The SOCCA membership committee had quite a busy year in 2023, and we are now working diligently with our new management team to continue to provide valuable programming for our members. The Early Career Intensivists group and the Physicians in Private Practice group are organizing their events for 2024.

Our committee has experienced a dynamic year, marked by significant accomplishments. In September 2023, we released one of our largest issues to commemorate Women in Medicine Month, featuring insightful contributions from several of our dedicated members. The response was exceptional, reflecting our commitment to celebrating diversity and excellence in our field.

As the new year approaches, the education committee would like to announce some new and exciting changes to the structure of the education committee, as well as our offerings for 2024.  As you will read in this month’s Interchange, the SOCCA component of the 2024 Annual Meeting in Seattle will be undergoing significant changes. We are excited that we will now be able to incorporate three days’ worth of educational offerings as a part of the combined IARS/SOCCA meeting. With this change likely to last beyond 2024, the Annual Meeting subcommittee will be continuing our work on grading and developing annual meeting content for years to come.

As we wrap up this year, we would like to take this opportunity to highlight the Intensivists in Private Practice subcommittee and provide an update on some of our recent activities.

Introduction
Anesthesia Critical Care Medicine (ACCM) is the oldest ACGME board-certified subspecialty within Anesthesiology, and similar to other subspecialty fellowship training programs, our growth has outpaced the current interest in our field. This year’s match proved again to be difficult for many programs in light of the low application numbers.

The SOCCA Service Chiefs’ Advisory Council (SCAC) aims to include representatives from every organization with an active anesthesiology critical care practice, specifically the one or two individuals with the broadest and most directly relevant administrative purview from each organization.

Introduction

This case report describes a young man who developed a tracheal-esophageal fistula (TEF) from endotracheal intubation with prolonged elevated cuff pressure after a traumatic fall. This case report describes the intra-operative management of profound hypoxia, shedding light on crucial pre-operative indicators that could serve as vital cues to prevent the occurrence of this potentially serious complication.

Introduction:

Acute right ventricular failure (RVF) due to post-left ventricular assist device (LVAD) placement is challenging to treat with the management often limited to placement of either surgical or percutaneous mechanical circulatory devices. The Protek Duo® (LivaNova) is a percutaneous right ventricular support device (RVAD), which due to its relative ease of placement, has been a breakthrough in the management of post-LVAD implantation acute RVF. ¹

Cardiac perforation from placement of a Protek Duo cannula is a rare but potentially lethal complication. This case is the first to describe a patient who developed cardiac tamponade from a Protek Duo cannula perforation of the right ventricle. The report discusses preoperative and intraoperative management of this condition and relevant transesophageal echocardiography (TEE) imaging that aided in the diagnosis and surgical repair of the perforation.

The transition between clinical training to independent practice is notoriously challenging. The goal of the SOCCA Early Career Intensivist (ECI) working group is to help support members through this progression. Founded in 2021, the ECI provides junior members with resources and content tailored to their concerns and interests. “The purpose of the group,” says Chair, Dr. Alisha Sachdev, “is to engage all SOCCA members in the first ten years of their careers with specific programming to meet their needs early on.”

Since the 2009 H1N1 pandemic, there has been exponential growth in the use of extracorporeal membrane oxygenation (ECMO) for severe cardiopulmonary disease.¹ The increased utilization of ECMO has allowed the management of more complex and severe diseases, pushing the boundaries of critical care medicine (CCM) as a specialty. However, this increase in ECMO use means that more intensivists are likely to encounter and care for patients with ECMO, necessitating the evolution and standardization of specialized training in this field.

Bedside point-of-care ultrasound (POCUS) has become ubiquitous in the critical care arena and is an essential tool for intensivists. POCUS has been used extensively to diagnose various cardiovascular and respiratory pathologies in critically ill patients and is now an integral part of various diagnostic algorithms in the intensive care unit (ICU). Yet, despite the proliferation of various portable and handheld devices, POCUS during emergency airway management in critically ill patients has never taken off.

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.

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.

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?

Over the recent years, it is no secret that SOCCA has made enormous strides in both its membership and mission. We have seen our ranks swell to over 1,150 in 2022 and our committees and workgroups similarly multiply as we seek to engage and impact all realms of critical care touched by anesthesiologists. The Communications Committee has the unique privilege of supporting and promoting all of these various initiatives in addition to continued general engagement with membership. I encourage all of our members both new and veteran to engage with us as well through our three main products: the Interchange Newsletter, SOCCA Drip Blog, and Twitter (@SOCCA_CritCare). Each of these outlets serves as a way to bring relevant up to date information to the membership on SOCCA webinars, society opportunities, recently published literature, and so much more! We are also always looking for exceptional content from the membership and welcome your submissions to these outlets as well.

We are extremely excited and are looking forward to our first in-person SOCCA annual meeting since 2019! The Annual Meeting Program Planning Committee has been working hard over the last year and has put together an outstanding program that promises to deliver exceptional educational content. The meeting will kick off on Thursday night with the opportunity to network with colleagues during the SOCCA Women in Critical Care Meetup and the SOCCA Early Career Group Networking Events.

The membership committee started off the new year with an Early Career Intensivists Zoom meet up in early February. The guest speaker was SOCCA board member Dr. Ashish Khanna, and the discussion was led by Early Career subcommittee members Drs. Lauren Sutherland, Christy Idichandy, and Alisha Bhatia. Participants on the call ranged from critical care fellows to anesthesiologist intensivists in their first few years of practice. We had a lively discussion about issues faced during the first few years out of fellowship, including establishing relationships with our surgical colleagues and getting involved in research. Dr. Khanna provided motivation and insight to everyone on the call and members benefited from hearing from multiple viewpoints.

The optimal storage temperature of transfused platelets for surgical and traumatic hemorrhage remains controversial. Standard practice since 1969 has been to transfuse platelets at room temperature (22^o). This practice is based on decades old research demonstrating that platelets are removed from the circulation more quickly when stored at 4^o than platelets at room temperature.¹ Since the most common indication for platelet transfusion is thrombocytopenia due to oncologic disorders in order to prevent bleeding, the increase in circulatory time with room temperature platelets was preferred.

As we approach the new year, we look forward to providing educational content to all of our SOCCA members and to the critical care community at large. The annual meeting subcommittee has been busy compiling a fantastic program with an outstanding group of speakers for what will hopefully be our first in person annual meeting in many years. We strive to ensure a meeting that will highlight the recent advances in critical care medicine and are also working with the research committee to bring the latest in cutting edge research to the meeting attendees.

Two years ago under the leadership of Drs. Robert Stevens and Matthew Warner the SOCCA Research Committee formed the SOCCA Data Subcommittee which was charged with expanding the portfolio of survey information that would be of interest and utility to our membership.

The SOCCA Membership Committee has been hard at work putting together a variety of programs for all of our members at various stages of their careers. For our graduating fellows, we put together a new “SOCCA Fellowship Exit Brochure” to make sure all of our newly minted intensivists are aware of everything SOCCA has to offer to them. This brochure was distributed with the help of the Program Directors committee. Our fellowship subcommittee also planned  our annual Job fair, which occurred on October 5.

On behalf of the SOCCA Education Committee, we would like to thank you all for another successful SOCCA Annual meeting this past spring. While we were disappointed that the increase in COVID cases led to a last-minute transition to a virtual format, the enthusiasm for educational talks, presentations of current research, and networking opportunities could not be fettered.

The members of the SOCCA Research Committee are moving into summer with great energy and enthusiasm. Our members have continued to advance a variety of initiatives in support of the SOCCA vision “to promote and advocate for current and future critical care anesthesiologists through collaboration and innovative patient care.”

Even prior to curricular changes necessitated by the COVID-19 pandemic, adult medical education had been evolving from a primarily in-person lecture-based structure to a more interactive and reflective approach to learning.

I will start out by saying that I share everyone’s disappointment in the annual meeting being (necessarily) converted to virtual yet again. Still, as the months drag on, we all become more adept at living in the “virtual meeting” era. The Communications Committee has experienced this first hand and has been hard at work spreading the many messages of SOCCA via these virtual avenues over the past two years from interactive webinars and educational content, to new initiatives and committees. I think it is safe to say that we have begun to collectively see the fruits of this labor in the metrics we follow from webinars joined, links clicked, and webpages visited. Just in terms of website traffic we have seen our unique visitors/sessions double year over year. I attribute this to all of the committees that are hard at work making sure that SOCCA produces a continual stream of quality content and opportunities for engagement from our membership.

The main mission for the SOCCA Membership Committee is to coordinate all membership activities for SOCCA. Our membership numbers and interest in SOCCA continue to grow. This interest and growth are a direct result of our members’ engagement and efforts to truly make this society desirable and valuable to each of the members and all of the Anesthesiology Critical Care community. This past year our focus was to launch a strategic structure realignment intended to better serve the members of SOCCA and the Anesthesiology Critical Care community with the goal of increasing engagement, diversity, and opportunities for members to contribute to the current and future of SOCCA.

The SOCCA membership committee decided to make subcommittees this academic year for better creativity and engagement amongst its members. In the fellowship subcommittee, we held a job search webinar in the fall for the current critical care fellow class. We were able to invite panelists from both the private and academic settings; we were also able to include a current program director and academic chair. Comfort with virtual conferences may be one positive to come out of the COVID-19 pandemic, as we had good participation from all over the country. Highlights included: discussion of timeline for job search, growth of private practice opportunities, approaches to contract negotiation, and types of ICU settings available. The webinar is available to view for SOCCA members as well as a follow-up thread in the Docmatter community.

As we start the new year with some bittersweet memories from 2021, we are again reminded that the pandemic still exists with the most recent surge again filling hospitals and ICUs alike. This current surge with the highly transmissible Omicron variant has not only overwhelmed hospitals but has also impacted the critical care workforce across the board. This has again upended many a plan, including the scheduled in-person annual meeting in Hawaii this March which has been converted to a virtual-only format. Although the decision was not easy, we believe that it was in the best interest of our members and the society in general. A lot of behind-the-scenes activity and hard work has gone into making this transition seamless and we are confident that we will be able to provide our membership, the same high quality and enriching content that the in-person meeting would have provided. For this, we would like to thank our administrative and education staff partners from the IARS, SOCCA and AUA. It was not easy to suddenly pivot and reorganize everything on the same dates as the actual in person meeting, within a less than two months span, and we would have not been here had it not been for their tireless efforts. The combined IARS/AUA/SOCCA meeting will be held virtually from March 17-20, with the dedicated SOCCA meeting day on Friday, March 18; and aligned SOCCA-IARS content on Saturday, March 19.

Despite another year of pandemic-related challenges in the clinical practice of intensive care medicine, the SOCCA Research Committee continues with enthusiasm as we move towards the end of 2021. Our three subcommittees (Data, Research Collaboration, Scientific Writing) have been extremely productive.

As educators, we strive for a mindset of innovation in both how and what we teach in Critical Care Medicine. The intensivists of tomorrow are expected to be clinically excellent, adept in responding to changes in the healthcare environment and also competent in the administrative arena.

I would like to start by saying it is an honor to take over the Communications Committee at SOCCA and subsequently as editor of Interchange. I have to give immense credit to my immediate predecessor Craig Jabaley for continuing to maintain—and even expand—the committee’s roles throughout the initial waves of the COVID pandemic. I hope to continue that process and build upon the foundations provided to better serve our organization. To that end we have created two subcommittees to better focus on the varying roles of the Communications Committee. These two subcommittees will focus on Twitter and SOCCA Interchange / Drip respectively. I would encourage any of our members who don’t yet follow us on Twitter (@SOCCA_CritCare) to do so as well as frequent our blog (SOCCA Drip) to stay up to date on all things SOCCA including webinars, meetings, and organizational opportunities.

