Sepsis management has traditionally focused on timely antibiotic treatment, hemodynamic support, and source control, but emerging evidence suggests that outcomes may be shaped long before patients reach the ICU. In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, speaks with Sayed Abdulmotaleb Almoosawy, MBChB (Hons), about his article “The Association Between Socioeconomic Position and Mortality in Patients With Sepsis and Septic Shock—A Systematic Review and Meta-Analysis,” published in the April 2026 issue of Critical Care Medicine.

Drawing on 13 observational studies that encompassed nearly 4 million patients, the analysis evaluates how factors such as insurance status, income, education, and neighborhood deprivation relate to short-term mortality outcomes. The findings reveal a consistent association between lower socioeconomic position and increased mortality, with lack of private insurance demonstrating the strongest signal—likely reflecting barriers to timely access to care and delayed presentation.

This episode challenges clinicians and researchers alike to recognize the link between socioeconomic disadvantages and worse sepsis outcomes, highlighting the need to collect equity-relevant data and reduce gaps in care to improve survival for critically ill patients.

Resources referenced in this episode:

• Almoosawy SA, Fernando SM, Rochwerg B, et al. The association between socioeconomic position and mortality in patients with sepsis and septic shock—a systematic review and meta-analysis. Crit Care Med. 2026;54(4):692-700.

• Prescott HC, Antonelli M, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Crit Care Med. 2026;54(4):725-812.

Long after acute infection has resolved, many survivors of severe COVID-19 experience persistent symptoms. Understanding the causes of long COVID and developing effective treatments pose a challenge for clinicians and researchers alike. In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Kyle B. Enfield, MD, speaks with Matthew Baldwin, MD, MS, about his article published in the March 2026 issue of Critical Care Explorations that examines post-acute sequelae of COVID-19 in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) survivors over a three-year period.

One of the study’s most notable findings is that approximately one in four study patients, many of whom were middle-aged and previously healthy, continued to meet criteria for long COVID three years after infection. This finding emphasizes the burden of chronic illness caused by COVID-19 infection and the need to focus research and treatment efforts on this population of ALI/ARDS survivors.

Drs. Baldwin and Enfield discuss the relevance of inflammatory, thromboinflammatory, and endothelial biomarkers in understanding illness due to COVID-19. Surprisingly, the study found no association between long COVID symptoms and these biomarkers. Dr. Baldwin contextualizes this finding and encourages future studies to employ multiomics to better uncover the underlying mechanisms of these symptoms.

The discussion emphasizes the patient-centered approach of the study, which examines functional outcomes as well as biomarkers. Dr. Baldwin encourages clinicians to validate the experiences of severe COVID-19 survivors and guide them towards the next step in their recovery as researchers continue to look for better therapies.

Resources referenced in this episode:

• Baldwin M, Jones AE, McGroder CF, et al. Post-acute sequelae of COVID-19 persist over three years in acute lung injury/acute respiratory distress syndrome survivors but are not associated with persistent thromboinflammation or endothelial dysfunction. Crit Care Explor. 2026;8(3):e1390.

• Hodgson CL, Higgins AM, Bailey MJ, et al. Comparison of 6-month outcomes of survivors of COVID-19 versus non-COVID-19 critical illness. Am J Respir Crit Care Med. 2022;205(10):1159-1168.

• Herridge MS, Tansey CM, Matté A, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011;364(14):1293-1304.

• National Institutes of Health RECOVER Initiative. RECOVER: Researching COVID to Enhance Recovery. https://recovercovid.org

• Leisman DE, Mehta A, Thompson BT, et al. Alveolar, endothelial, and organ injury marker dynamics in severe COVID-19. Am J Respir Crit Care Med. 2022;205(5):507-519.

• Cervia-Hasler C, Brüningk SC, Hoch T, et al. Persistent complement dysregulation with signs of thromboinflammation in active long COVID. Science. 2024;383(6680). doi:10.1126/science.adg7942

• Oelsner EC, Krishnaswamy A, Balte PP, et al. Collaborative cohort of cohorts for COVID-19 Research (C4R) Study: study design. Am J Epidemiol. 2022;191(7):1153-1173.

Propofol remains a cornerstone sedative for mechanically ventilated critically ill patients and is supported by PADIS guidelines and favored for its rapid onset, titratability, and limited side effects. However, its use in hemodynamically unstable patients remains a persistent clinical dilemma. In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Kyle Enfield, MD, is joined by Scott Benken, PharmD, MHPE, BCCCP, and Nathan Smischney, MD, MS, to explore the risks, benefits, and evolving evidence surrounding propofol use in this high-risk population.

The discussion examines the physiologic basis of propofol-associated hypotension and how that can manifest in different patients, such as those with sepsis and septic shock. Patient selection and real-time assessment of hemodynamic trends are essential. Additional considerations include the recognition of and monitoring for propofol infusion syndrome, a rare but life-threatening complication.

The episode also explores alternative drugs such as dexmedetomidine and ketamine, highlighting the benefits and risks of each. Emerging strategies are discussed, including a ketamine-propofol combination called ketafol and its utility in balancing sedation and hemodynamic stability.

Listeners will gain expert insights into propofol use in the ICU and a deeper understanding of patient-centered approaches to sedation.

Resources referenced in this episode:

• Lewis K, Balas MC, Stollings JL, et al. A focused update to the clinical practice guidelines for the prevention and management of pain, anxiety, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med. 2025;53(3):e711-e727.

• Russotto V, Myatra SN, Laffey JG, et al. Intubation practices and adverse peri-intubation events in critically ill patients from 29 countries. JAMA. 2021;325(12):1164-1172.

• Boncyk C, Devlin JW, Faisal H, et al. INhaled Sedation versus Propofol in REspiratory failure in the Intensive Care Unit (INSPiRE-ICU1): protocol for a randomised, controlled trial. BMJ Open. 2024;14(10):e086946.

• O’Gara B, Serra AL, Englert JA, et al. Inhaled sedation versus propofol in respiratory failure in the ICU (INSPiRE-ICU2): study protocol for a multicenter randomized controlled trial. Trials. 2025;26(1):114.