Dr. Siddarth Dugar talks with Congress Co-chair Roshni Sreedharan, MD and Cleveland Clinic Director of Translational Critical Care Research, Vidula Vachharajani, MD about the 2024 SCCM Congress. They discuss interesting sessions such as: identifying modifiable treatments on ARDS, typing of Sepsis biomarkers, whether to get a chest X-ray post-central line placement or not and a late-breaker session on a study involving the impact of head elevation during cardiac arrest. They also talk about a popular session on providing effective review of manuscripts whether they’re for publication or not and offer tips on submitting proposals for the next SCCM Congress.
Dr. Siddarth Dugar talks with Congress Co-chair Roshni Sreedharan, MD and Cleveland Clinic Director of Translational Critical Care Research, Vidula Vachharajani, MD about the 2024 SCCM Congress. They discuss interesting sessions such as: identifying modifiable treatments on ARDS, typing of Sepsis biomarkers, whether to get a chest X-ray post-central line placement or not and a late-breaker session on a study involving the impact of head elevation during cardiac arrest. They also talk about a popular session on providing effective review of manuscripts whether they’re for publication or not and offer tips on submitting proposals for the next SCCM Congress.
Respiratory Exchange Podcast Series
Episode
Host: Siddarth Dugar, MD
Guest: Vidula Vachharajani
Guest: Roshni Sreedharan, MD
Highlights from 2024 SCCM Critical Care Congress
Raed Dweik, MD
Hello and welcome to the Respiratory Exchange podcast. I'm Raed Dweik, Chairman of the Respiratory Institute at Cleveland Clinic. This podcast series of short digestible episodes is intended for healthcare providers and covers topics related to respiratory health and disease. My colleagues and I will be interviewing experts about timely and timeless topics in the areas of pulmonary critical care, sleep, infectious disease, and related disciplines. We will share information that will help you take better care of your patients today, as well as the patients of tomorrow. I hope you enjoy today's episode.
Siddarth Dugar, MD
Hello everybody. My name is Siddharth Dugar. I'm a staff intensivist at the Respiratory Institute at Cleveland Clinic. Welcome to another episode of Respiratory Exchange. With me today, I have Dr. Vidula Vachharajani and Dr. Roshni Sreedharan and we are going to talk about the Society of Critical Care Medicine’s Annual Congress 2024 that just concluded in Phoenix. First, I would like to ask my attendees to introduce themselves. Vidula, we’ll start with you.
Vidula Vachharajani, MD
Hi everybody I'm with Vidula Vachharajani. I'm a Critical Care physician scientist. I’m also the director of Translational Critical Care Research. I also co-direct the Center for Sepsis-induced Immunosuppression and I'm happy to talk to you about the recent Critical Care Congress that we attended in Phoenix.
Siddarth Dugar, MD
Thank you so much, Vidula. Roshni, can you introduce yourself to the attendees?
Roshni Sreedharan, MD
Oh, absolutely. I'm Roshni Sreedharan. I'm an anesthesiologist and intensivist here in the Department of Anesthesiology in the IHI. I do spend my critical care time mostly in the surgical ICU and the cardiac ICU at main campus and I’m the program director for the Anesthesiology Critical Care Medicine Fellowship and the Vice Chair for Education for our Institute of Hospital Care. And I have the distinct honor of being the co-chair for this Congress 2024 for the SCCM.
Siddarth Dugar, MD
Thank you so much. So we'll start with you, Roshni. Excellent work on co-chairing the SCCM 2024. Just wanted to get your impression about the conference. What did you take back from the conference?
Roshni Sreedharan, MD 2:33
So you know, the conference was a grand success. There were, you know, there was lots of trepidations kind of getting into it because Phoenix generally is not our most well attended site. So we were a little worried and we were worried about, you know, the little slump that COVID brought in for Congress attendance over the years.
But we were very, very pleasantly surprised. There was a lot of energy. We got a lot of positive feedback. We had over 5500 attendees at Congress, which is much higher than our pre-COVID Phoenix attendance rates. So that was a very pleasant surprise and it we felt very validated and rewarded for the program that was put together.
So overall, very, very positive response and we were very happy with it.
