Doesn't the decision to delay surgery depend upon the type of cancer? Can you measure complications as an outcome? What's the cause of non cardiac complications that are related to lack of exercise? Can we change the mindset of prehabilitation by explaining that prehabilitation is the start of treatment? How do we convince patients and decision makers that delaying surgery is a good idea? How involved are oncologists in perioperative decisions? Presented by Duminda Wijeysundera, Professor in the...
May 27, 2020•16 min
"We wanted to know if goal directed therpy using a (Hypotension Prediction Index) HPI monitor can prevent hypotension". This piece looks in detail at the HPI monitor in practice- what is the benefit of this piece of technology in relation to hypotensive episodes? Furthermore how else is it to be tested and when will these tests be carried out? Presented by Desiree Chappell and Monty Mythen with their guest Marit Habicher, Specialist, Department of Anesthesia and Critical Care at UKGM Giessen....
May 26, 2020•13 min
Some practitioners habitually prescribe opioids, the consequences in America are now described as a national crisis. Essentially the focus here is "better opioid stewardship" and a "move away from the traditional fundamental principle of opioids first". Presented by Michael Manning, MD, PhD, Assistant Professor at Duke University Medical Center, Director of Research for the Perioperative Medicine Fellowship at Duke.
May 25, 2020•15 min
After a short overview of the history of the Society of Cardiovascular Anesthesiologists (SCA) this conversation zones in on some of the hot topics that are being discussed in the field; devices and extracorporeal membrane oxygenation (ECMO) machines, as well as trans-esophageal echocardiography and how the practice has evolved. The conversation ends with a discussion about pre-habilitation in a resource stretched environment. Presented by Desiree Chappell with Sol Aronson with Jamie Ramsey Medi...
May 24, 2020•19 min
The Centre for Perioperative Care (CPOC) is a cross-specialty centre dedicated to the promotion, advancement and development of perioperative care. Led by the Royal College of Anaesthetists to facilitate cross-organisational working on perioperative care for the benefit of patients. A partnership between patients and the public, other professional stakeholders including Medical Royal Colleges, NHS England and the equivalent bodies responsible for healthcare in the other UK devolved nations. The ...
May 23, 2020•14 min
This piece focuses on The Centre for Perioperative Care (CPOC). How does it work, what are its goals and who is involved? Also, what digital innovations will CPOC be looking towards? For more information check out the website here: https://cpoc.org.uk/ Originally recorded live at Anaesthesia 2019; where world-renowned experts presented the latest advances in perioperative medicine, critical care and pain medicine. Presented by Monty Mythen and Mike Grocott with their guest David Selwyn, Deputy M...
May 22, 2020•13 min
The Royal College of Anaesthetist's National Audit Projects (NAP) are frequently fascinating and always important, here we get a look at NAP7, which will examine Perioperative Cardiac Arrest. The conversation also explores the Sprint National Anaesthesia Projects (SNAP) organised by the National Institute of Academic Anaesthesia. There's also discussion regarding muscle quality, malnourishment and ultrasound. The conversation progresses to Quality Improvement and the latest evidence there. This ...
May 21, 2020•32 min
Developmental neurotoxicity; can human infants exposed to anaesthesia early in their early development really be facing risks which we were previously unaware of? There's a lack of evidence at the moment but outcomes for young animals have raised concern. Given the complexities of human neurodevelopment how can such issues be reliably detected? Presented by Joff Lacey with his guest Hugh Hemmings Senior Associate Dean for Research, Professor and Chair of Anesthesiology at Weill Cornell Medicine....
May 20, 2020•16 min
This excellent conversation explores how Anaesthesia as a profession will the profession evolve as the years pass; change is inevitable and the direction of it is becoming clearer but what it's pace will be is still uncertain. How will we adapt to the new roles and requirements we can see coming towards us in the near future? Will "the computers take over" or do we see a future where roles will be made simpler and more automated? Should Anaesthetists expect to tackle more of a leadership role in...
May 19, 2020•10 min
"Keeping the care in healthcare", is the agenda for this powerful and wide ranging conversation with one of our most popular contributors. How do we keep the priority of what we do at the forefront of our minds? Does the information we've learned recently on TopMedTalk about "burn out" impact on our understanding of poor levels of care in healthcare? Is it possible to rate providers on how much care they display? Also; "what is a microbiome"? The second half of this conversation is a deep dive i...
