President's Message
Were you at SOCCA’s 30th annual meeting, held last month in Washington DC? If you were, you (hopefully) came away with a strong sense of excitement and enthusiasm for the future of SOCCA. Despite clearly cramped facilities, the excellent presentations, number of interested intensivists, bustling poster sessions, and sense of possibility were sustained and full of promise. I should note that the IARS contract in DC was finalized before their merger with the AUA and us, so we should have more meeting space next year in Chicago. Continue Reading...
PEEP Strategies in the Morbidly Obese
The care of morbidly obese patients presents many challenges to the intensivist. Notable among them is the optimization of mechanical ventilation. Obesity is associated with prolonged mechanical ventilation and increased ICU length of stay.1 The optimal strategy for mechanical ventilation of obese patients is still a matter of debate.2 Decreased compliance of the chest and abdominal walls lead to atelectasis, low end-expiratory lung volumes, and hypoxemia.3-6 Continue Reading...
A Brief Conversation with...David Shimabukuro
Dr. David Shimabukuro, M.D. is a Clinical Professor of Anesthesia and Perioperative Care at the University of California San Francisco (UCSF). In addition, he is an Associate Medical Director for several of the intensive care units at the UCSF Moffitt-Long Medical Center. His research interests and clinical expertise center around sepsis detection and treatment and the development of healthcare system measures to improve organ system dysfunction in critical illness. Continue Reading...
PRO: Suddenly Sugammadex: Should Sugammadex Become the New ICU Standard for Reversal?
Sugammadex, which was approved by the FDA recently, is being integrated into anesthetic practices throughout the United States. Sugammadex is a superior reversal agent for intraoperative muscle relaxation compared to the standard regimen of Glycopyrrolate and Neostigmine (Glyco/Neo). It has a faster onset, reliably reverses deep blockade, can be redosed rapidly, and causes fewer side effects than alternative medications.1,2 Despite multiple recommendations favoring sugammadex reversal in the OR, there has been little discussion as to the role of sugammadex in the ICU. However, the same factors that make Sugammadex superior in the OR apply to the ICU as well. Continue Reading...
CON: Suddenly Sugammadex: Should Sugammadex Become the New ICU Standard for Reversal?
Sugammadex, a new steroidal muscle relaxant encapsulator, is now officially in the US and Canadian market and is quickly gaining popularity as the best reversal agent for any depth of neuromuscular blockade (NMB) that is provided by rocuronium, vecuronium or pancuroinium (with efficacy for rocuronium > vecuronium >> pancuronium). Although sugammadex seems like the ideal selective chelating agent for rapid reversal of NMB by the aforementioned agents, I would like to caution critical care anesthesiologists who might care for these patients either in the ICU or OR. Continue Reading...
SOCCA 2017 Board of Directors Election Results
It is with pleasure that I announce the results of the recent election for the two open SOCCA Board positions for 2017-2018. Our new Board members are James Blum, MD, FCCM and Benjamin Kohl, MD, FCCM. They will join the SOCCA Board beginning immediately. Continue Reading...
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