Critical Matters

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.
Books mentioned in this episode:
Culpability: A Novel. By Bruce Holsinger

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

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, 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 Critical Matters episodes 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

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.

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.