In this episode, Dr. Sergio Zanotti discusses the different aspects of managing pneumonia in critically ill patients. He covers the initial management of severe pneumonia, management of ventilator-associated pneumonia, and highlights the clinical approach to non-resolving pneumonia in the intensive care unit (ICU). 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).	

Additional resources:
How to approach a patient hospitalized for pneumonia who is not responding to treatment? Pedro Povoa, et al. Intensive Care Med 2025: https://link.springer.com/article/10.1007/s00134-025-07903-3 

Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Andre Kalil, et al. Clin Infect Dis. 2016: https://pmc.ncbi.nlm.nih.gov/articles/PMC4981759/ 

Management of Ventilator-Associated Pneumonia: Guidelines. M Metersky and Andre c. Kalil. Infect Dis Clin North Am. 202: https://pubmed.ncbi.nlm.nih.gov/38280768/ 

Hydrocortisone in Severe Community-Acquired Pneumonia. CAPE-COD Clinical Trial. N Eng J of Med 202: https://www.nejm.org/doi/full/10.1056/NEJMoa2215145 

Continuous vs. Intermittent β-Lactam Antibiotic Infusions in Critically Ill Patients with Sepsis. BLING III Clinical Trial. JAMA 2024: https://jamanetwork.com/journals/jama/fullarticle/2819971

Music mentioned in this episode:
 
Pat Metheny Group – We Live Here: https://bit.ly/44gt8Jl

Antonio Carlos Jobin – Terra Basilis: http://bit.ly/4k4Amq1

Mahler: Symphony No.9 – Chicago Symphony Orchestra: http://bit.ly/4k9sXWn

Management of pneumonia in the ICU

It’s Herbal Prescription Interaction Awareness Month—yes, that’s a thing! In this episode, April and Alicia discuss some of the most famous homeopathic remedies that may not be playing nice with the prescriptions in your medicine cabinet. From flu season fixes to natural mood boosters, our hosts dig into the pros, the cons, and the "wait, this does what?!" moments. Spoiler alert: just because it grows in your garden doesn't mean it's risk-free.

Mixing with caution

In this episode, April and Alicia have the pleasure of sitting down with friend, colleague, and adventurer extraordinaire Stephanie Byrne. As VP of Specialized Clinical Solutions at Sound, Stephanie knows a thing or two about problem solving, providing support, and conflict resolution - all things that make a great leader. Tune in to hear Stephanie's story!

The art of showing up feat. Stephanie Byrne

This month, we’re scrubbing in with a two-parter on the latest health headlines—literally. From the buzz about “skin cancer soap” to the ongoing debate around BMI, April and Alicia break down the breakthroughs, bust some myths, and ask the big (and sometimes weird) questions facing the future of healthcare. Tune in for your dose of news and nuance.

Healthcare headlines - Part 1

In this episode, Dr. Sergio Zanotti discusses ECPR–Extracorporeal Cardiopulmonary Resuscitation. ECPR is still be considered a niche therapy, but its relevance and availability are increasing. He is joined by Dr. Adam Green, a practicing intensivist at Cooper University Health Care and an Associate Professor of Medicine at Cooper Medical School of Rowan University (CMSRU). Dr. Green is the director of research for the division of Critical Care and has authored over 50 peer-reviewed publications. He has been part of the ECMO team at Cooper since its inception. 

Additional resources:
Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest. The Lancet Respiratory Medicine 2025: https://www.sciencedirect.com/science/article/pii/S2213260025001225  

Effect of Intra-arrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Immediate Invasive Assessment and Treatment on Functional Neurologic Outcome in Refractory Out-of-Hospital Cardiac Arrest. JAMA 2022: https://jamanetwork.com/journals/jama/fullarticle/2789313  

Association between increasing institutional experience with ECPR and outcomes in patients with out-of-hospital cardiac arrest: A nationwide multicenter observational study in Japan (the JAAM–OHCA registry) RESUSCITATION 2025: https://www.resuscitationjournal.com/article/S0300-9572(24)00862-1/fulltext  

Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest. N Eng J of Med 2023: https://www.nejm.org/doi/full/10.1056/NEJMoa2204511  


Books mentioned in this episode: 

The Perfect Predator: A Scientist’s Race to Save Her Husband from a Deadly Superbug. By S. Strathdee and T Patterson: https://amzn.to/3Hxjmez 

ECPR

Ready for part two? April and Alicia are back with more health news headlines and hot takes! In this episode, they dive into the battle against C-section site infections and the innovations saving the lives of countless women. Also, April unpacks what a compact license means for physician assistants on the move. It's breaking news, and you won't want to miss it!

