SCCM Resource Library-Something Old and Something New Contemporary Medication Management of Critical Care Classics

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The 2022 Congress session titled "Something Old and Something New: Contemporary Medication Management of Critical Care Classics" explored innovative approaches in critical care. It featured discussions on venous thromboembolism prophylaxis, upper gastrointestinal bleeding, and euglycemic diabetic ketoacidosis (EDKA).<br /><br />Dr. Arzo Hamidi critiqued traditional dosing for thromboembolism prophylaxis, recommending low-molecular-weight heparin (LMWH) over unfractionated heparin (UFH). She emphasized tailoring enoxaparin doses based on body weight and adjusting prophylaxis according to new risk stratifications. She also revisited stress ulcer prophylaxis, recommending its initiation based on a patient's risk factors.<br /><br />Dr. Bridgette Kram reviewed pharmacologic management of upper gastrointestinal bleeding (UGIB), reaffirming the use of proton pump inhibitors (PPIs) to prevent rebleeding and introduced new guidelines for high-risk patients. She discussed the limited effectiveness and potential risks associated with octreotide and the unnecessary use of tranexamic acid (TXA) outside trial settings.<br /><br />Dr. Emily Perriello focused on euglycemic diabetic ketoacidosis (EDKA), highlighting the impact of SGLT2 inhibitors which, although beneficial for type 2 diabetes, can lead to EDKA. Diagnosis is challenging due to normal glucose levels and similar symptoms to DKA. She advised discontinuing the inhibitors before invasive procedures and avoiding triggers like alcohol and ketogenic diets.<br /><br />Overall, the session underscored the importance of reassessing traditional treatments, considering updated evidence, and tailoring interventions to optimize patient outcomes.

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Quality and Patient Safety, 2022, 0:08:22

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This article was first published in the Summer 2022 issue of Critical Connections.

Clinicians seek to achieve optimal patient outcomes by delivering the right care at the right time. But what if that right care is not actually right? What if a certain treatment is delivered to a patient just because that is how the patient’s condition has always been treated? What if there is a newer approach that could be more effective? These were the types of questions asked at the 2022 Congress as part of the back-to-basics session, “Something Old and Something New: Contemporary Medication Management of Critical Care Classics.” The session featured three talks that aimed to put a fresh perspective on classical disease states.

Critical Connections, the critical care industry's only magazine, provides information in cutting-edge topics in critical care useful to the entire multiprofessional team.

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Meta Tag

Content Type Article

Knowledge Area Quality and Patient Safety

Knowledge Level Foundational

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Associate

Membership Level Professional

Membership Level Select

Tag Evidence Based Medicine

Year 2022

Keywords

critical care

venous thromboembolism

upper gastrointestinal bleeding

euglycemic diabetic ketoacidosis

low-molecular-weight heparin

proton pump inhibitors

SGLT2 inhibitors

risk stratifications

stress ulcer prophylaxis

patient outcomes

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