This week on Critical Care Time we take a slight departure from our usual content and turn an eye towards sustainability in the ICU. What low-hanging fruit exists in your ICU in the fight against medical waste? Why reach for a nebulizer when HFAs are so much more convenient? We had a great chat with Dr. Stephanie Maximos and Dr. Hari Shankar where we unpack this emerging concept and discuss options to take great care of your patients AND be mindful of waste and excess in your ICU! Listen, learn ...
May 18, 2026•1 hr 17 min
On this week’s episode, Cyrus and Nick host a spirited discussion with Drs. Rory Spiegel and Max Hockstein where we debate the merits of Airway Pressure Release Ventilation (APRV). What's the rationale for this? When is it appropriate? IS it appropriate… or is it witchcraft? Is it physiologically foolish or a perfectly logical option for hypoxemic respiratory failure? Good for all comer, good for a subset or does it belong with the vials of succinylcholine and DL blades? We may not have all the ...
May 04, 2026•1 hr 32 min
In this episode of Critical Care Time , we tackle one of the most complex and high-stakes corners of critical care: the lung transplant patient in the ICU. From evaluating candidates at the edge of respiratory failure to managing the crashing post-transplant patient, we break down the practical bedside decisions that matter most — including bridge strategies, hemodynamics, immunosuppression, infection, rejection, and the complications that can rapidly spiral if you miss them. Whether you work in...
Apr 20, 2026•1 hr 31 min
On this week's episode of Critical Care Time, Cyrus & Nick go all-in on DKA and spend a little time talking about alcoholic and starvation ketosis too! In this jam-packed, clinically robust episode, the guys discuss the importance and pathophysiology of DKA before discussing all things treatment. After listening to this - and perusing the show notes - you'll be a DKA master! Check it out and let us know what you think. Special thanks to Integration Health and The Difficult Airway Course: Cri...
Apr 06, 2026•1 hr 29 min
On this week, Cyrus & Nick are joined again by intensivist extraordinaire, Dr. Adam Mora, for a long overdue episode on ICU Toxicology! Together, the three of us embark on a case-based journey covering some of the more common ICU toxidromes as well as some of the more unusual, but can't-miss diagnoses. This is a bit of a longer one but it's super high-yield and very practical for anyone who is studying for their boards and/or participating in the care of the critically ill! Thanks to our tag...
Mar 23, 2026•1 hr 53 min
We've been teasing this one for a while and now it's finally ready! This week we've released our first LIVE podcast from Chest 2025 where we cover cases in cardiogenic shock with our amazing panel of incredible clinicians. Nick & Cyrus moderate a discussion using a choose-your-own-adventure format, leveraging the expertise of our panelists in an hour long, fun-filled and practical discussion where we put some of our earlier CCT content to practice in some real world cases. Check out the YouT...
Mar 09, 2026•50 min
Buckle up because on this week's episode of Critical Care Time we are treated to a master class on Right Heart Failure with world-class educator Dr. Matt Siuba. We are taking a deep dive on diagnosis, management and of course, sharing our love for the PAC! Make sure you clear your schedule and take notes for this one because as far as we are concerned, this is required listening for anyone who cares for the critically ill! Hosted on Acast. See acast.com/privacy for more information....
Feb 23, 2026•1 hr 39 min
Folks this right here is a JAM PACKED episode of CCT goodness for you guys to enjoy! In this show for the ages we take a deep dive into the world of Mechanical Circulatory Support (MCS) and Cardiopulmonary Critical Care with one of the best in the biz, Dr. Bindu Akkanti! We will go through several fictional patients illustrating use cases, pitfalls and pearls of tools such as the balloon pump, ECMO and the microaxial flow devices used in ICUs all over the globe to help care for the sickest of th...
Feb 09, 2026•1 hr 46 min
On this week’s BONUS episode of Critical Care Time, Cyrus & Nick flip the coin on sleep and discuss the importance of sleep for those of us that have to work nights. We also discuss how to find ways to still get rest even when your whole world is flipped upside down! Be prepared to keep taking excellent care of your patients using some of the tricks we review here. Give it a listen - or a watch and let us know what you think! Hosted on Acast. See acast.com/privacy for more information....
Feb 02, 2026•1 hr 8 min
On this episode of Critical Care Time we delve into the fascinating world of sleep with a focus on the importance of sleep in our ICU patients and how we can promote good quality sleep in the sickest patients in the hospital. Try not to sleep through this one as we provide some valuable insights and high quality pearls to get you geared up and ready to be a champion for sleep in your ICU! As always, listen and let us know what you think. Special thanks to The Difficult Airway Course: Critical Ca...