So as far as the scientific program goes for the Congress, we had a very robust program that was put together. So we kind of aligned the critical care topics in groups and we had over 25 critical care topic areas that we covered.
We had about 250 critical care experts, multi-professional multidisciplinary speakers and as far as abstracts and awards go, we had over 1100 abstracts that were presented at Congress. We had at least, I wanna say, guidelines that we had released and we had some fantastic late breakers and thought leader plenary sessions as well. So overall, really great experience and I'm curious to hear what Vidula felt about the Congress.
Vidula Vachharajani, MD 4:11
All right, so I agree with you, Roshni. It was a fantastic Congress and we had a great representation from Cleveland Clinic and that struck me the most. We know there were over 40 sessions from Cleveland Clinic, and this included our trainees, our advanced practitioners, our pharmacists' staff. Everybody was involved and not only moderating sessions, but giving research talks in various venues.
Research snapshot theaters as well as in the Star Research Symposium. Also, concurrent session talks were all speakers were from Cleveland Clinic so we had a very good representation. We're not to forget we had a pre-course put together by Dr. Kapoor on acute kidney injury. And that was very, very well received. People were talking to us about that throughout the Congress, so I think we had the representation and I'm very happy about this year's Congress, very enthused when I came back.
Siddarth Dugar, MD
Completely agree. There were some sessions that I wanted to attend and there was literally no space because there was so well attended even though they were in one of the bigger rooms and I agree like you know, I went through some of the sessions that our CCF colleagues presented and the response to all of them was amazing.
Thank you so much.
So the next thing we wanted to discuss is the formats. You know SCCM has always strived towards presenting formats or content in a very interesting way. We had plenary sessions, we had pre-debate pro/con debate roundtables. Is there any particular format that you always find very interesting that you know, “I cannot miss that.”
Roshni Sreedharan, MD 6:14
So I can take that. I agree with you said there was so many different formats to it.
So I think some of them are, you know, present in most conferences like the plenaries and you know the concurrent sessions and the pro/con debates.
One of the things that was striking to me, the program debate on ECMO and survival was fantastic on without of hospital in cardiac arrest with ECMO cancellations, beneficial for outcomes. So it was a fantastic pro/con debate which I think was valuable to hear the insights of the experts.
One of the formats that I thought was very interesting and we very intentionally had a place for that was the AV/non-AV rooms. It pretty much means that you can't use a PowerPoint, which almost forces the presenters to have some form of an interactive session which I thought went really well. So, we had a session, we had actually multiple sessions in that room. But the one thing that was really helpful, I thought, resonated with a lot of the attendees.
It was the SCCM review and the Academy put together a session with expert panelists. And the reviews Academy is actually a really neat initiative that the SCCM is undertaken for young professionals who are getting into the space of being reviewers on how to tackle difficult situations. How to provide effective review to manuscripts even if the decision was not to publish in a particular journal, to give something constructive for the authors to take with them and improve their manuscript to submit to some of the journals.
So we had about 7 panelists there and leaders from editorial boards and our CCM and PCCM journals, and it was very, very valuable, interactive and very robust.
Actually debate that went on. So it was very refreshing to see sessions where it is not a PowerPoint and you know presentations that kind of go on for about 50 minutes and then 10 minutes for discussion, whereas the entire session was geared towards having a robust discussion and identifying what people want to hear, want to know and kind of to deliver to that. And moreover, SCCM, Reviewer Academy is going to be you know it's going to be available on the SCCM website for people to utilize and you know avail these resources that we have. So that probably was my favorite piece. was the non-PowerPoint non-AVR piece.
Siddarth Dugar, MD 8:53
That I completely agree. The flip flop of the classroom model works so well, it engages you more than somebody with expertise presenting on PowerPoint.
I always look forward to those sessions. And for me personally, as a reviewer who just starting to review some manuscripts and learning on the fly, you know this session that you were talking about is going to be so helpful for the earliest careers researcher. And I'm glad that SCCM is putting it on the digital format.
Use as if somebody missed it. Please go ahead if you are thinking about reviewing the article. This is an excellent resource for you. With that, Vidula, we'll come to you. Is there any particular format presented at SCCM that you think that you don't want to miss?
