Colleagues,

We had a fantastic SOCCA and IARS meeting in Denver. It was great seeing so many friends and colleagues and watching our packed conference room during the meeting. Even more impressive was the membership involvement with our new committees, task forces, and workgroups. The goal of SOCCA is to continue to offer numerous areas and opportunities for our members to engage and grow our society.

I would like to start off by saying that it is a great privilege to be taking over as Chair of the Communications Committee from Dr. Brent Kidd (Immediate Past Chair and Editor); thank you to Dr. Kidd for his leadership and efforts on behalf of the Communications Committee. He oversaw the development of the two sub-committees focused on social media and SOCCA Interchange/Drip respectively and guided us with engagement with our members through the COVID-19 pandemic and beyond. It is a great honor to be the first woman editor of the SOCCA Interchange and I am excited to continue to build on the work done by the previous Chair. I have been involved with the SOCCA Communications Committee since 2021 and was Chair of the social media sub-committee in the past. As Chair I hope to continue to expand member engagement with our SOCCA Twitter account, promote the work of our members through the Interchange newsletter, and bring timely industry news to our members. I appreciate the mentorship and guidance of my colleagues in helping me develop the skills to take on this new role and look forward to any feedback on how we can serve the organization.

As Chair of the Research Committee, I am thrilled and privileged to share with you the notable progress we’ve made in recent months. With the support and guidance of the Board we have grown our membership, been focused on deliverable products for our membership, and continued to increase the visibility and contribution of the committee to SOCCA and the wider community.

SOCCA is growing! Thanks to the visionary leadership of our president, Dr. Michael Wall, SOCCA has now created what is known as the Clinical Practice Committee (CPC). This committee reports directly to SOCCA’s Board of Directors and has a singular function: enable our growing membership to participate as much as possible in creating the resources and programs of the future.

One Year (and Counting!) of Action and Engagement

With the Women in Critical Care (WICC) section’s one-year anniversary, we presented several initiatives accomplished in the past year at the SOCCA 2023 annual business meeting. We have shared several Interchange articles, Fireside chats, and two webinars that have been well received—one on Wellness and a recent webinar on strategies to enhance women applicants in CCM.

For the second year in a row, we have witnessed a decline in the number of applicants interested in anesthesiology critical care fellowships. The gap between the number of positions available and the number of rank lists submitted continues to increase, with only 0.65 applicants per position offered in the 2023 match cycle. This year an alarming 39% of positions were left unfilled post-match. These distressing statistics demand a serious reflection on the challenges we face and the necessary steps to ensure the future of our subspecialty.  As we move forward after inspiring stories of anesthesiology intensivists as healthcare heroes and leaders of the COVID-19 pandemic, we must reflect on the past, current state, and future of our subspecialty. While it may be tempting to attribute the current lack of interest to a robust job market and attractive pay, perhaps an introspective approach and reflection are needed to understand other factors that contribute to our specialty’s diminishing appeal to today’s trainees?

In recent years, the critical care community has debated the benefits of vitamin C in septic shock. Vitamin C is thought to have antioxidant effects that attenuate tissue injury mediated by inflammation¹. A controversial retrospective analysis to evaluate the efficacy of vitamin C demonstrated a major reduction in mortality, AKI, and vasopressor duration². This fascinating result led to several prospective trials and meta-analyses^{3, 4}. Most recently, a large trial showed that patients in intensive care who received vitamin C therapy had a higher risk of death or persistent organ dysfunction⁵. With this result, the community has explored alternative therapies to manage septic shock. Vitamin B12, hydroxocobalamin, may be the next in line for evaluation, scrutiny, and debate.

Implementing Pathways to Anesthesiology: Promoting Diversity, Equity, Inclusion, and Success. O’Conor et al. International Anesthesiology Clinics (2023) 61:1.

Summary

An interesting review article that is relevant to our field. The article touches on what we constantly encounter: a gap between equality and equity for anesthesiologists from underrepresented minorities in Medicine (URiM). While there are “advertised” equal opportunities for anesthesiologists hired at different stages of their careers, there remains a gap between what is advertised as equality and what is actually exercised of equity.

Introduction

Hemorrhage from or around a tracheostomy is a relatively common and possibly life-threatening complication. Complications from a tracheostomy can be early or late and can be related to the placement of the tube, prolonged time duration of tracheostomy tube requirement, or abnormal healing at the surgical site. Tracheo-arterial fistulas represent a rare but often lethal complication from tracheostomies. This case report describes a patient who developed a fistula between a mature tracheostomy site and the innominate artery. The report discusses important practical considerations for preoperative and intraoperative management of this condition and describes the most common risk factors, diagnostic approach, and surgical technique.

Dr. Jessica Cassavaugh is a T32 Research fellow and Clinical Instructor in the Department of Anesthesia, Critical Care, and Pain Medicine at Beth Israel Deaconess Medical Center. She completed her anesthesiology residency and critical care fellowship at the University of Pittsburgh Medical Center. Her current research focuses on estrogen-dependent regulation of inflammatory and hypoxic signaling, especially as it relates to cardiovascular and metabolic diseases.

We are no longer in a world where—as current or future leaders of our respective medical communities—we can remain impartial to discrimination. Workplace mistreatment, discrimination, and microaggressions can limit access to resources and opportunities for growth. It can fuel persistent disparities experienced by caregivers and patients belonging to marginalized communities. As leaders we can’t not see, not hear or not act on inequalities.

Read members-only job posts.

If you would like to post a job, please email a short description and/or PDF flyer including location, contact information, and closing date to SOCCA Society Director, Vivian Abalama, IOM, CAE at vabalama@iars.org.

Interchange seeks to deliver timely, relevant, and high-quality content to SOCCA members. Contributions from members are not only welcome but essential to ensure that Interchange meets these goals. If you are interested in authoring content concerning clinical challenges, emerging research findings, member accomplishments, or anything of general interest to the membership, please reach out to vabalama@iars.org.