We will base our discussion on a recently published United Kingdom multisociety consensus statement. Our guests for this episode are two of the authors of this consensus statement.

    Dr. Zanotti is joined by Dr. Waqas Akhtar, a consultant at Guy's & St Thomas' NHS Foundation Trust in the United Kingdom. Dr. Akhtar completed full postgraduate certification in Cardiology, Intensive Care & General Internal Medicine with a particular interest in cardiogenic shock, heart transplantation, and mechanical circulatory support. He is also joined by Dr. Vasileios Panoulas, a consultant cardiologist at Royal Brompton & Harefield NHS Trust and honorary senior clinical lecturer at Imperial College London. He has clinical expertise that encompasses both general and interventional cardiology.

    Additional resources:

    UK multisociety consensus statement on the emergency management and resuscitation of patients with left-sided Impella support: https://heart.bmj.com/content/early/2025/12/17/heartjnl-2025-326896

    Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock. DanGer Shock Investigators: https://www.nejm.org/doi/full/10.1056/NEJMoa2312572

    Effect of Microaxial Flow Pump on Hemodynamics in STEMI-Related Cardiogenic Shock. DanGer Shock Investigators: https://www.jacc.org/doi/abs/10.1016/j.jacc.2025.04.062

    Long-Term Outcomes of the DanGer Shock Trial. DanGer Shock Investigators: https://pubmed.ncbi.nlm.nih.gov/40888722/

    Music mentioned in this episode:

    Unlearning. By Teddy Swims.

    Minute a Moment. By Myles Smith.

    Sable, Fable. By Bon Iver.

    9 April 2026, 7:00 am
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