Vidula Vachharajani, MD
I'm just gonna come out and say I'm a nerd. I'm a researcher and that shows because what I like about SCCM for a number of years now is that the research snapshot those I know used to be poster talks, but now it's gonna be research snapshot theater and also the Star Research Symposium. So those are those are short talks of 5 minutes or 15 minutes, jam packed with information, and they keep you engaged and that's where the whole pulse of research is. And so I always look forward to those and try to get as many of those in as possible.
Having said that, this congress was so jam packed with information that it was kind of like drinking from a fire hose. That it is impossible to keep up with everything that's going on, but those the SRTs in the Star Research Symposium talks.
The research talks were my most favorite ones.
Siddarth Dugar, MD 10:47
That's excellent. You bring it up with, you know, I think like the content that you like totally goes with your personality as well. I'm a very people's person. My favorite is research roundtables. Actually, I just get along with a couple of colleagues of yours who have the same interest and talk about a topic. I find that very refreshing.
Have a cup of coffee while you discuss about content. Going from research methodology that I presented to how to use AI in manuscript or research or in life, I found those very interesting and cross talk has always been my favorite being involved with the in-training section. So, excellent.
Roshni, we come back to you this year. The conference was three days and a lot of content was made available in digital format only. I would like to start with you.
What was your thought about the conference being three days and the change in the longer days of Congress?
Roshni Sreedharan, MD 11:48
Yeah. So a lot of thought went into how the Congress is structured in reality.
If you look at it, we have two pre-Congress days, right? So we have Friday and Saturday is usually when we have our pre-Congress sessions like you know the pre-courses that we do the ultrasound goes the ELSO course and then like you know the pre course is like Angel put together.
So we have those on Friday and Saturday and usually the opening session is on Sunday and then we pack Sunday, Monday and Tuesday. So the difference is that we used to have 1/2 day Wednesday as well. One of the things or challenges that we noticed over the years was, first of all, it's hard for, you know, critical care professionals to get that time off if they were attending like a pre-Congress session and to stay until Wednesday and the attendance kind of tended to do dwindle by the time it was Wednesday afternoon and from a cost efficiency standpoint too, it was tough when we had rooms that were not filled and it was kind of demoralizing for the presenters or speakers when they kind of they Wednesday afternoon session and they don't have a ton of attendees to listen to the talks that they've really worked hard to put together, so that was kind of like multiple factors that played into making the Congress packed, but in a succinct manner over Saturday or Sunday, Monday and Tuesday.
And it seemed to work really, really well, because even on Tuesday for the last session that was happening at 4:30 as I was walking around each of the venues where we had all the different sessions, they were full. So I think when people tend to stay on, you know, it's just a third day of Congress and people are staying, they kind of stay until the end, get all the knowledge and information that they want and kind of absorb it all before they leave for the day. So it seemed to work very, very well for us. It seemed like they were very happy with it, and we've got excellent feedback.
So I would envision that it's probably going to stay that way in the foreseeable future. So I think that that's kind of like my take on it.
Roshni Sreedharan, MD
And as far as the recorded sessions go, when we have sessions that are submitted for Congress, like the accepted ones, we look at how well they scored. We have several fantastic. We had about 468 concurrent session proposals that were put together and submitted to us. So, then they get ranked by the program committee members and the most highly ranked sessions tend to be always presented live in Congress. Now there are some sessions that are close enough, but they're very interesting and very engaging. Those are the ones that are available only on digital format.
Those sessions that were kind of at the very interesting topics, excellent speakers, but we just don't have enough room to include them in the live Congress.
So we have them in as bonus CE sessions, so these are recorded digital sessions which are available while people are live in Congress at that time.
Even the digital sessions are available and we have about 40 sessions or talks I would say, or panels that exist which are purely available in the digital format.
Everything else in the Congress is available, except for the absolutely virtual, not virtual, I should say like the round tables, right? So those are not recorded.
The no-AV room sessions are not recorded, but other than that everything else is recorded and available on Congress digital as well. So we have like various different formats in which our attendees could attend sessions which they wanted to attend, but then something else interesting was also going on. So we have it available for the attendees to access and gain all that knowledge.
