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Pathophysiology of blood pressure auto regulation P2 | TopMedTalk Dec 17, 2021

Show notes

This piece continues the discussion regarding blood pressure regulation, moving from the brain to the kidney, heart and lungs via a number of distinguished experts in the field. How do we safely cut through the opinions on these areas and focus instead on relevant data? How do these organs interact in terms of auto regulation? How closely do our clinical tools allow us to infer accurately what a particular patient's needs are?

This piece is part two of two, the first part is advised listening and can be found here: https://topmedtalk.libsyn.com/pathophysiology-of-blood-pressure-auto-regulation-p1-topmedtalk

Presented by Dan Martin, with Monty Mythen, Sol Aronson and panelists Damian Bailey, Professor of Physiology at the University of South Wales, Maryam Khosravi, clinical nephrology, University College London, Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for Anesthesia, Alberta Health Services Edmonton Zone and Fellow of the Royal College of Anaesthetists (UK), the American College of Critical Care Medicine and the Faculty of Intensive Care Medicine (UK), Erik Swenson, Director of Pulmonary Diagnostics Service at VA Puget Sound Health Care System, Seattle, WA, Kim Dora, Professor of Microvascular Pharmacology, Oxford University, Chris Garland, Professor of Vascular Pharmacology, Oxford University.

Pathophysiology of blood pressure auto regulation P1 | TopMedTalk Dec 17, 2021

Show notes

The focus of this conversation is auto regulation in the brain, it leads into a longer conversation - part 2 - where the subject is discussed more broadly. What tools do we now have and how are they changing the way we see and understand this area? Are there hard and fast rules when it comes to blood pressure or is there still significant debate?

Although this works as a stand alone listen it is in reference to the talk "Redefining Hypotension based on Real-time Cerebral Autoregulation Monitoring | EBPOM Chicago" - https://www.topmedtalk.com/redefining-hypotension-based-on-real-time-cerebral-autoregulation-monitoring-ebpom-chicago/

Presented by Monty Mythen with Dan Martin, OBE, Professor of Perioperative and Intensive Care Medicine, University of Plymouth and the Royal Free Hospital, London and Sol Aronson, tenured Professor, Duke University, Durham, North Carolina with their guest Charles Hogue, Professor and Chair of Anesthesiology at Northwestern University in Chicago.

How to set up and run a Perioperative Anemia Clinic | EBPOM Chicago Dec 13, 2021

Show notes

"Choosing Wisely is an initiative of the American Board of Internal Medicine started about 10 years ago to advertise important aspects of medicine ... their number one recommendation was to not proceed with elective surgery in patients with properly diagnosed and correctable anemia, until the anemia has been appropriately treated."

Taken from the hugely popular EBPOM Chicago meeting this piece explains how and why you need an anemia clinic as part of your perioperative practice.

For more of this check out our piece here, which also features Bobbie Jean Sweitzer: "Promote your anemia clinics in the pandemic era?" https://www.topmedtalk.com/covid-19-promote-your-anemia-clinics-in-the-pandemic-era/

Presented by Professor Bobbi Jean Sweitzer, The Associate Chair for Clinical Perioperative Practice, Northwestern University in Chicago, Illinois.

Near infrared spectroscopy (NIRS) Round Table | EBPOM Chicago Dec 06, 2021

Show notes

Near infrared spectroscopy (NIRS) ... 'a variation of pulse oximetry; it transmits red and infrared light into tissue' measures information from arterial venous and capillary blood simultaneously to deduce tissue saturation; an aggregate estimate of arteriovenous capillary blood and whatever tissue you're shining the light into. 'So typically, we're using it in on the brain at least in the cardiac and vascular space, but people also in other areas like the surgical ICU, can use it to measure muscle oxygenation as well'.

Learn how this technique could enhance your practice, what its potential for advancement is and where its limits lie. This piece is likely to be of critical interest to most cardiac surgeons and those who work alongside them.

This piece was generously supported and brought to you by Medtronic.

Presented by Desiree Chappell and Monty Mythen with their guests Robert Thiele, Cardiac Anesthesiologist and Intensivist at the University of Virginia, Carol Ann Rosenberg Associate Director of Perfusion and ECMO, Kenan Yount, Cardiac Surgeon and Director of the Valve center and Director of the Aortic Center at the University of Virginia.

Perioperative Pulmonary Complications | EBPOM 2021 Nov 29, 2021

Show notes

Originally recorded during Evidence Based Perioperative Medicine (EBPOM)'s London conference this piece focuses upon pulmonary complications in the perioperative period. What do the data say, what are the key trials?

Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton with Mark Hamilton, Consultant and Honorary Senior Lecturer in Anaesthesia & Critical Care Medicine at St. George's Hospital and Medical School, clinical lead for the Perioperative Assessment & Planning Unit at St. George's Hospital, clinical director for critical care at St. George's Hospital, alongside, Linda Denehy, Head of the Melbourne School of Health Sciences and Professor of Physiotherapy at The University of Melbourne, Australia, Rinaoldo Bellomo, Professor of Intensive Care Medicine, University of Melbourne, Honorary Professor, Faculty of Medicine, Monash University, Honorary Professorial Fellow, Faculty of Medicine, The University of Sydney, Honorary Professorial Fellow, The George Institute, Honorary Fellow, Florey Institute of Physiology, Honorary Professor, Faculty of Medicine, Nanjing University, Visiting Professor, Università Vita-Salute San Raffaele, he was awarded an Officer of the Order of Australia for distinguished service and Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London.

