In the past, not many neurointensivists have had a major role
in planning the Critical Care Congress. What was your focus for
neurocritical care on the meeting program?
CC: I definitely thought this was the chance to highlight newer
topics in the neurosciences, including some of the novel
concepts of detecting intracranial hypertension, such as optic
sheath diameter and cerebral vascular pressure reactivity; the
direct-acting oral anticoagulants and discussion of reversal
and restarting these medications in the setting of intracranial
hemorrhage; and even the discussion of brain death in light
of recent national cases or detecting potentially neurologically
devastated patients in this era of ECMO. It was a chance to share
the latest in stroke with a critical care audience, for example,
genetics, plasticity in recovery, endovascular therapy and newer
minimally invasive therapy for ICH. Finally, even the basics
of neurocritical care is still a very interesting area for many
learners, so as co-chair and with input from the committee, we
brought back the popular pre-congress session dedicated to
the management of the neurologically critically ill patient. The
pre-congress sessions are highly competitive, and it was great to
bring it back on the program this year.
This is the third year that Emergency Neurological Life
Support (ENLS) was offered as a live course during the Critical
Care Congress. How do you see that relationship evolving in
the future?
CC: Only in the last three years has SCCM allowed offering “colocated”
courses with the Critical Care Congress to other medical
societies. Fortunately, being on the program committee, I saw
that this was a fantastic opportunity to get ENLS on the grid
with a wider critical care audience. The NCS worked with the
SCCM and first offered this as a pre-congress co-located course
in Phoenix in 2015, again in Orlando in 2016 and as a postcongress
session in Hawaii. We had 54 attendees alone from the
Honolulu City and County EMS and the Queen’s Medical Center
this year. It will be nice to continue this relationship. In addition,
SCCM is inviting critical care societies from around the world
to participate in “Critical Care Week” that will take place in the
next few years. NCS has already expressed interest in being a part
of this novel collaborative. With a neuroscience representative
on the SCCM Council, I would see that the relationship
between the two societies will continue to strengthen with
more opportunities to collaborate to improve the care of the
neurologically critically ill patient.
Which sessions did you think were the major highlights of the
congress this year?
CC: I was particularly proud of putting together the late-breaking
sessions coinciding with the concurrent publication of hot topics
from Critical Care Medicine, New England Journal of Medicine and
the Journal of American Medical Association. This took a lot of time
and collaboration with the editors to make this happen. Topics
included physician-assisted suicide and euthanasia, the release of
HALFPINT regarding pediatric glycemic control, hypothermia after
pediatric cardiac arrest, the validation of the prognostic accuracy
of the Sepsis -3 criteria, and ICU staffing and mortality.
Also, the plenary sessions are always fascinating, but even more so
with Pat Kochanek, MD, this year’s SCCM Lifetime Achievement
Award Winner, who spoke about the brain and hypothermia: “
From Aristotle to Targeted Temperature Management, the Good
Stuff Keeps Coming Back.” It was also gratifying to incorporate
timely topics such as the medical response to an active shooter
event and the SCCM/ESICM Joint Session that reviewed the
International Guidelines for the Management of Sepsis and Septic
Shock in adults.
What was it like being able to host the congress in your own
home town of Honolulu?
CC: Having the cultural background
of living in Hawaii allowed me to give
input to integrate some of our local
culture into congress. Each year, the
congress program co-chairs pick a
theme. For the 46th congress, we chose
the Hawaiian word “Ka’a’ike,” which
means the transference of knowledge to
underscore a theme of communication
between members of the care team
including the patient and family for
best care in the ICU. We also integrated
Hawaiian titles into the talks, such as
“Ho’ola hou” (revive) for a resuscitation
pre-congress educational course, our
overtime area “Hola Kaulele,” and the
preliminary brochures that used words
such as “malama,” which means to take
care of or attend to. Ruth Kleinpell, RN,
Ph.D., SCCM’s president personally
explored words in the Hawaiian
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