In this forward-looking episode of the SCCM Podcast, Daniel F. McAuley, MD, explores how the clinical and research communities are rethinking acute respiratory distress syndrome (ARDS), shifting from a one-size-fits-all model to a focus on identifying and targeting modifiable traits. Building on his Thought Leader Session at the 2024 Critical Care Congress, Dr. McAuley unpacks the major thematic shift toward precision medicine in critical care.

Instead of treating ARDS as a single, homogenous condition, researchers are increasingly identifying biologically distinct subgroups—especially hyper- and hypoinflammatory phenotypes—that may respond differently to therapies. These insights are fueling a new generation of trials that aim to prospectively apply this knowledge to treatment strategies.

Central to this evolution is the Precision medicine Adaptive platform Network Trial in Hypoaemic acutE respiratory failure (PANTHER), of which Dr. McAuley is a team member. PANTHER is a Bayesian adaptive platform randomized clinical trial studying novel interventions to improve outcomes for patients with acute hypoxemic respiratory failure. Designed to be adaptive and biomarker informed, PANTHER will test therapies such as simvastatin and baricitinib, based on real-time phenotyping of patients with ARDS.

Throughout the episode, Dr. McAuley reflects on how advances in machine learning and biomarker identification are making precision treatment more feasible. He discusses the importance of maintaining evidence-based supportive care, such as lung-protective ventilation and prone positioning, while integrating new targeted therapies. Discover the latest investigations into potential therapeutic agents—including mesenchymal stromal cells, statins, and extracorporeal carbon dioxide removal—as Dr. McAuley aims to translate early findings into tangible improvements in patient outcomes.

This episode offers critical insights into the changing landscape of ARDS research and patient care, as Dr. McAuley articulates a hopeful vision for the future—one in which targeted, individualized treatments can improve outcomes for patients with one of critical care’s most challenging conditions.

Dr. McAuley is a consultant and professor in intensive care medicine in the regional intensive care unit at the Royal Victoria Hospital and Queen’s University of Belfast. He is program director for the Medical Research Council/National Institute for Health and Care Research (MRC/NIHR) Efficacy and Mechanism Evaluation Program and scientific director for programs in NIHR. Access Dr. McAuley’s Congress Thought Leader Session, ARDS: From Treating a Syndrome to Identifying Modifiable Traits here.

The ICU Liberation Campaign from the Society of Critical Care Medicine (SCCM) has transformed critical care, but the COVID-19 pandemic and subsequent staffing challenges have posed major obstacles to maintaining progress. In this episode of the SCCM Podcast, host Ludwig H. Lin, MD, speaks with Juliana Barr, MD, FCCM, a key architect of the ICU Liberation Campaign. Dr. Barr was a lead author of the 2013 “Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit,” known as the PAD guidelines, an original cornerstone of the ICU Liberation Campaign (Barr J, et al. Crit Care Med. 2013;41:263-306). The guidelines’ recent 2025 update also addressed immobility and sleep disruption (Lewis K, et al. Crit Care Med. 2025;53:e711-e727).

Dr. Barr shares her personal journey from traditional ICU practices of heavy sedation and immobility to leading efforts that prioritize patient recovery, well-being, and post-ICU quality of life. She emphasizes how ICU Liberation reintroduced low-tech, high-impact interventions such as minimizing sedation, promoting early mobility, and engaging families—leading to better outcomes at lower costs. She cites the 2017 international survey by Morandi et al that demonstrated uneven but steady improvements in global ICU Liberation practices before the pandemic (Morandi A, et al. Crit Care Med. 2017;45:e1111-e1122).

Dr. Barr details the need for reeducation, multidisciplinary team engagement, and reworking electronic health record (EHR) systems to better support ICU Liberation goals.

Looking forward, Dr. Barr offers a "burning platform" approach, stressing that delaying ICU Liberation practices risks poorer patient outcomes. She advocates for cultural change, leadership engagement, real-time metrics visibility, and hospital-wide investment—including IT support to surface buried ICU Liberation Bundle data within EHRs.

By reframing ICU Liberation as a "team sport" and making best practices part of daily ICU culture, Dr. Barr believes institutions can reestablish the bundle’s momentum and reconnect healthcare teams to their core mission—helping patients return to meaningful lives after critical illness.

This conversation offers energizing, practical strategies for ICU teams at every stage of ICU Liberation implementation or reinvigoration.

Traditional career development frameworks often overlook the importance of well-being. This podcast episode emphasizes why wellness is essential to building a sustainable and fulfilling career. Host Kyle Enfield, MD, FCCM, is joined by Jennifer Duncan, MD, and Raquel Cabral, PhD, CPH, to explore how team members and leaders can integrate personal values, connection, and purpose into career decision-making.

Dr. Duncan, director of wellness for graduate medical education (GME), and Dr. Cabral, a staff psychologist for GME, both at Washington University School of Medicine, share insights from their work supporting trainees’ personal and professional growth. Together, they explore the nuanced meaning of well-being—not as constant happiness, but as a sense of satisfaction and alignment with a person’s values, even amid challenges.

The conversation highlights the importance of helping team members identify and live by their personal values as a foundation for career satisfaction. Dr. Cabral distinguishes between goals and values, underscoring that, while goals can be achieved or not, values guide how a person shows up in all aspects of life. She outlines how residents and other early-career professionals can uncover values by reflecting on meaningful or difficult work experiences. These reflections can then guide decisions about clinical rotations, job searches, and leadership opportunities.

Dr. Duncan emphasizes how small but intentional adjustments—such as carving out just 20% of one’s time for personally meaningful work—can protect against burnout. Both guests discuss the critical role leaders play in supporting well-being, from understanding each team members’ values to fostering a strong sense of community.

They refer to The Burnout Challenge (Maslach C, Leiter MP. Harvard University Press. 2024), which outlines six workplace drivers of burnout, including mismatches in values.

Finally, the episode highlights the work of the Mayo Clinic’s Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) Groups. The COMPASS randomized clinical trial (West CP, et al. Mayo Clin Proc. 2021;96:2606-2614) evaluated a small group established to promote well-being. The group was provided discussion topics without trained facilitators. Protected time was not provided but meal expenses were compensated. This model showed positive outcomes in reducing burnout and strengthening collegial connections.

This episode is part of SCCM’s Leadership, Empowerment, and Development (LEAD) series and offers actionable insights for anyone invested in building healthier, value-aligned medical careers.