Critical Matters

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 [https://www.cdc.gov/sepsis/pdfs/sepsis-core-elements-H.pdf] CDC Additional Sepsis Clinical Resources [https://www.cdc.gov/sepsis/core-elements/resources.html] SCCM Surviving Sepsis Guidelines 2021 [https://journals.lww.com/ccmjournal/pages/articleviewer.aspx?year=2021&issue=11000&article=00021&type=Fulltext] 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 [https://implementationscience.biomedcentral.com/articles/10.1186/s13012-015-0300-7] 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 [https://escholarship.org/content/qt4j222757/qt4j222757_noSplash_ad94a5b7db24a75b6176198a51129f5a.pdf] Recent episodes of Critical Matters related to sepsis: Sepsis – Beyond the guidelines [https://www.soundphysicians.com/podcast/critical-matters/sepsis-beyond-the-guidelines/] Surviving Sepsis Campaign 2026 Guidelines [https://www.soundphysicians.com/podcast/critical-matters/surviving-sepsis-campaign-2026-guidelines/] Capillary Refill Time (CRT) [https://www.soundphysicians.com/podcast/critical-matters/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 [https://www.amazon.com/Autumn-Ghost-Against-Epidemic-Revolutionized/dp/1771649453/ref=sr_1_1?crid=K1OFKS5NTQM4&keywords=the+autumn+ghost+hannah+wunsch&qid=1694808152&sprefix=autumn+ghosts%2Caps%2C108&sr=8-1]

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. [https://pubmed.ncbi.nlm.nih.gov/34195776/] 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. [https://pubmed.ncbi.nlm.nih.gov/24495519/] 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. [https://pubmed.ncbi.nlm.nih.gov/41965105/] 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. [https://pmc.ncbi.nlm.nih.gov/articles/PMC10833611/] 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. [https://pmc.ncbi.nlm.nih.gov/articles/PMC11846697/] Books mentioned in this episode: Culpability: A Novel. By Bruce Holsinger [https://www.amazon.com/Culpability-Novel-Bruce-Holsinger/dp/1954118961/ref=tmm_hrd_swatch_0?_encoding=UTF8&dib_tag=se&dib=eyJ2IjoiMSJ9.j-La5STVzgzVBOTZoAGHtxLO2q4WLLeu6OSuztWbIFYKkQu-_fI3V1LqKHri1qKBfvntt3K97SSc3Mg5P-C10Up8y86WKGmhqN1oGhYI9TxSQStyLJ62CXBMhq0Qw3ChRfbxKqwXqyQGKIfL_audMoVOXcYt8fYNGidV9fwNVyRj72axgWPmoBA0VmC6wUlWbLttSQFiq8fXIc6Um8FZKo6FW9aBtP3VLulLSkjQb9E.c02LIzDpQC8iuZGVNfwZzW9UeJkKNZkmIQBDPmje6_s&qid=1787702159&sr=8-1]