Siddarth Dugar, MD
Vidula, what are your thoughts about the Congress being three days and content being available digitally?
Vidula Vachharajani, MD
I agree with Roshni because the last Wednesday was very hard to kind of justify staying away from the lab. So I always cut it short, either left on Wednesday morning or late Tuesday night. So I like the fact that it's sort of shortened and the fact that the sessions are available to view later on, and I go back to them a lot. So I agree with Roshni on that. I think it's a good format.
Siddarth Dugar, MD
Now, coming back to the sessions, you know, as Vidula rightly pointed out, it was like drinking from a water hose. There was so much information coming along.
Is there any particular content that you remember and you're like, OK, this is going to be path breaking and I'm going to see how it evolves over the next few years or I'm going to apply it to my bedside practice. Roshni we’ll start with you.
Roshni Sreedharan, MD
Sure. So one of the thought leader sessions which were presented by Danny, Dr. Danny McCauley from the United Kingdom, he presented on ARDS from treating a syndrome to identifying modifiable treatments. It was a very interesting session and I'm curious to hear what with the things about it too, because I thought it was very interesting in all the content that he put together and talking about the various modifiable traits and the non-modifiable aspects of it and how we treat ARDS.
I thought that was fantastic and that it is available on digital, the guidelines, sessions, you know, for liver transplant patients. And then the brain death guidelines, they were in separate sessions, but also extremely well attended as far as the new things that happened in guidelines, I mean nothing was specifically, like, path breaking, but also like there were nuances that were addressed and it's always valuable to look at these guidelines and see how they're evolving over time. So the guideline sessions where they are current and they're new and they just came out and they were concurrently put out along with or recently put out right before Congress.
So those were valuable to go to and gain those pearls.
And hear from the experts on those the other session that I thought was fantastic was the one on workplace violence and this one also should be available on Congress digital. It was actually a very good session that was put together by the panelists who were there, were people who have endured workplace violence and what their experience was, and some expert opinions on what are the instigating factors, what are the warning signs and what are some of the resources that we have to avail in such situations? I think if it was a fantastic session, actually it got a standing ovation from the audience who were like 100% engaged in it.
So I think that was another session that I absolutely would like to actually bring to our institute as a Grand Rounds because I think it was. It was such a valuable session to gain that insight into these kind of unique situations. Vidula, what are your thoughts? What were the ones that really stood out for you?
Vidula Vachharajani, MD
So when you should ask that I like. I liked that ARDS session, but I also like the endotyping that went along with it. The endotyping of ARDS session.
There was another one. And then the typing of sepsis biomarker that was a part of the session that I spoke into earlier and those together were very thought provoking. It just was a demonstration of how far we have come in both these diseases and yet how little we know. The more you know, the little, the more you know how little you know. You know what I mean?
Roshni Sreedharan, MD
Yeah, yeah.
Vidula Vachharajani, MD 19:54
So those were very thought provoking. The one you're talking about was very thought provoking. And what I've found very interesting were those late breaking sessions too. The late breaking publications that will change your practice and they were actually truly changing practices. One that stands out is about the PI's and gosh, they're all running together, but there were so many of them that I absolutely would want to think about.
There was one RST, actually 2 RST things that they had put together about the whether or not we should get a chest X-ray. Something as simple and as practical as that. Whether or not we should get a chest X ray post-central line placement because we do it under ultrasound, we check positions of the guard wires. So literally this morning when we put in accordance, I would just question whether or not we should actually get a testing. So, of course, we had to get a test set because we put in a PA catheter, but I'm just saying that those were very practical practice changing sessions that I always like and this Congress, this year's Congress, did not disappoint at all in that respect either.
Siddarth Dugar, MD 21:07
I completely agree. I think you know the best part about SCCM, for me, this year was what you have already alluded to. It is trying to give clinical knowledge for people who are purely clinician, but also trying to push the boundaries of critical care where it is going and you know also kind of questioning the age-old practices on why are we doing certain things. Can we think beyond that and start evolving, you know, either going into endotypes or trying to question why are we using chest X rays?
I found all of them very engaging.
One of the late breaking studies that I really liked was the elevation of the head during cardiac arrest and how it helped with achievement was really, I was amazed by the work they have done and I'm so excited about the work they will be doing in the future and how we can improve outcomes in such a vulnerable population. OK, let's try to talk about outside the conference. Any fond memories about your visit to Phoenix? We'll start with Roshni.
Roshni Sreedharan, MD 22:08
Oh yes. I wanna say this is probably a a little selfish thought on my side. When I had to go early because of, you know, the preparation for Congress, it was just absolutely perfect weather on Wednesday, Thursday, and Friday. And as soon as the Congress started, it started raining. And it was cold, and it was 55 degrees, which is very unlike Phoenix. It seems like Phoenix has 344 warm perfect, sunny, 74 degree days, but then it was not so for the three days of Congress. That being said, although at that moment, I think it was disappointing. I think it kept everybody in the Congress and all the conversations were in and around the the Congress areas and the various sessions and the Congress was packed. So that was fantastic.
And again, the way the changed immediately after Congress, but my most fond memory is my co-chairs. There were three of us for this year, one was Temash Sakuni. He's an anesthesiologist from Wales, and Marilyn Bullock is a pharmacist from Alabama, so the three of us put in a lot of work preparing for this Congress, figuring out the programming and all of this works. So, before we started Congress, we did a hike, an early morning sunrise hike, where we went at 5:00 a.m. and started our hike up a mountain with a guide with these headlights in. It was over the Mahipala Pass it was not Camelback, but it was right opposite Camelback, and we were right at the peak of the mountain at sunrise. That was probably, I was not sure that I would go through with it, but it was absolutely exhilarating to be at the peak at sunrise and it was a great start right before the Congress for us. So that is probably my fondest memory of Phoenix.
Siddarth Dugar, MD 24:01
Yeah, I was looking at the social media. I was boarding the flight and I saw some the co-chairs from last year doing goat yoga and I'm like that is what SCCM is supposed to be.
Roshni Sreedharan, MD 24:10
Yes.
Siddarth Dugar, MD 24:13
You know, you learn a lot, but you also meet your friends and do all these amazing things. Vidula any point you remember about your visit to Phoenix?
Vidula Vachharajani, MD 24:22
As usual, again, I did not go anywhere other than the conference. Of course I'm a nerd, but I met a lot of people from Louisiana, people I worked with, people from Wake Forest. Now they're everywhere. They're chair of other section, Chief Bill, pulmonary critical care chief from UAB. We used to work together at Wake Forest and he came from my talk on Clark files. He is now Apple Medical device and Wake Forest. He came for my talk.
There were a couple of other people we just met up, from Wake Forest, and caught up with people, caught up with friends. That's one thing. And then I made a lot of connections, the network thing, etc. And that's why I was not present for the entirety of our alumni meeting or dinner that we had put together, for the Cleveland Clinic.
But I made a lot of connections with to my collaborators from Florida and went out for dinner with them, so I have a lot of fun memories about the place.
Siddarth Dugar, MD
I cannot agree more. SCCM is, as we all alluded to, SCCM is as much about attending the sessions, as much as meeting with old friends and trying to make new networking connections. And it's a discussion that happens at the coffee table that is, I think like those discussions are what pushes us forward both in terms of clinical and a personal level.
So you alluded to the alumni reception. I personally love attending the CCF Alumni receptions. They're amazing. This year we had it for the Center for Critical Care, and it was amazing to visit. All this illuminates who have moved forward in their life and what have they achieved, but also interesting to see people from Abu Dhabi, Cleveland Clinic Abu Dhabi visiting us. Roshni, I will start with your thoughts on the big Center for Critical Care Alumni reception.
Roshni Sreedharan, MD
Oh, it was fantastic. I think this is and I was talking to Dr. Khouli about it too, this is something that really gets us all together at the center. And it was wonderful to meet, you know, fellows and faculty members from pulmonary and critical care from the pediatric ICU, from the neuro ICU, from the different anesthesiology ICUs. So, it's a fantastic way to connect and I saw a lot of the fellows from all these different areas kind of sitting together and talking about their experiences and connecting.
I think that that carries a lot and that they bring it back to Cleveland when they come here and it continues along and builds lifelong, you know, a bond of friendships.
