Periop SIG18 | Perioperative Evaluation of the Cancer Patient
Release Date: 10/17/2019
This piece focuses upon the unique 'Collaborative Clinical Trials in Anaesthesia biennial conference', of which this was the fifth, organised in Prato, Italy, by Monash University. TopMedTalk was given the chance to listen in on this cutting edge gathering of trialists, academics and practitioners as it happened. We take a deeper dive on the history behind this very special meeting, how it works and special moments from the meeting. Learn how some of the big trials gather pace and how major studies get established. The ANZCA Clinical Trials Network is here: More detail on the African Surgical...info_outline TopMedTalk | A step between a simple monitor and a fully automated system
This piece focuses upon goal directed fluid therapy, with an automated system, for decision support; "a step between a simple monitor and a fully automated system". The "proof of concept" paper we highlight towards the end of the podcast, "Feasibility of closed-loop titration of norepinephrine infusion in patients undergoing moderate - and high-risk surgery" has now been published and can be found here: This paper here "Perioperative goal directed therapy using automated closed-loop fluid management: the future?" is also referenced: You may also find this piece, which our guest is also part...info_outline Periop SIG | Updates in cardiac devices Part 2
"Updates in cardiac devices, Part 2" was a talk originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019. This piece is focused upon transcatheter aortic valve implantation (TAVI) devices. "A balloon valvular plasti in comparison to a TAVI is 90% of the risk, 10% of the gain" you're trading one problem with another, argues our speaker. Find out more about ANZCA here: Presented by Dr Karl Poon, TAVI specialist at St Andrews War Memorial...info_outline Periop SIG | Updates in cardiac devices, Part 1
"Updates in cardiac devices, Part 1" was a talk originally given at the 8th Australian and New Zealand Symposium of Perioperative Medicine Special Interest Group: “Updates in Perioperative Medicine 360” which took place between November 7th-9th 2019. This piece is a look at some of the new technology which looks set to become more widely used. A leadless pacemaker is a small implantable "bullet like" device that sends electrical pulses to the heart whenever it senses that the heartbeat is too slow. Also new implantable cardioverter defibrillators are discussed as are implantable cardiac...info_outline POCAPALOOZA | Hong Kong
The POCAPALOOZA, a celebration of perioperative care that went around the world in the wake of EBPOM 2020. "Early intervention and people taking it seriously is a big thing" The conversation evolves as our guest speaks to the realities of moving internationally to pursue your career in medicine. Can a truly global perspective better position the medical community when it comes to international co-operation? The World Congress of Anaesthesiologists is here: Also, what's the future of medical conferencing in the world of COVID 19 and the global pandemic? Presented by Desiree Chappell and Monty...info_outline AANA | Opioids: Pain, Euphoria, and a New Surgical Complication. Are Your Patients Safe?
"4-10% of opioid naïve patients will continue to use opioids more than 90 days after surgery" Opioids are good for pain control but there's another issue, they also numb emotional pain. How do we responsibly deal with this? It's important to remember: "When you give patients high doses, you're putting them at risk". Long term listeners will recall TopMedTalk spent the best part of our launch year on this topic. If you're one of our many new listeners please use this huge resource of podcasts to help update your practice and cut down unnecessary risk: "We should be minimizing opioids every...info_outline EBPOM London 2020 | The Business Case for Prehabilitation
"It was successful early on within the National Health Service.. [because] you could eliminate the cost of some unhelpful, unnecessary tests... referrals to other "-ologists"... in our system that works, because more work is just more work. It's not more money." Is the business case for prehabilitation a "slam dunk", as some enthusiasts claim? If so how do you measure value versus volume, is value always a subjective term and can the balance between the two be addressed? How does the NHS's "internal market" compare to the US's fee for service environment? Furthermore, where are the sensible...info_outline TopMedTalks to ... | Maurizio Cecconi
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 and Intensive Care Department at Humanitas Research Hospital; President-elect of the European...info_outline EBPOM Chicago 2020 | Frailty, Brain Health and Perioperative Cognitive Dysfunction
"Cognitive testing has been in the news ... there are recommendations for keeping pets mentally sound by implementing nutritional modifications, regular exercise and mental stimulation, we should certainly think about providing the same support to our geriatric patients." What does the latest research say about this vital issue? How is frailty defined? What's the clinical impact of preoperative cognitive dysfunction? Presented by Angela Bader, MD, MPH Professor of Anesthesia at Harvard Medical School and Vice Chair for Perioperative Medicine in the Department of Anesthesiology, Perioperative...info_outline EBPOM Highlight | SNAP-2 - EPICCS
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: This talk explains the study and its far reaching implications. Another talk on SNAP-2 is available here: Presented by Ramani Moonesinghe, Professor of Perioperative Medicine at...info_outline
Cancer continues to present a seirous challenge to health care practitioners, particularly with elderly patients. Operations on cancer patients can occur for a variety of reasons, how do we ensure we make decisions that are right for them? Often cancer surgery is both urgent and emergent; the question of 'how long do we have to prepare' is paramount. How do we get patients to a surgical option that may be curative? How do we deal wirth "deconditioned" patients who have been subjected to difficult treatments as part of their cancer care? What are immune checkpoint inhibitors? What is 'targeted chemotherapy'? What are the pulmonary side effects of chemotherapy? Furthermore who do we deal with anemia in cancer Patients?
Finally the talk focuses upon post operative care.
The fuller version of this talk is supported by slides which you can see here: http://www.anzca.edu.au/documents/01-sunil-sahai_periop-evaluation-of-cancer-patient.pdf
Presented by Sunil K. Sahai, MD, FAAP, FACP, Co-Director, The PeriOperative Evaluation & Management Center Section Chief & Professor of Medicine, Section of Consultative Medicine, Department of General Internal Medicine, MD Anderson Cancer Centre.
Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine.
The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups.
For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine