Only 2 weeks left to nominate SCCM - Midwest Chapter Officers! Nominations end on 4/27. sccmmidwestchapter.org/survey.php?i...

We are two weeks away from Critical Care Pharmacist Rebecca Hilton's virtual webinar reviewing Stress Ulcer Prophylaxis.
Claim your FREE spot by RSVPing to SCCMMWC@gmail.com!

Are you or a colleague interested in getting more involved with the Midwest Chapter in a leadership capacity?
Please consider nominating yourself or someone you know for a leadership role in SCCM-MWC by completing a very brief survey.
sccmmidwestchapter.org/survey.php?i...

15/ DCD + NRP Fundamentals:
~ 5-minute observation rule
~ Death declared before perfusion
~ Cerebral circulation excluded
~ Real-time organ assessment
~ Expands heart transplant access + improves transplant outcomes across multiple organs.
When the heart stops… it may still save a life. 🫀

14/ The bigger picture:
Technology is expanding the donor pool.
NRP + ex-vivo perfusion are transforming what was once “non-viable.”
Critical care doesn’t stop at death.
It enables legacy. 🕊️

13/ Ethical safeguards are non-negotiable:
✔ Decision for WLST made independently
✔ Death declared by treating team
✔ No brain reperfusion
✔ Transparent communication
🛡️ Trust is everything.

12/ ICU relevance:
Your role is critical.
~Timely OPO referral
~Hemodynamic optimization before WLST
~Clear separation of care decisions
~Family-centered communication
DCD starts in the ICU.

11/ Why this matters:
DCD hearts have increased transplant volume significantly in centers using NRP.
In some programs, DCD now accounts for 20–30% of heart transplants.
That’s lives saved.

10/ What happens next?
Cardiac activity may resume within the isolated regional circulation.
This allows organs to be:
🔍 Assessed in real time
🫀 Hemodynamically optimized
⭐ Procured under controlled perfusion
Outcomes with NRP now approach those of brain-death donors.

9/ Let’s be clear.
Regional blood flow is re-established to:
🫀 Heart
🫁 Lungs
🫄 Abdominal organs
But NOT the brain.
This preserves the ethical boundary.

8/ Adapted from Alamouti-Fard et al., 2022 (Cureus), CC BY 4.0

7/ Abdominal NRP (A-NRP)
~Perfuses abdominal organs only
~No thoracic perfusion
Thoraco-abdominal NRP (TA-NRP)
~Perfuses heart + lungs+ abdominal organs
Result: Organs perfused. Brain remains without flow.

6/ ⚙️ How?
• An extracorporeal perfusion circuit is initiated to restore circulation to the thoraco-abdominal organs. Aortic arch vessels surgically occluded. Cerebral circulation permanently excluded.

5/ Normothermic Regional Perfusion (NRP) re-establishes regional thoracoabdominal perfusion after death is declared.

4/ Historically, DCD hearts were not used.
Warm ischemia → myocardial injury → poor outcomes.
⚡ But that’s changing.
Enter: Normothermic Regional Perfusion (NRP).

3/ Why only 5 minutes?
Evidence shows autoresuscitation does not occur beyond 2–5 minutes without intervention.
The 5-minute rule balances:
⚖️ Ethical certainty of death
🫀 Organ viability
This protects the “dead donor rule.”

2/ DCD = organ donation after irreversible cessation of circulatory and respiratory function.
This differs from brain death. 🧠
Here, death is declared after:
• Withdrawal of life-sustaining therapy
• Asystole/ PEA
• 5-minute “no-touch” observation period

DCD + NRP — When the Heart Stops… Can It Beat Again?
1/ The heart has stopped. 🫀
5️⃣ minutes pass. ⏱️
Could that same heart be transplanted into another patient ❓
Yes ‼️
Welcome to Donation After Circulatory Death (DCD).

Congress 2026 in Chicago was a success! It was great seeing familiar and new faces at the Midwest Chapter Reception yesterday. Thanks to all who came, and thank you to the Society of Critical Care Medicine (SCCM) for yet another fantastic Critical Care Congress!

We hope to see you TODAY at the Midwest Chapter reception from 4-6pm!
Enjoy Congress.

Wondering where the data stands on Stress Ulcer Prophylaxis? Join the MWC for our upcoming FREE Virtual Webinar where Critical Care Pharmacist Rebecca Hilton will be discussing exactly that!
Wednesday, 4/22 at 6pm CST on Zoom.
RSVP REQUIRED: Email SCCMMWC@gmail.com to claim your spot!

SAVE THE DATE! March 23, at SCCM Congress, the Midwest chapter invites you to our Reception from 4-6pm.
Where: 3rd floor of Marriott Marquis Chicago, RR Donnelley Room

No RSVP required - stop by for food, drinks, and fun!
MIDWEST CHAPTER MEMBERSHIP IS NOT REQUIRED to attend!

SAVE THE DATE!
March 23, 2026, at SCCM Congress, the Midwest Chapter is thrilled to invite you to our Chapter Reception.
When: 4-6pm
Where: 3rd floor of the Marriott Marquis Chicago - RR Donnelley Room

No RSVP required - stop by for some food, drinks, and a fun time!

Meet ICU Pharmacist Morgan Ridout, a member of the Midwest Chapter's Communications Committee. We had the opportunity to ask Morgan a few questions. Check out her answers below!

Interested in joining SCCM - Midwest Chapter? Email sccmmwc@gmail.com to learn more!

11/ 📝Pregnancy ACLS Fundamentals:
~Communicate with team early
~Standard ACLS
~Manual LUD is the standard
~No change in drug dosing
~Prepare for resuscitative delivery
~Deliver within 5 minutes

10/ 🚨Suspecting amniotic fluid or hemorrhage? Initiate massive transfusion protocol early with balanced blood products.
⚡ When standard CPR isn’t enough, consider extracorporeal CPR to support circulation!

9/ Activate the team early!
📞Contact obstetricians, neonatologists, anesthesiologists, nurses, pharmacists, and other healthcare teams that may be needed depending on local resources.

8/ Maternal resuscitation takes priority! Detach fetal monitors while ACLS is ongoing. If ROSC is not achieved, perform resuscitative delivery within 5 minutes🕐.
Resuscitative delivery assists with unloading the IVC, improves venous return, and increases CPR effectiveness!

7/ If magnesium is infusing at the time of cardiac arrest, STOP the magnesium! Magnesium blocks calcium channels which decrease myocardial contractility and slow AV conduction. Give calcium chloride (central access preferred) or calcium gluconate to improve contractility🫀

6/ Med dosing doesn’t change for ACLS in pregnancy!
💉Epinephrine 1 mg IV q3-5min
💉Amiodarone 300 mg -> 150 mg
💉Lidocaine 1-1.5 mg/kg -> 0.5-0.75 mg/kg (max 3 mg/kg or 300 mg)
💡Place IV/IO above the diaphragm for med delivery!