Jan 26, 2026•1 hr 19 min
On this episode of Critical Care Time, we tackle the enigma - shrouded in mystery and caped in uncertainty - know as rheumatologic emergencies in the critically ill patient! We sit down with Dr. Marcela Ferrada - a QUADRUPLE boarded intensivist/rheumatologist/ID specialist and internist - who guides us through her approach to rheumatologic emergencies in the sickest of the sick. As we often do, we approach this via a pragmatic, cased-based journey for your listening pleasure. Please check it out...
Jan 12, 2026•1 hr 31 min
This Critical Care Time bonus is our ode to RSI... that is the RSI Trial! In this episode, we'll unpack all the important elements of the recently released RSI Trial by the Pragmatic Critical Care Research Group exploring whether there is a signal favoring etomidate vs ketamine for tracheal intubation of critically ill adults. Does one drug reign supreme? Is this practice changing, practice affirming or perhaps the devil's in the details? Listen, learn and let us know YOUR thoughts! Hosted on Ac...
Dec 29, 2025•29 min
This week we drop a journal club extravaganza! Should we do away with the A-Line? Is Bicarb a sure-fire way to treat metabolic acidosis in the setting of AKI? What about selective decontamination and all that capillary refill business!? We tackle all these topics through thoughtful journal discussion, provide our $0.02 and a little witty repartee, of course! Check it out and let us know what you think! Hosted on Acast. See acast.com/privacy for more information....
Dec 15, 2025•1 hr 21 min
The importance of leadership in the hospital setting is critically important yet often overlooked. It’s even more important to have sound leaders and adhere to well-founded leadership practices when taking care of the critically ill. Join us as we sit down with Dr. Josh Hartzell - internist, infectious disease physician, author, veteran and physician-leader - as we discuss Leading in the ICU and Beyond!As always, please leave us feedback and let us know what you think! Hosted on Acast. See acast...
Dec 01, 2025•1 hr 13 min
For those who work in an ICU - or with any patients for that matter -the concepts of burnout and moral injury are no stranger. In order to mitigate the effects of these forces, it’s important to understand them. Join Nick and Cyrus, as they sit down with an incredible guest, Dr. Venktesh Ramnath, with the hopes of doing just that. On this episode we step away from the pressors and central lines and focus on the contributors to burn out and moral injury in the medical field while developing some ...
Nov 17, 2025•1 hr 21 min
Join Cyrus & Nick as the FINALLY tackle mechanical ventilation. In this episode - first of many we suspect - we lay the foundations for mechanical ventilation. If you stick with us through this one you'll come away with a great introduction to vents to include why we use them, what we adjust, and about a number of the primary vent modes you'll likely seen in your ICU. We've got something for everyone with this episode so please give it a listen and let us know what you think! Hosted on Acast...
Nov 03, 2025•1 hr 40 min
Join Nick and Cyrus as they teach a master class on hypoxemia for everyone and anyone who is ICU adjacent! We discuss why oxygen is so crucial, share some very interesting animal physiology and - perhaps most importantly- discuss the 6 causes of hypoxemia you MUST know… and what you can do about them! Take a listen, let us know what you think, and leave us a review! Hosted on Acast. See acast.com/privacy for more information.
Oct 20, 2025•1 hr 8 min
This week on Critical Care Time, Nick & Cyrus discuss the recent article in the Journal of Critical Care titled “Impact of initial jugular vein insertion site selection for central venous catheter placement on hemodialysis catheter complications.” Is this bunk or is this practice changing? Did they select the right population for this study or is the question they asked and answered... maybe not such a great question? We'll cover all this and more during this week's episode! Please take a li...
Oct 06, 2025•31 min
Join us this week on Critical Care Time as we take on Airway Controversies with Dr. Jarrod Mosier - course director for The Difficult Airway Course: Critical Care! We talk induction agents, pre-oxygenation and cover so much more in this episode! If you love this - consider attending the upcoming Difficult Airway Course at the Manchester Grand Hyatt in sunny San Diego, California from November 14th to the 16th and use our Discount Code CCTIME25 at checkout and save $250! Hosted on Acast. See acas...
Sep 22, 2025•1 hr 41 min
On this mini-sode, Cyrus & Nick are once again joined by Dr. Prager as they follow up on last week's episode with some cases & practical pearls to really hammer home some of the points previously discussed. Here we look at practical uses for the volume assessment tools discussed in our prior show, along with some commentary on when such assessments may or may not be warranted. This is a great, practical, rubber-meets-the-road episode for folks looking for a quick review/refresher. Listen...
