Breaking Trials: ITACS Trial on Preoperative IV Iron for Anaemia Before Cardiac Surgery
Release Date: 08/20/2026
EBPOM London: Cancer Care, Surgical Robotics and Pain Management
TopMedTalk
At the Evidence Based Perioperative Medicine (EBPOM) World Congress, and the first World Congress of Enhanced Post-Operative Care (EPOC), Andy Cumpsty interviews Deena Harji, Consultant Robotic and Colorectal Surgeon at the Manchester University NHS Foundation Trust (MFT) and the Professor of Robotics and Digital Healthcare Technologies, alongside Cathy Price, Consultant in Pain Medicine at Southampton NHS Foundation Trust. Harji covers the rapid UK adoption of surgical robotics, noting potential benefits such as lower systemic inflammatory response, less pain, faster recovery, and earlier...
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Enabling the next generation of research leaders.
TopMedTalk
At the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine (FPM) held in Auckland, New Zealand, Kate Leslie and Andy Cumpstey interview ANZCA president David Story and the ASM New Zealand Visitor Tim Walsh about what inspired them to pursue a career in research and how they support emerging research leaders. David Story is Professor and Chair, Department of Critical Care, University of Melbourne, Australia, and Consultant Anaesthetist at the Austin Hospital, Australia. Tim Walsh is Professor of Critical Care at the...
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GLP-1 Receptor Agonists and Anaesthesia: Aspiration Risk in a UK Multicentre Study
TopMedTalk
Recorded in Prato, Italy at the 8th Collaborative Clinical Trials in Anesthesiology meeting. Desiree Chappell and guest co-host Mark Priestley interview Professor Kariem El-Boghdadly, Consultant Anaesthetist and Clinical Lead for Theatres, Anaesthesia, and Peri-operative Medicine at Guy's and St Thomas' NHS Foundation Trust, as well as an Honorary Reader at King's College London about the perioperative implications of GLP-1 receptor agonists. El-Boghdadly explains expanding GLP-1 use, delayed gastric emptying, and why early “hold for a week” guidance may be impractical. He describes a UK...
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TopMedTalk Classic: Detecting and managing frailty
TopMedTalk
This month’s TopMedTalk Classic was originally aired in 2019 but remains very relevant today. Presented by Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust, and an expert on frailty. This talk explores how our understanding and discussion has improved regarding a condition that is still yet to have a clear, universally accepted, definition. How do we build a patient's physical reserve? What is the best way to conceptualise frailty? Are there any universal treatments available? TopMedTalk’s back catalogue contains over 2000 episodes covering...
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EBPOM Ireland 2026: Pre-Hospital Care in Mountain Rescue and at Sporting Events
TopMedTalk
Recording from TopMedTalk at EBPOM in Dingle, Ireland, Kate Leslie and Imogen Fecher-Jones interview Oliver Pratt, Consultant Anaesthetist at Salford Royal Hospital, Chair of the Primary FRCA Structured Oral Examinations for the Royal College of Anaesthetists, and a Medical Officer for the Kinder Mountain Rescue Team and Joe Cosgrove, a Consultant in Anaesthesia and Intensive Care Medicine at the Newcastle upon Tyne Hospitals NHS Foundation Trust, a Primary FRCA Examiner for the Royal College of Anaesthetists, and the Critical Care Outreach Lead specializing in advance care planning. He is...
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Perioperative Profiles: Duminda Wijeysundera
TopMedTalk
This month’s Perioperative Profile features Duminda Wijeysundera, Professor in the Department of Anesthesiology and Pain Medicine and IHPME at the University of Toronto, and a Staff Physician at St. Michael's Hospital, who holds the Endowed Chair in Translational Anesthesiology Research, serves as Head of Science at SPHERE, acts as a Senior Adjunct Scientist at ICES, and is a Trustee for the International Anesthesia Research Society (IARS). He describes growing up across Sri Lanka, the US, Singapore, and Canada, and how adaptability and cultural sensitivity shaped him; he entered medicine...
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EBPOM London 2026: Enhanced Postoperative Care Units (EPOCs)
TopMedTalk
Recorded at the Evidence Based Perioperative Medicine (EPBOM) World Congress in London, this TopMedTalk episode, presented by Andy Cumpstey, features Guy Ludbrook, Professor of Anaesthesia and Head of Acute Care Medicine at the University of Adelaide and resident Georgia Cadzow, discussing the Perioperative Quality Initiative (POQI) POQI is a not-for-profit that uses a formal Delphi process to distill evidence and expert consensus into publishable clinical recommendations on topics such as perioperative hypotension, acute kidney injury, delirium, health economics, and fluid therapy. Georgia...
