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EBPOM 2019 | Preoperative risk stratification

TopMedTalk

Release Date: 11/11/2019

EBPOM 2020 London | Fit for surgery with Denny Levett show art EBPOM 2020 London | Fit for surgery with Denny Levett

TopMedTalk

How important is it to screen patients and measure their fitness prior to surgery? What is exercise training in the preoperative period? There is a very clear relationship between physical fitness and mortality. Importantly, when we think of prehabilitation, or exercise training, it's good to remember that you get the greatest benefit in the most unfit patients, in terms of mortality reductions. The "pandemic ... of physical inactivity worldwide" is believed to cause more than 5 million deaths annually. The advantage of fitness in terms of predicting perioperative outcomes is it is an...

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Periop SIG | Ward Based postoperative care; where should we focus? show art Periop SIG | Ward Based postoperative care; where should we focus?

TopMedTalk

This wide ranging talk asks where and how we should focus on the needs of postoperative care patients. "Brain care has an impact way beyond the acute surgical episode"; how do we minimise the risks of a poor outcome when it comes to postoperative care? "Advanced recovery from anaesthesia and surgery" is 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. Presented by Professor Jacqueline Close, Principal Research Fellow, NeuRA...

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COVID 19 | Essential COVID knowledge; Dr. Manuel Ignacio Monge García. show art COVID 19 | Essential COVID knowledge; Dr. Manuel Ignacio Monge García.

TopMedTalk

This piece has been released to coincide with the first virtual International Fluid Academy Day (IFAD). TopMedTalk listeners have enjoyed following the meeting annually for some time now; we're equally as excited about their online proposition. Find out more here: This piece digs deep into the realities of coping with COVID 19 patients who have had their care escalated to the Intensive Care Unit (ICU); "we don't seem to be looking at our typical sepsis patients who get multiple organ failure in the classical way" and "you're surprised at how young some of the patients are...". Our guest...

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TopMedTalk | POQI 5 - Fluid Management show art TopMedTalk | POQI 5 - Fluid Management

TopMedTalk

This piece has been released to coincide with the first virtual International Fluid Academy Day (IFAD). TopMedTalk listeners have enjoyed following the meeting annually for some time now; we're equally as excited about their online proposition. Find out more here: The Perioperative Quality Initiative (POQI) is a vital part of the process needed to more widely implement sensible practice which, using a clear evidence base, provides better value care with more positive outcomes for the patient. POQI continues to provide its work in an attempt to clarify fundamental concepts in perioperative...

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Fluid Matters | Series Highlight: Total body water and electrolytes show art Fluid Matters | Series Highlight: Total body water and electrolytes

TopMedTalk

This piece has been released to coincide with the first virtual International Fluid Academy Day (IFAD). TopMedTalk listeners have enjoyed following the meeting annually for some time now; we're equally as excited about their online proposition. This piece is a chance to hear a now famous discussion which TopMedTalk recorded at the Peroperative Quality Initiative (POQI) at Washington Duke University in Durham. The discussion is predominately about total body water, electrolytes and the movement of fluid around the body; the idea of circulation of interstitial fluid; the Starling Curve and...

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Prato | The 5th Collaborative Clinical Trials in Anaesthesia biennial conference show art Prato | The 5th Collaborative Clinical Trials in Anaesthesia biennial conference

TopMedTalk

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...

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TopMedTalk | A step between a simple monitor and a fully automated system show art TopMedTalk | A step between a simple monitor and a fully automated system

TopMedTalk

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...

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Periop SIG | Updates in cardiac devices Part 2 show art Periop SIG | Updates in cardiac devices Part 2

TopMedTalk

  "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...

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Periop SIG | Updates in cardiac devices, Part 1 show art Periop SIG | Updates in cardiac devices, Part 1

TopMedTalk

"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...

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POCAPALOOZA | Hong Kong show art POCAPALOOZA | Hong Kong

TopMedTalk

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...

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More Episodes

Preoperative risk stratification; what is are the risks and controversies behind preoperative exercise testing and the six minute walk test? This piece looks at the evidence behind both and some practical guidance for informing clinical care.

Does the six minute walk test predict complications? What is the true value for cardiopulminary exercise testing (CPET)?

For more on the METS study go here: https://www.topmedtalk.com/the-measurement-of-exercise-tolerance-before-surgery-mets-trial/

Presented by Duminda Wijeysundera, Professor in the Department of Anaesthesia and the Institute of Health Policy Management and Evaluation at the University of Toronto, and a Staff Anesthesiologist at St Michael’s Hospital.