Upon Completion of this learning activity, participants should be able to:

Dr. Srinivas Sarma and Dr. Howie Tran’s Presentation:

1. Describe 3 key changes in the assessment and management of critically ill cardiac surgical patients, including contemporary approaches to cardiogenic shock and acute heart failure.

2. Recognize clinical and hemodynamic features that facilitate early identification and risk stratification of heart failure after cardiac surgery.

3. Discuss current evidence supporting multidisciplinary teams, invasive hemodynamic assessment, pharmacologic therapy, and selective use of temporary mechanical circulatory support in post-op cardiac surgical patients.

Rita Wadhwani:

1. Describe key changes in gut microbial ecology during critical illness and the ICU exposures that contribute to dysbiosis.

2. Explain how nutrition interacts with the gut microbiome to influence barrier integrity, immune signaling, and microbial metabolic function during critical illness.

3. Evaluate emerging evidence for microbiome-informed nutritional interventions across pediatric and adult critical care, including their potential benefits, limitations, and context-dependent effects.

Dr. Pascaul: At the conclusion of this session, participants should be able to:

Objective 1: Understand the benefits and greater reach of video review of morbidity and mortality review in the SICU

Objective 2: Be able to distinguish how to strongly proceed towards determination of opportunities for improvement while maintaining patient privacy

Objective 3: Understand how access to performance improvement video review can be leveraged for quality improvement research opportunities

Brad De Souza, Sabrina Derrington, and Charles Pohl objectives:

1. Describe historical origins of defining death by neurologic criteria (DNC)

2. Identify sources of controversy about DNC

3. Consider ethical concerns and approaches to family dissent/objections to DNC

Dr. Karanjia & Yama Akbari:

-Understand the most recent guidelines for post-cardiac arrest cerebral optimization

-Discuss the recent evidence and possible strategies to individualize goal-directed therapies for post-cardiac arrest patients, including targeted temperature management and multimodal neuromonitoring

Paul Wong & Natalie Leung:

1. Explain the pharmacologic rationale for the use of methylene blue and hydroxocobalamin in refractory vasoplegic shock.

2. Evaluate the efficacy and safety data for methylene blue and hydroxocobalamin as adjunctive therapies for refractory vasoplegic shock.

3. Identify patient-specific clinical factors that support consideration of methylene blue or hydroxocobalamin in refractory vasoplegic shock.

Stephen Robert:

1. assess whether their local pediatric critical care workforce has the appropriate staffing, team composition, expertise, and workload distribution to meet current and anticipated needs

2. conduct a thought experiment for a practical workforce-development intervention that aligns a team member’s strengths with an organizational need and provides resources—such as mentorship, protected time, compensation, authority, or title—necessary for success.

Panelists Objectives: 1. Compare the approaches, patient selection, and workflows of the Los Angeles and San Diego regional ECPR programs.

2. Identify key lessons, challenges, and opportunities for improving regional ECPR systems.