Sep 15, 2025•33 min
What is the microcirculation? How are terms like volume-status and fluid-responsiveness misleading? Join us as we sit down with Dr. Ross Prager to unpack and de-mystify the concepts of congestion and volume tolerance along with our survey of the tools of the trade as it relates to these terms. On this Critical Care Time episode we really get into the weeds on this stuff and even get theoretical at some points so it's NOT for the faint of heart! However, if you listen to us for the deep dives int...
Sep 08, 2025•1 hr 20 min
This week, Nick & Cyrus try something a little different with Tales from the ICU. Here, we explore clinical reasoning in the ICU in the context of a mystery case! Don't worry, we'll reveal the diagnosis and go through all the pitfalls, pearls and pathophysiology! This way, you get to play along for a while AND learn some cool medicine. As this is a new episode format, PLEASE leave us feedback and let us know if you like it or if we should send this one to the crypt! Hosted on Acast. See acas...
Aug 25, 2025•50 min
On this week's episode of Critical Care Time, Dr. David Dulaney rounds out GI bleeds in the ICU by taking on cirrhosis & variceal bleeds! During this show we discuss the unique challenge associated with managing a patient with cirrhosis - specifically focusing on the coagulopathy of advanced liver disease. We then delve into the nuances associated with managing a variceal bleed, both in terms of the unique critical care elements but also the challenges faced by the endoscopist when trying to...
Aug 11, 2025•1 hr 33 min
Join us on this week's episode of Critical Care Time as we embrace blood-and-guts with Dr. David T. Dulaney, gastroenterologist-extraordinaire! Nick & Cyrus host David for a pearl-laden discussion on non-variceal GI bleeds where we talk guidelines, expert opinion and so much more. Who needs a scope? When do you scope them? Why is stabilizing your patient SO important before GI comes in to save the day? How can we work together effectively with our colleagues in GI to ensure the best outcomes...
Jul 28, 2025•1 hr 53 min
On this episode of Critical Care Time, Nick & Cyrus embark on a deep dive into the world of lactic acidosis! As it is the beginning of the academic year, we figured this would be a great topic to demystify and disambiguate for our listeners. We discuss why lactic acidosis matters, and deconstruct all the clinically relevant elements from diagnosis to management, so that you are fully equipped with the tools necessary to conquer your next case of lactic acidosis - or maybe your first!! Ring i...
Jul 14, 2025•1 hr 14 min
This week on Critical Care Time , we’re turning the mic over to you , our brilliant listeners! In this special Q&A episode, Nick and Cyrus read your comments, tackle your toughest clinical questions, and share how your insights have sent them diving back into PubMed, Reddit, and beyond. Whether you’re commuting, charting, or on break in the ICU, this episode is packed with practical pearls, literature deep-dives, and the human stories that make critical care so rewarding. Thank you for helpi...
Jun 30, 2025•51 min
On this week's episode of Critical Care Time, Cyrus & Nick take a deep dive into the wide world of sepsis! This one has been a long time in the making so buckle up for a journey through the history of sepsis and critical care, culminating in a review of our approach to diagnosis and management in 2025 complete with some hot topics and controversies. Please give us a listen or a watch, leave us some feedback and share our show with your friends and colleagues! Hosted on Acast. See acast.com/p...
Jun 16, 2025•1 hr 43 min
We see fever every day in the ICU but what’s the best approach to diagnosis and when do we need to go on a Zebra hunt? In this episode, we’re joined by Dr. Luis Tatem, a physician triple-boarded in Internal Medicine, Infectious Diseases, and Critical Care — plus certified in Tropical Medicine from the London School of Hygiene & Tropical Medicine . We explore the diagnostic and therapeutic approach to fever in the ICU, including practical pearls for evaluating fevers in patients returning fro...
Jun 02, 2025•1 hr 39 min
On this week's episode of Critical Care Time, we revisit ARDS... sort of! We are joined again by Dr. Whittney Warren & for the first time by Denitza Blagev for a dynamic discussion on ARDS imitators: Things that looks like ARDS but aren't technically ARDS - or are they? It's a bit of a confusing landscape as you'll see, where the lines are blurred and things get a bit murky. We'll unpack diagnoses like EVALI, DAH, AIP and more in the context of ARDS and help you guys come up with a framework...
May 19, 2025•1 hr 28 min
In this episode of Critical Care Time , Dr. Joshua Boster joins Cyrus and Nick to explore how interventional pulmonary (IP) skills can be life-saving in the ICU. From managing malignant central airway obstruction with rigid bronchoscopy to navigating pleural disease, persistent air leaks, and even life-threatening hemoptysis, Dr. Boster shares practical insights from the front lines. Listeners will learn how IP tools can transform critical care decision-making and offer meaningful interventions ...
May 05, 2025•1 hr 26 min