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) [https://podcasts.apple.com/us/podcast/post-intensive-care-syndrome-pics/id1335759655?i=1000442612525] The Forgotten Patient [https://podcasts.apple.com/us/podcast/the-forgotten-patient/id1335759655?i=1000663293656] Additional resources: Communicating to Patients and Families About Post-Intensive Care Syndrome. CHEST, 2025. [https://pubmed.ncbi.nlm.nih.gov/39892718/] Post-Intensive Care Syndrome Awareness and Communication: Surveys of ICU Providers and Patients. CHEST, 2026. [https://pubmed.ncbi.nlm.nih.gov/41076066/] The Heroism of Incremental Care. Atul Gawande. The New Yorker, 2017. [https://www.newyorker.com/magazine/2017/01/23/the-heroism-of-incremental-care?_sp=39023c83-2fda-41cf-9fa7-0f00dc85f7e4.1785784771471] Critical Illness, Brain Dysfunction. And Survivorship (CIBS) Center. [https://www.icudelirium.org/cibs-center/overview] CAIRO- Critical and Acute Illness Recovery Organization. [https://www.cairorecovery.com/] Books mentioned in this episode: The Diving Bell and the Butterfly: A Memoir of Life in Death. By Jean Dominique-Bauby [https://www.amazon.com/Diving-Bell-Butterfly-Memoir-Death/dp/0375701214/ref=tmm_pap_swatch_0?_encoding=UTF8&dib_tag=se&dib=eyJ2IjoiMSJ9.KqSta6aCD3gQUj6uJsfEWpQEXww6ge823oM1JaBLEPYsaE9mfV7AnaFNVKTuH5muQoMTshbJgvlKhq5O9WKVObSKUF4xlxOswxnUxLzMpP1_mD_wAtSSJ0p6W653KFYTABW_XPUGkrtZmqyjgt2ZEOHkcpgPetS3ob1IWFGmNRcfd0lkJRAyKBYTNRHOjNF4YYl_-4Qltzo5hgJvBL5jFmPnKf-NjWyFol6qTehuz9o.lVcRN_Axv79GG5CfgJxga7Z6kcES9MqrjOymJ4rdkyM&qid=1785785224&sr=8-1] The Correspondent: A Novel. By Virginia Evans. [https://www.amazon.com/Correspondent-Novel-Virginia-Evans/dp/0593798430/ref=tmm_hrd_swatch_0?_encoding=UTF8&dib_tag=se&dib=eyJ2IjoiMSJ9.D76nq4yGpTti41c7DtcoCiMvkrJc72Rbo0phaurusHYng9P_FROvEmKtzVLtYuadpOt7f2NiH_fv9nnCsMnhIkCPMbEo-qInO1J0MnA2bI3agJQ6EoZS97haDs4gilaotJXX6Uxwj1OC7mFvGQa4Pl6YNlZJgvGKpwY1xoNx5mzdGH40SMBVOL4LvMc0Dgg6gB5EbwjU06_OnRTLc8sMylsjhV19InULPRJt1FVzX0o.nPBJm7Zo8IqMYTQEw-epNAOXNj_nczpZSaiRSNFYM7E&qid=1785785103&sr=8-1] The Wall. By Marlen Haushofer [https://www.amazon.com/Wall-Marlen-Haushofer/dp/0811231941/ref=tmm_pap_swatch_0?_encoding=UTF8&dib_tag=se&dib=eyJ2IjoiMSJ9.4V3oauahHKDtz3aliPcMpP6jOOecWzn2RCRizWEE8fRmZiIQKy90wxn27or-prVWbMiLka3kKVaHtvd66z5eEC-rkVfysui1ygDxv8SKfHooL-mL7Ts5EFJWiX6ywSyM7oqpIF9OvaLzwxEJdDbWi-sYICs9n1x_lL51LNlbYIw7uyeVdGUmIT4uGXFDV0hN0g-eGef8hvjk9xI2qpVKjGl1qwJu7TX39Wn4NpXFU50.ra-ShdXTdFkJyYWFAQ7s6t0wB1PVsNiFoEJAqN9FQFU&qid=1785785333&sr=8-1]

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. [https://www.nejm.org/doi/full/10.1056/NEJMra2506111] * Trial of the Route of Early Nutritional Support in Critically Ill Adults. CALORIES Trial. NEJM 2015. [https://www.nejm.org/doi/full/10.1056/NEJMoa1409860] * Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2). LANCET 2018. [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32146-3/abstract] Books mentioned in this episode: * The Road to Character. By David Brooks. [https://www.amazon.com/Road-Character-David-Brooks/dp/0812983416/ref=tmm_pap_swatch_0?_encoding=UTF8&dib_tag=se&dib=eyJ2IjoiMSJ9.x3qP1bgxsh5RuSmmZooHQosrBncOJNi3Th3z3bC8fSUag_5sIV8FIyuBVvddoWmmu7gtuC_KckVDGmHMxQuUx7DemnI9fvw8DE8Vma1JCv5SFVrNyQF6yvfby2f6MfPKgruI700_V54H8SfzdjQT-MbEIlaMzoMYRg3C-iG6vU9-d4SFKdJWt1bCxU_KKUBaBXuA0A2Qj4IuYbEOyXJCUeypt4p7AvTkPilPqkcEog8.Uz71TdXKXddCTMHS3MaU_YCENZGsmSV_gIAcyj0tY0g&qid=1785246704&sr=8-1]

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 [https://www.soundphysicians.com/podcast/critical-matters/surviving-sepsis-campaign-2026-guidelines/] Sepsis. M Singer, et al. The Lancet 2026. [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02422-5/abstract] Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Crit Care Medicine 2026. [https://journals.lww.com/ccmjournal/pages/articleviewer.aspx?year=2026&issue=04000&article=00005&type=Fulltext] Subphenotypes and phenotypes to resolve sepsis heterogeneity: hype or hope? Andre Kalil, et al. Intensive Care Med 2025. [https://pubmed.ncbi.nlm.nih.gov/40047867/] Early Goal-Directed Therapy for Sepsis: A Novel Solution for Discordant Survival Outcomes in Clinical Trials. Andre Kalil, et al. Crit Care Med 2017. [https://pubmed.ncbi.nlm.nih.gov/28067711/] Books mentioned in this episode: Curious: The Desire to Know and Why Your Life Depends on It. By Ian Leslie. [https://soundphysicians.sharepoint.com/sites/MarcomTeam/Shared%20Documents/General/Media/Audio/Critical%20Matters%20Podcast/2026/9%20Sepsis/Curious-Desire-Know-Future-Depends]