Ernest Henry Starling Plenary Lecture - David Story | EBPOM World Congress 2021 Nov 25, 2021

Show notes

One of the standout moments of Evidence Based Perioperative Medicine (EBPOM) 2021 this piece is a bonus podcast for the holiday season which looks in detail at oxygen from a perioperative medicine perspective, amongst other things this talk throws up some troubling and challenging observations about pulse oximetry.

The piece is introduced by Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

Presented by David Story, Professor and Foundation Chair of Anaesthesia at the University of Melbourne; Head of the University Department of Critical Care and a member of Council of the Australian and New Zealand College of Anesthetists (ANZCA) and the Chair of the ANZCA Safety and Quality Committee.

Like this, want more? Check out www.ebpom.org now, great prices on conferences are available including access to high quality video presentations on demand.

Respiratory care and management during COVID-19 | EBPOM 2021 Dingle/Chicago Nov 22, 2021

Show notes

"We have seen a very significant transition (in respiratory care) through COVID"

What have we learned about how to treat lung and breathing issues over the last few years? Away from alarming headlines and looking instead at data - is there a consensus on how COVID-19 should be treated? How has ventilation improved and developed?

This podcast focuses on respiratory intervention and was originally broadcast as part of the hugely successful EBPOM Dingle/Chicago 2021 conference. For more details on EBPOM and for access to a huge library of resources, that goes beyond even TopMedTalk's extensive archive, go now to www.ebpom.org

Presented by Desiree Chappell and Monty Mythen with their guest Karen A. Phillips, Chief Medical Officer, Respiratory Interventions, Consultant Anesthesiologist and Intensivist.

Stop your patients feeling sick | EBPOM Dingle Nov 15, 2021

Show notes

Amisulpride is an antiemetic medication used at lower doses intravenously to prevent and treat postoperative nausea and vomiting; what does it look like in practice? Can it work as a 'rescue therapy'? What does the data tell us? Could a treatment for post-operative nausea and vomiting be a way to really enhance value based care and enhanced recovery?

Supported in part through an unrestricted educational grant from Acacia Pharma, Inc.

Presented by Desiree Chappell and Monty Mythen with their guest Dru Riddle, Associate Professor of Professional Practice in the School of Nurse Anesthesia at Texas Christian University, Associate Professor of Medical Education, TCU School of Medicine, and Director of the Center for Translational Research: A JBI Center of Excellence and Cochrane US TCU Center.

Nociception monitoring and pain management in 2021 | EBPOM Dingle/Chicago Nov 08, 2021

Show notes

"Precision anesthesia [...] where we can give patients the anesthetic and the doses that they require on a patient specific basis"

This piece looks at nociception, the neural processes of encoding and processing "noxious" stimuli. By monitoring this anesthetic practitioners can deploy a level of precision not previously possible.

Regular listeners may wish to refer back to previous podcasts on this subject:

EBPOM LIVE from London | Pain monitoring - with Frank Overdyk, Professor of Anaesthesiology, Charleston, South Carolina: https://www.topmedtalk.com/11813-2/

TopMedTalks to … | Dan Longrois on nociception: https://www.topmedtalk.com/topmedtalks-to-dan-longrois-on-nociception/

Presented by Desiree Chappell and Monty Mythen with their guest Anil Hormis, Professor, Consultant in anesthesia and Critical Care Medicine, Rotherham NHS Foundation Trust.

The HPI Monitor - avoiding hypotensive events | TopMedTalk Nov 01, 2021

Show notes

The Hypotension Prediction Index is rapidly gaining a well deserved place in the hands of modern perioperative practitioners. Here we look at the history of this tool, why it is needed so badly and how it has developed.

Many of the conversations referenced in this piece are worthy of further attention. The clips used are taken from the following TopMedTalk programmes:

Live from Boston ASA 2017 – The Elephant In The Room – intraoperative hypotension: https://www.topmedtalk.com/live-from-boston-asa-2017-the-elephant-in-the-room-intraoperative-hypotension/

Intraoperative Hypotension: https://www.topmedtalk.com/intraoperative-hypotension/

ASA 2019 | Perioperative Quality Initiative P.O.Q.I. news https://www.topmedtalk.com/asa-2019-perioperative-quality-initiative-p-o-q-i-news/

ASA 2019 | Hypotension Index: Data drives change https://www.topmedtalk.com/the-hypotension-prediction-index-hpi/

The Roundtable | The Hypotension Prediction Index (HPI) https://www.topmedtalk.com/the-roundtable-the-hypotension-probability-index-hpi/

EBPOM 2018 | Hypotension probability in practice https://www.topmedtalk.com/ebpom-2018-hypotension-probability-in-practice/

Prehab Periop World Congress: Feras Hatib, Simon Davies https://www.topmedtalk.com/prehab-periop-world-congress-feras-hatib-simon-davies/

The Hypotension Prediction Index (HPI) https://www.topmedtalk.com/the-hypotension-prediction-index-hpi/

The picture features TopMedTalk in conversation with Thomas Scheeren, Chair Cardiovascular Dynamics Section at European Society of Intensive Care Medicine (ESICM).

TopMedTalk is proud to act as the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM) - our world famous conferences continue to grow in size and scope as the COVID recovery gets underway -, find out more here: www.ebpom.org

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