Twenty years ago, I was in the middle of my critical care fellowship year when we admitted a patient that was “found down.” The patient was comatose, and we really did not have a lot of information or leads to guide our therapy. The patient had been admitted to the surgical ICU on the presumption that he was a trauma patient, but after the initial work up found no injuries, we were left with a long list of possible diagnosis and extensive detective work in front of us.

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.”

The SOCCA Early Career Working Group held its first meeting on January 28, and it was a success! We discussed how we want to organize the group and what we hope to accomplish together. Our top priority will be to keep fellows and early career members engaged in the society. We are currently planning to organize several webinars, including advice for residents applying for fellowship, advice for fellows applying for jobs, and early-career guidance for fellows reaching the end of fellowship before starting their jobs.

We are pleased to announce the newly published SOCCA Parental Leave and Lactation Recommendations. This initiative was undertaken in hopes of providing support for intensivists who are new parents by birth or adoption and/or breast feeding. The document exemplifies the role SOCCA takes to support all intensivists in their personal endeavors, to enhance mental and physical health and well-being, and to continue championing women in critical care.

Obstructive sleep apnea (OSA) is the most common form of sleep-related breathing disorder encountered in the perioperative setting. It is defined by recurrent upper airway collapse, potentially leading to decreased oxygen levels during sleep and an increased risk of long-term cardiovascular illness. While OSA is more prevalent in surgical candidates than in the general population, between 60-90% of patients remain undiagnosed.

COVID-19 has drastically changed how end-of-life care is practiced in the intensive care unit (ICU). Safety concerns for society limits family visitation but is contrary to patient and family-oriented care. This article provides an ethical analysis of the pros and cons of having family members present at the death of a critically ill patient with COVID-19 and provides a framework that can be used in future surges.

She was breathing laboriously and had all but lost consciousness. In the subcutaneous tissues of her right arm, a syringe pump was delivering morphine and midazolam to help her breathe more easily and prevent the seizures she had been having earlier. Her right cheek still twitched periodically. She was in her daughter’s home surrounded by her grandsons and daughter. Just yesterday she had opened her eyes and smiled at her loved ones, tracking their movements.

Postoperative pulmonary complications have been recognized and appreciated by physicians since symptoms of pneumonia were first described by Hippocrates, the father of western medicine, in 460 BC. Despite our extensive familiarity with this pervasive ailment, pneumonia remains the third-most common postoperative complication with an overall incidence of 1.3-1.8%.

Advance care planning (ACP) is a process that supports adults at any age or stage of health in understanding and sharing their values, goals, and preferences regarding future medical care. The goal of ACP is to help ensure that people receive medical care that is consistent with their preferences during serious and chronic illness. At the Cleveland Clinic, we operationally defined ACP as having two elements: documentation of the surrogate decision-maker in the electronic medical record (EMR) for all adult patients and goals of care discussion documentation for seriously ill patients. Ideally, this conversation between a seriously ill patient with a chronic condition and their primary provider would happen long before the moment of a critical illness crisis.

Read members-only job posts—including roles with Emory University School of Medicine, Ochsner Health System, University of Arkansas for Medical Sciences, and University of Wisconsin School of Medicine and Public Health—at SOCCA’s Job Board.

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.