May 18, 2020•23 min
This piece focuses on intensive care, the use of data and the future of fluid therapy research and its related physiological outcomes. The article mentioned in this podcast is here: "Perioperative haemodynamic therapy for major gastrointestinal surgery: the effect of a Bayesian approach to interpreting the findings of a randomised controlled trial" https://bmjopen.bmj.com/content/9/3/e024256 Presented by Desiree Chappell and Monty Mythen with their guest Maurizio Cecconi, Head of the Anaesthesia...
May 17, 2020•22 min
The 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care after Surgery (SNAP-2 - EPICCS) study launched in March 2017 around the UK. More than 2,200 investigators at more than 250 sites across the UK were signed up to take part. The observational study collected data on all patients undergoing inpatient surgery during a one-week period (21 March to 27 March) in UK NHS hospitals. The website is here: https://www.niaa-hsrc.org.uk/SNAP-2-EpiCCS?newsid=1710 This talk explains the s...
May 16, 2020•14 min
This piece is a question and answer session regarding the care of elderly patients undergoing surgery. Discussion topics include; The RELIEF trial, e health tools, gathering and accessing data, whether it is better to over estimate risks and which risk calculator is most appropriate to use where you are? It features; Professor Jacqueline Close, Geriatrician, Prince Of Wales Hospital, Clinical Director, Falls, Balance and Injury Research Centre, David Storey, Head of Anaesthesia, Perioperative an...
May 15, 2020•20 min
We begin with a conversation about The UK Perioperative Medicine Clinical Trials Network, their website is here: https://www.pomctn.org.uk/ This piece focuses on the Optimising Shared decision-makIng for high-RIsk major Surgery (OSIRIS) programme. Shared decision making can be very challenging when we're not sure what the risks are and older patients with chronic diseases often make very different decisions when informed. How do we make this process more evidence based? How do we better understa...
May 14, 2020•21 min
Mentorship, diversity and inclusion are key parts of any socially responsible institution's practice. This piece speaks to how we make medicine more diverse and inclusive overall, there is much work to be done but an active focus coupled with mentorship programes is shown here to be an effective way forward. This piece was part of our coverage of The American Association of Nurse Anesthetists (AANA) 2019 Annual Congress in Chicago, Illinois. Check out the AANA here: https://www.aana.com/ Check o...
May 13, 2020•29 min
How do we best negotiate working in a multidisciplinary team? Generalisations regarding surgeons and anaesthetists only ever work generally, the specifics of each practitioner and their priorities inevitably contrast. How do we keep sight of these broad differences without falling foul of stereotypes? The conversation evolves; how does the surgical journey fully utilise the team based perioperative approach? With specific focus on geriatric care there is further discussion regarding shared decis...
May 12, 2020•14 min•Season 3Ep. 6
This piece gets into the detail regarding one of the big talking points in perioperative medicine over the last year or so; what is the impact of intraoperative hypotension on post operative outcomes? Further discussion encompases the modern uses of a pulmonary artery catheter. If you enjoyed hearing Andy Shaw's take on these topics further listening can be found here; https://www.topmedtalk.com/hemodynamic-monitoring-and-the-pulmonary-artery-catheter/ Presented by Desiree Chappell with Monty My...
May 11, 2020•12 min
This special four part series explores the fascinating story of Xtreme Everest – the ground-breaking, research programme that has pursued a novel approach to scientific exploration. Over the last decade, this innovative team has performed large scale studies at high altitude to mimic some of the effects of critical illness. The objective is for their findings to be brought “from the mountainside to the bedside” so that the care for our sickest patients may be improved. In this podcast, Chris Imr...
May 10, 2020•16 min
This special four part series explores the fascinating story of Xtreme Everest – the ground-breaking, research programme that has pursued a novel approach to scientific exploration. Over the last decade, this innovative team has performed large scale studies at high altitude to mimic some of the effects of critical illness. The objective is for their findings to be brought “from the mountainside to the bedside” so that the care for our sickest patients may be improved. In this podcast, Andrew Mu...
May 09, 2020•20 min
TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis. "It's very normal to sit with some difficult thoughts and feelings" after a cancer diagnosis. Broadly there are two types of mindsets; anxiety, which can be helpful, an element of wanting to 'do something' and, on the other hand, low mood, a feeling of not wanting to do anything, this can be unhelpful if not addressed at a c...
May 08, 2020•25 min
This special four part series explores the fascinating story of Xtreme Everest – the ground-breaking, research programme that has pursued a novel approach to scientific exploration. Over the last decade, this innovative team has performed large scale studies at high altitude to mimic some of the effects of critical illness. The objective is for their findings to be brought “from the mountainside to the bedside” so that the care for our sickest patients may be improved. In this podcast, Dan Marti...
May 07, 2020•13 min
This piece is a look at the fightback against COVID 19; the search is on for a safe and effective vaccine against coronavirus. A group of investigators in the UK are about to begin trialing a vaccine using a ChAdOx virus vector. This piece gets into the detail of the trial and how the vaccine might work. Presented by Joff Lacey with his guest Professor Paul Heath, consultant in pediatric infectious diseases, at St George's Hospital in London. He co-leads the Pediatric Infectious Disease research...
May 07, 2020•27 min•Season 1Ep. 57
"There's no advertisements popping up, non of that nonsense, this is just the data you need on the front lines to help save time and save lives" This piece focuses on the Ventilator Training Alliance APP, developed to meet the need practitioners have to use and understand ventilation equipment which may be new or unfamiliar to them. Download the APP now and share it with all friends and colleagues who may find themselves in this situation. The app is here: https://www.allego.com/ventilator-train...
May 06, 2020•26 min
TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis. We know food gives us energy "but it also provides so much more". This podcast looks at the raw materials you'll need, when facing a cancer diagnosis, to get a better outcome; the vitamins, minerals and proteins, as well as the energy sources you're best using. What is a balanced diet when you have cancer? "We're talking abo...
May 06, 2020•14 min
This special four part series explores the fascinating story of Xtreme Everest – the ground-breaking, research programme that has pursued a novel approach to scientific exploration. Over the last decade, this innovative team has performed large scale studies at high altitude to mimic some of the effects of critical illness. The objective is for their findings to be brought “from the mountainside to the bedside” so that the care for our sickest patients may be improved. In this podcast, Denny Lev...
May 05, 2020•24 min
TopMedTalk in Collaboration with MacMillan Cancer Support in the UK developed this podcast series to support patients during their cancer journey amidst the COVID 19 crisis. It's vital you remain active after a cancer diagnosis, why is this? Hear the fascinating story behind the discovery that activity not only reduces your overall levels of fatigue but also improves your chances of recuperation. "You have to pace yourself [...] listen to your body"; but any physical activity will help fight fee...
May 04, 2020•27 min
This piece is taken from the free papers presentations given at EBPOM 2019. Malnutrition and functional capacity; what is the effect of multimodal prehabilitation? What can the six minute walk test really show us? Does nutritional status predict preoperative change in a six minute walk test in colorectal cancer patients following a prehabilitation programme? Presented by Lauren Richer, Director, Nutritional Services, Keyto, Registered Dietician, Greene Family Medicine Clinic and Montreal General...
May 04, 2020•11 min
The Covid 19 crisis - and our collective response to it - has had an immediate and, in some instances worrying, drop off in cases that are not directly related to the virus. As the normalisation process in medicine begins and we find a way to live with this new virus in our midst how do we adapt and promote healthcare? What are the exciting opportunities available for patient optimisation? Further, there is a detailed and engaging discussion about fluid management. Presented by Desiree Chappell ...
May 03, 2020•15 min•Season 1Ep. 56
"Babies are still being born" This piece looks at the area of obstetrics in the midst of an unprecedented global crisis regarding the COVID 19 outbreak. How can the delicate balance between reducing infections and social distancing be interwoven with the needs of modern childbirth. Should we be concerned that some patients may shun hospital assisted births for fear of contagion? How has the data from China, much of which focused upon cesarean section births, been useful to us in the West? Why do...
May 02, 2020•33 min•Season 1Ep. 55
"I'm also a United States Air Force Officer and reservist and on April 4th was activated and given approximately 48hrs to deploy on a C-5 Galaxy Military Aircraft to the epicenter, New York City and I've been here for approximately, it's been almost a month now" This piece follows on from a previous exclusive conversation regarding the US military deployment to New York; here we get more detail and spend time thinking about how Enhanced Recovery must be an essential part of any "new normal". The...
May 01, 2020•21 min•Season 1Ep. 54