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Regulating AI in Perioperative Medicine: Data, Trust, and Evidence
TopMedTalk
Today’s TopMedTalk AI podcast was recorded at the Association of Anaesthetists of Great Britain and Ireland in London. It features Andy Cumpstey and Desiree Chappell and their guests, John Whittle, honorary associate professor of Perioperative medicine at University College London and Duncan McPherson, Head of the clinical team at QMD Services and Anesthesiologist and Honorary Professor at University College London. We discuss how early AI research shares core requirements with other research—especially data safety and governance—while medical device regulation applies the same legal...
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SOAP: Caesarean Pain, Patient Voice and System Change
TopMedTalk
At the 58th Society for Obstetric Anesthesia and Perinatology (SOAP) meeting in Montreal, TopMedTalk hosts Mike Grocott and Desiree Chappell interview Heather Nixon, SOAP immediate past president and Section Chief for Obstetric Anesthesiology; Section Chief for Simulation, Education, and Training Department of Anesthesiology University of Illinois, about SOAP’s educational mission, governance, outreach, and special interest groups. Nixon describes her focus on intraoperative pain during caesarean delivery after a sentinel event and how listening to patient narratives, including The...
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ANZCA ASM: Neuroscience, neuroimaging and practice in pain medicine
TopMedTalk
Recorded at ANZCA and the Faculty of Pain Medicine’s Annual Scientific Meeting in Auckland, TopMedTalk hosts Andy Cumstey and Kate Leslie interview visiting pain research leaders, Professor Irene Tracey, the Vice-Chancellor of the University of Oxford and Professor Lesley Colvin, the Chair of Pain Medicine at the University of Dundee and an Honorary Consultant in Anaesthesia and Pain Medicine at NHS Tayside. They discuss how thinking has shifted from chronic pain as a simple transition from acute pain, to a distinct disease with separate mechanisms and early “pre-vulnerability” factors...
info_outlineRecorded at the excellent ANESTHESIOLOGY® 2025 in San Antonio. Hear Andy Cumpstey and Mike Grocott interview Paul Myles, a Professor of Anaesthesiology and Perioperative Medicine at Monash University in Melbourne, Australia.
Here we focus upon his group’s approach to large pragmatic, multicenter international trials and the process of selecting and developing study questions within a clinical trials network. Myles presents the ITACS trial (intravenous iron treatment for anaemia before cardiac surgery), designed because anaemia is common (~30%) in elective cardiac surgery and is associated with increased complications, longer hospital stay, mortality, and greater transfusion requirements, while prior randomized evidence supporting routine preoperative IV iron clinics has been weak despite observational associations.
The two-arm randomized controlled trial enrolled about 1,000 patients scheduled for cardiac surgery 1–26 weeks ahead across 33 hospitals in 10 countries; patients with anaemia due to causes unlikely to benefit from iron (e.g., megaloblastic anemia, certain iron storage diseases) were excluded, while non–iron deficiency anaemia was included. Participants received a single 1 g dose of IV iron in the weeks preoperatively, with a primary endpoint of days alive and at home at 90 days to capture patient-centered recovery and the functional impact of complications.
Results included a statistically significant one-day improvement in days alive and at home, modestly higher preoperative haemoglobin, markedly improved iron indices, and a marked reduction in red cell transfusions intraoperatively and through 30 days and 3 months; the team estimated saving 44 units of red cells per 100 patients treated. The one-day benefit was mainly driven by fewer readmission days, and a formal cost-effectiveness analysis (with Australian resource-use data) is underway with planned publication within six months. The discussion highlights why mild anaemia matters in major surgery due to postoperative blood loss and recovery, and notes that while extrapolation to other major surgeries with expected blood loss >500 mL may be considered, the hosts and Myles emphasize ongoing equipoise and the need for additional large randomized trials outside cardiac surgery.
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We strongly suggest you investigate our forthcoming EBPOM Ireland conference, being held in the beautiful location of Dingle. World leading experts in perioperative medicine presenting the latest cutting edge research in periperative medicine and enhanced recorvery after surgery.
Find more information at EBPOM.org