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Dan Sessler | TopMedTalks to... Dec 15, 2018

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The Elephant In The Room - intraoperative hypotension. A discussion regarding the exciting results from the first multicentre, randomised controlled trial into targeted intraoperative blood pressure management. This conversation reflects the start of many debates and concern regarding hypotension, a frequent topic here on TopMedTalk. Monty Mythen and Mike Grocott are with Tim Miller, Duke University Medical Centre, speaking with their guest Dr Dan Sessler, Cleveland Clinic.

POET 1.02 | Shared decision making for high risk surgery Dec 14, 2018

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POET - The Perioperative Enhancement Team

How can cardiopulmonary exercise testing lead to shared decision making? Hear how aortic aneurysms are dealt with by a world class professional perioperative physician. Learn how that process and its success then spread out into other areas of healthcare within his institution. Do you need to develop a broad knowledge of all surgery and medicine so that you understand what is going on within the different surgical specialities

Presented by Monty Mythen, Joff Lacey and Desiree Chappell with their guest Dr Michael Swart, Consultant in Anaesthesia and Critical Care Medicine at Torbay Hospital and advisor to the UK Department of Health for the Enhanced Recovery Programme.

Critical Care Practitioner Podcast | Intensive Care Society Dec 13, 2018

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TopMedTalk catches up with another online media source, The Critical Care Practitioner podcast, organised by our guest who - appropriately enough - is a critical care practitioner. What's it like being a critical care practitioner in the UK at the moment? Originally a lot of nurses moved into the sphere but now paramedics, physiotherapists and many others progress into it. Furthermore what's it like taking your professional passion into the world of podcasting? You can hear the Critical Care Practitioner podcast here. Presented by Desiree Chappell with her guest Jonathan Downham, Critical Care Practitioner and podcaster.

The RELIEF Trial; a 'deep dive' into the results | Journal Club Dec 13, 2018

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The RELIEF (Restrictive versus liberal fluid therapy in major abdominal surgery) trial has been a huge story for us here at TopMedTalk, recorded on the second day of The Royal Collage of Anaesthetists' annual conference at the British Museum this is the moment the team get to pick over the results in detail. One of the biggest trials ever, it has both raised questions and provided answers. Inevitably there has been a huge debate, this piece puts all the major questions and concerns to the organiser of the trial. Send us your thoughts on The RELIEF trial: contact@topmedtalk.com

Presented by the TopMedTalk team; Professor Monty Mythen, Dr Joff Lacey, Desiree Chappell and Professor Mike Grocott, with their guest Paul Myles, Head of Alfred Health's and Monash University's Department of Anaesthesia and Perioperative Medicine and organiser of the RELIEF trial.

Nasogastric feeding | Intensive Care Society Dec 13, 2018

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How is it the case that some people can lose significant muscle mass while they are being cared for on the Intensive Care Unit (ICU)? What can practitioners do to help avoid this? How do we integrate a dynamic stimulus and react to new research relating to nasogastric feeding? In this piece you will hear about a randomised controlled pilot study investigating the effect of intermittent versus continuous nasogastric feeding on muscle mass and function in intensive care unit survivors. Hugh Montgomery presents with his guest, Dr Angela McNelly, clinical researcher at the ISEH and the UCL Centre for Human Health and Performance.

Point of care ultrasound | Intensive Care Society Dec 13, 2018

Show notes

How essential is training in focused transthoracic echo for adult intensive care? Ultrasound technology has evolved in recent years, some people say handheld devices look set to become as ubiquitous as a doctor's stethoscope. Could the nurse at the bedside get more involved in the process or is it 'protected turf'?

Also, can this technology help patients to become more involved in their treatment and its monitoring?

Presented by Monty Mythen and Desiree Chappell with their guest Marcus Peck, NHS consultant and Chair of Focused Intensive Care Echo (FICE).

Nutrition | Intensive Care Society Dec 13, 2018

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This piece starts with a discussion about indirect calorimetry and the challenges associated with it as well as recent improvements in the field. The penn state equation is discussed. Muscle wastage and the need for resistence training, as well as protein feeding is covered. More widely; what does good ICU feeding look like? How can friends and relatives of patients be sure that a loved one is getting good nutritional care? Desiree Chappell and Monty Mythen presenting with their guest Danielle Bear, ICU dietician at Guy's and St Thomas' NHS Foundation Trust.

Mike of the antarctic | Intensive Care Society Dec 13, 2018

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Fresh from an expedition to Antarctica, on the National Geographic Explorer, Mike Grocott gives us an update on the "Anaesthesia at the Extreme" conference.

Regular listeners will remember his excellent talk about Xtreme Everest, which you can find here: https://www.topmedtalk.com/10-xtreme-everest-physiology-on-top-of-the-world/

Presented by Desiree Chappell and Monty Mythen with their guest Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton and Dr Jim Down, University College London Hospital.

Alfie the therapy dog | Intensive Care Society Dec 12, 2018

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The Pets as Therapy team have been a huge hit at the Intensive Care Society annual conference. How would you incorporate something like this into your practice? There are currently over 6,000 dogs and cats working in healthcare in the UK.

Presented by Desiree Chappell with Monty Mythen and their guests Alfie the therapy dog, Suzy Emsden, volunteer for Pets as Therapy and a pediatric intensivist from the North West, and Matthew Robinson, national project co-ordinator for Pets as Therapy.

Hydration | Intensive Care Society Dec 12, 2018

Show notes

How do we maintain hydration in a way which is both safe and comfortable for the patients we treat? What about the post-surgical patient who is full of salt and water but tells us they are thirsty? How can we allow patients to hydrate themselves?

Presented by Desiree Chappell with Monty Mythen and their guests Professor Hugh Montgomery, Intensive Care Society Board Member and Professor of Cardiovascular Genetics and Critical Care University College London and Fintan Hughes, Academic Intern at St. James's Hospital Dublin.

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