Critical Matters

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

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.

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.

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

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.