Healthcare headlines - Part 2

Days are shortening, temperatures are cooling, and pumpkin spice is back - it can only mean one thing: It's Fall, y'all! Our hosts April and Alicia are thrilled to kick off the season with a fact or fiction that will test their knowledge on all things autumnal and cozy. Are there any nutritional benefits in your favorite pumpkin treats? Will colder weather actually make you sick? And is there any truth around "seasonal depression?" Tune in and play along!

It's Fall, y'all!

It's our favorite time of the year here at On Call: National APP Week! Sept. 22-27 is dedicated to recognizing advanced practice providers for the expertise, compassion, and care they bring to patients every day. To celebrate, April and Alicia—APPs themselves—are adding a little friendly competition into the mix with a fact or fiction all about their beloved profession. If you're an APP out there listening, we hope you play along with us and feel celebrated this week!

Happy APP Week!

Originally posted in April of 2023, we are sharing this episode of Critical Matters again as Dr. Sergio Zanotti's discussion about the long journey to healing and recovery for those who've survived critical illness in the ICU remains pertinent and important. This conversation features Dr. Margaret Herridge, Professor of Medicine, Senior Scientist in Critical Care and Respiratory Medicine at the University of Toronto. Dr. Herridge is also Director of Critical Care Research. Director of the RECOVER Program, and Clinical Director of the Grace RECOVER Program for Chronic Critical Illness, in the University Health Network, Toronto, Canada.

Additional Resources:
Outcomes after Critical Illness. M. Herridge and E. Azoulay: https://pubmed.ncbi.nlm.nih.gov/36884324/

Neuropsychological sequelae and impaired health status in survivors of severe acute respiratory distress syndrome. Hopkins RO, et al: https://pubmed.ncbi.nlm.nih.gov/10390379/
One-year outcomes in survivors of the acute respiratory distress syndrome. Herridge m, et al: https://pubmed.ncbi.nlm.nih.gov/12594312/

Long-term cognitive impairment after critical illness. Pandharipande PP, et al: https://pubmed.ncbi.nlm.nih.gov/24088092/

The RECOVER Program: disability risk groups and 1-year outcome after 7 or more days of mechanical ventilation. Herridge M, et al: https://pubmed.ncbi.nlm.nih.gov/26974173/

Determinants of long-term outcome in ICU survivors: results from the FROG-ICU study. Gayat E, et al: https://pubmed.ncbi.nlm.nih.gov/29347987/

Symptoms of anxiety and depression in family members of intensive care unit patients. Pochard F, et al: https://pubmed.ncbi.nlm.nih.gov/11588447/

Books Mentioned in this Episode:
Bel Canto. By Ann Patchett: bit.ly/3nWs7Vp
Commonwealth. By Ann Patchett: bit.ly/43pWSCt

Outcomes after critical illness

April and Alicia diving back into the headlines with a chilling twist! This episode, hear some of the latest healthcare news (and personal encounters) about all things creepy, crawly, and cutting-edge. From new-age cadaver labs to advancements in freeze-dried blood, these innovations are as fascinating as they are frightening. Spoiler alert: maybe skip this one if you're scared of bugs!

Healthcare headlines - Spooky edition

Welcome to On Call, the insightful and engaging podcast hosted by April Burke and Alicia Scheffer two seasoned Sound advanced practice providers with over 15 years of combined experience in healthcare. Join them as they delve into the ever-evolving landscape of healthcare, exploring trending topics that shape the future of medicine, patient care, and the healthcare workforce.
On Call serves as an indispensable resource for healthcare practitioners, administrators, and anyone passionate about transforming the healthcare system for the better. Whether you're a medical professional looking to stay on top of industry trends or a patient seeking to understand the dynamics shaping your care, this podcast promises thought-provoking conversations and valuable takeaways.

Happy APP Week!

On Call with April and Alicia