On behalf of the SOCCA Education Committee, we would like to extend our thanks to our new members. It is heartwarming to see such an overwhelming enthusiasm to advance the educational mission of SOCCA. As SOCCA membership grows, the Education Committee has realigned its structure to create working groups, dedicated to meeting the education needs of our SOCCA members and the anesthesiology critical care community at large. The last few months have been a testing time for any practicing intensivist in the United States. We have been working overtime fighting the delta COVID sweeping through the country. Despite this, the SOCCA Education Committee aptly supported by the rest of the SOCCA membership has continued to produce remarkable new critical care education content. We are deeply appreciative and truly admire each of you as you deal with this once in a lifetime ‘ICU pandemic.’ Our update highlights our working groups that have been extremely busy in developing diverse educational content and adapting to the ever-changing landscape imposed by the COVID-19 pandemic.

The Early Career Working Group has been working hard to put together some exciting content for this fall. First off will be our Job Seminar for Fellows on October 21 at 6pm EST. This webinar has been specially arranged for our members who have just started their fellowships and are starting to look for jobs and plan their careers. Please join us for what promises to be a lively discussion with your co-fellows from around the country. Our panelists will include department chairs, program directors, members in private practice, and recent fellowship graduates.

The strength of SOCCA is the wealth of talent and energy of its members. One of the ways to serve the Society is through volunteer activities. The SOCCA Nominations Committee annually evaluates nominees and develops an election ballot for available Officer and Director positions. This election cycle we will be electing a Secretary (2-year term) and 3 Board of Directors (3-year term). The Secretary position serves as the entry position for eventual advancement to Society President. Further details about the governance structure of SOCCA are described in our Society Bylaws.

I was a second-year anesthesia resident when my teachers and mentors encouraged me to go the annual Society of Critical Care Anesthesiologists (SOCCA) meeting. At my very first meeting, I found the atmosphere very family-like, very open, very healthy and a lot of positivity all around. Ten years later, I chaired my very first SOCCA meeting at the recently concluded SOCCA Annual Meeting in 2021. I never thought that a decade of association with the SOCCA would get me here, and neither did I ever think that I would one day chair a virtual meeting.

A big welcome to all our new members to the SOCCA Membership Committee! We look forward to collaborating with you all. The main mission for the SOCCA Membership Committee is to coordinate all membership activities for SOCCA. Our membership numbers and interest in SOCCA continue to grow. To answer the asks of our members (‘I want to be more involved, but how do I do it?’), the SOCCA Membership Committee has launched a strategic structure realignment intended to better serve the members of SOCCA and the Anesthesiology Critical Care community. The realignment should foster increased engagement, diversity, and opportunities for members to contribute to the current and future of SOCCA.

The SOCCA Research Committee is enthusiastic and energized heading into the 2021-2023 term! As we reflect on the past two years, there has been substantial growth in committee activities. Under the leadership of committee Chair Dr. Robert Stevens and Vice-Chair Dr. Matthew Warner, the committee developed several short surveys designed to assess the current state of anesthesiology-led critical care, including: clinical practice patterns, research initiatives and mechanisms of support, current and future models of anesthesia-based ICU training and education, anesthesiology intensive care engagement in the COVID-19 pandemic, and point of care ultrasound utilization in clinical practice.

The SOCCA Committee on Research is currently engaged in multiple efforts to expand the scientific objectives of the society. First, the committee has developed a series of short surveys targeted to SOCCA members to assess diverse aspects of anesthesiology-led intensive care. These include: clinical practice patterns, research initiatives and mechanisms of support, current and future models of anesthesia-based ICU training and education, anesthesiology intensive care engagement in the COVID-19 pandemic, and point of care ultrasound utilization in clinical practice.