So I think it really helps you know, get us all together collegially as a group under one center. And I thought it was a fantastic experience and this I was actually saying they should probably be as a part of the Congress agenda and just have Cleveland Clinic Center for Critical Care, get together as a reception, as a part of Congress agenda for SCC every year.
Siddarth Dugar, MD
I completely agree with you. You know, sometimes you read a paper and you are like this: people are so smart. These people are doing this amazing job, you know, like them, and then you go and visit and you're like, oh, the paper that I was reading.
And what I was so amazed by, was one by one of my colleagues. So that just tells you how much knowledge we have in Cleveland Clinic and that it is these meetings that bring us all together to push the field of critical care forward. I will start with like you know, we are coming to the end of our session. So I will look forward to the future.
So for everybody who is interested, the SCCM Annual Congress proposal submission is going to end by 31st January. So few more days, but both of you, Roshni and Vidula, have put forward a strong proposal that, you know, people have enjoyed.
So I wanted to talk with you, Vidula, any particular proposal that you are excited about submitting in 2025 and for our listeners, is there any suggestions on how to make a strong proposal?
Vidula Vachharajani, MD
Yes, I put in one and not me, but my partner and I got together with a colleague of mine from University of Kentucky and we put together a proposal about alcohol use disorder and critical illness and basically this explores through the disease processes and how alcohol effects it and it's actually, she came up with a very clever title, "AUD in ICU: OMG! You know, it's quite clever actually, and I'm excited about that.
I don't know if it'll be accepted or not. But I think if it is, it'll be awesome to talk about it. So the key, I think, or what I have done over the years is I have done multidisciplinary proposals and not just multiple disciplines, but multiple institutes, not necessarily intentionally, but the subject that I do or I deal with is always about you know it's sort of, there are specific focus areas where people do this kind of work. And so it all just comes together that way. But it turns out that that actually brings in a lot of enthusiasm.
Roshni Sreedharan, MD
Oh yes, so one of the unique things about SCCM is that it is probably the largest multi-professional critical guest society. So we have several professions in critical care that are represented in SCCM and that is something that the program committee looks for closely when they're reviewing proposals. So I would say a strong proposal, again, there's some topics which are just so niche that probably there are specific physician scientists who would be the experts at speaking about it.
Most of the time, if it's the general critical care topic, there is valuable input from multiple team members. So having a multi professional and a multidisciplinary proposal from different institutes usually catches the attention of the program committee members for a higher score.
The other piece that is extremely important is to have a complete proposal. So when I say complete, it is to have some kind of a thought process or an idea or an introduction as to why you're putting this panel together in the initial description aspect of it, and to have clear objectives for the session. It's very important to have speakers and some backup speakers who are listed as well.
So the completeness of the proposal and the multi-professional multidisciplinary multi-institute aspect of it is probably going to catch the eye. And of course, like we talked about, a catchy title is always helpful. The other thing I do want to highlight is that, yes, the session proposal submissions do end this month, but if any of you have some interesting proposals that you really want to get across, please send them my way. As the program committee member, I can put proposals in until March 1st.
So if you have anything that you've just not got it ready yet and you would like to get it in and submit it for the program for 2025, feel free to email me with it and I'll be happy to get it in for you.
Siddarth Dugar, MD
Thank you so much, Roshni and Vidula for sharing your thoughts again. I have submitted and am keeping my fingers crossed. It's a great, great conference.
You know if you have any thoughts on a session that you think should be discussed, please do submit. You can always reach out to Dr. Vachharajani and Dr. Sreedharan, as they are both great mentors. Now we are coming to the end of this podcast.
I would like to thank Dr. Vachharajani and Dr. Sreedharan for sharing their thoughts and look forward to seeing both of you in SCCM 2025.
Roshni Sreedharan, MD
Absolutely. Thank you so much Sid for having us.
Vidula Vachharajani, MD
Absolutely. Thank you, Sid, for putting this together. Thank you and everybody for participating.
Raed Dweik
Thank you for listening to this episode of the Respiratory Exchange podcast. For more stories and information from the Cleveland Clinic Respiratory Institute, you can follow me on Twitter at raeddweikmd.