The Society of Critical Care Anesthesiologists

Our center has supported 43 patients with COVID-19 ARDS on ECMO. Of these, 8 cases (19%) were in peripartum women, and their rate of survival was 86%. Notable points regarding the pregnant cohort (4 patients) include the fact that all neonates born on ECMO were preterm and required intubation but ultimately survived.

“Mostly Dead is Slightly Alive” has been for more than 40 years the maxim for Dr. Lance B. Becker when somebody claims that a cardiac arrest (CA) patient is dead. We believe that our failure in improving outcomes in CA has grounds in the “myth of the single magic bullet.” For decades, the mainstream of resuscitation science was represented by unsuccessful clinical trials targeting single pathways while expecting miracles. Unfortunately, we have not had very positive outcomes and still we are questioning if epinephrine should be routinely used during cardio-pulmonary resuscitation.

Cardiac output monitoring is essential for understanding flow and pressure relationships in critically ill patients after cardiac surgery. While the Swan-Ganz catheter is the traditional gold standard, new technology has used relatively non-invasive methodology to estimate cardiac output. Long time interval (LTI) analysis of the arterial blood pressure waveform is one such method.

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.

We previously reviewed data related to the risk of healthcare workers contracting COVID-19 in December of 2020 (Interchange:31[3]). One study of front-line healthcare workers demonstrated a 4% positive COVID-19 testing rate compared to just 0.33% for the general population. In a survey study of 105 anesthesiologists and intensivists at a New York City hospital, 58% reported a workplace exposure (mostly related to airway management), 26% of those reported COVID-19-like symptoms after that exposure, but only 12% of providers tested were found to be positive for antibodies.

According to Oxford Languages, to “practice” means to pursue a professional activity or exercise a skill regularly and routinely to improve proficiency. I am an anesthesiologist who “practices” critical care medicine and the residency program director for more than seventy-six residents in a large training program. I am also a mother, a wife, sister, and daughter; and I have to practice being human every day. We are all human, and we deserve more competence and proficiency as we interact together. Often, my biggest challenge that demands practice for proficiency is the transition from work to life.

To at least some degree, we all entered medicine for altruistic reasons: helping others, finding meaning in providing comfort and care, and saving lives. We in critical care are especially driven to offer management of life-threatening disease states as well as solace and comfort to critically ill patients. This aspect has been highlighted in striking detail during the pandemic where, despite the grueling physical demands of working in ICUs during this time, the discomfort of PPE, and the trauma of watching so many people die and so many families suffer, we still find joy and reward in the lives we save and the families whose lives we touch by our compassion.

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.”