There is no doubt that both SOCCA and its individual members are busier now than ever. SOCCA has expanded its efforts in every domain, and with this growth there is a need for continued evolution and revitalization of our communications efforts. Our blog, the SOCCA Drip, the Interchange newsletter, @SOCCA_CritCare, electronic mailers, and related efforts are all member-driven initiatives. In order to keep pace with increasing demands and feature the work done by our members within the organization and externally, we must come to embody the proverb, “many hands make light work.”

What a year! In continuing to improve well-organized bookcases and other real or virtual backdrops, we have clearly embraced the new normal. While the disappointment of missing real human contact associated with education is difficult to quantitate, there is certainly a silver lining to be appreciated. Developing and delivering didactic materials during a pandemic has required us to dig deep into the reserves of our creativity, and the results have been excellent to say the least.

On behalf of the Communications Committee, we invite you to take a look at the newly launched SOCCA Drip online. To provide a greater wealth of resources to members in a timelier fashion, SOCCA Drip will be regularly updated to feature both long-form content written by members and brief topical highlights from the popular media, peer-reviewed literature, relevant professional societies, and other sources that will be of interest to the membership. We will continue to aggregate the majority of these features into our quarterly Interchange newsletter.

The SOCCA Research Committee met in-person during the February 2020 SCCM Congress in Orlando. We arrived upon several goals further outlined below. While progress has been slower than planned for obvious reasons, we remain committed to gradually ramping up over the coming weeks.

This time of the year the SOCCA Education Committee turns its focus toward the final planning of the Annual Meeting in San Francisco. This year the meeting will comprise up to three days of content beginning with a new board review course on Thursday, May 14; followed by the dedicated SOCCA day on Friday, May 15; and finally aligned SOCCA-IARS content on Saturday, May 16.

With two months of 2020 already behind us, the Communication Committee is collaborating with the Board of Directors and SOCCA’s other committees to create a unified communication strategy moving forward. This is an exciting time for SOCCA: membership is on the rise, the inaugural SOCCA board review course is forthcoming in conjunction with the Annual Meeting, and a clinical trials group is beginning to coalesce.

At the recent SOCCA Board meeting prior to the annual Anesthesiology conference, we continued to explore means by which to grow and sustain the organization’s membership. Understanding our membership patterns, and the challenges our members face, is key. One critical issue that we have identified is member loss during transition periods: namely residency to fellowship and fellowship to faculty.

The SOCCA Education Committee has undergone substantial changes in the past year. We have grown to become 12-person strong and we have developed clear directives, focusing on the SOCCA strategic goals. Coordinating a successful annual meeting remains the prime focus of the committee and planning for the next annual meeting (to be held in San Francisco) has already begun under the direction of Peter Von Homeyer MD, FASE, the annual program chair.

The SOCCA Research Committee has embarked on a strategic realignment intended to best serve the members of the Society and of the Anesthesiology Critical Care community, at large. The Research Committee has traditionally worked to aggregate and analyze data on Anesthesiology Critical Care practices and on SOCCA membership.

Communication is the action of exchanging information and ideas. It is a give and take. It is a part of our everyday lives…in the everyday interactions we have with our families, friends, co-workers, patients and their families. Communication is a two-way street and relies on a free-flowing give and take of ideas.

As we approach the annual SOCCA meeting, it is a great time to reflect on the benefits of being a member of SOCCA. We, therefore, asked a few current SOCCA members why they belong and this is what we heard.

According to SOCCA bylaws, the work of the nominating committee is to recommend a slate of candidates for board and executive committee elections to the SOCCA board, and to suggest candidates for the two awards given out by SOCCA in alternate years: the Burchardi and Lifetime Achievement awards.

The SOCCA Education Committee is primarily charged with creating educational content for the Annual SOCCA Meeting. To date, this has been our priority focus and we are working hard to develop a unique and challenging annual meeting for 2019.

The SOCCA Membership Committee would like to welcome all of our current members, as well as, new Critical Care Anesthesiology faculty and fellows to the 2019 academic year! Overall, our current membership remains strong. Maintaining a strong and engaged membership is important to the long-term health of SOCCA. We’ve been able to maintain this strong membership level because of you!