Journal Club 1.12 | Various articles from; BMJ Open, Journal of Bone Joint Surgery American volume, Diabetes Care, Annals of Surgery.
Release Date: 02/21/2019
"At the moment perioperative care in the UK doesn't really have the profile that I think it needs; now I suspect that COVID-19 has raised it up the agenda" If you enjoyed Monty's explanation regarding the UK's perioperative journey you may find this link interesting: Evidence submitted by the Improving Surgical Outcomes Group (ISOG) (NICE 75): "Now we're here at this Pocapalooza" - POC, standing for Perioperative Care and "apalooza" being an extravagant event. However, as one of our guests suggests, perhaps we should call this one a "CPOC-apalooza!" as a lot of our focus is on The CPOC...info_outline POCAPALOOZA | Sydney: Education, education, education.
"It also must start and end in primary care" This piece is a fascinating in-depth conversation moving through various medical perspectives on perioperative medicine from Australia and New Zealand. A real highlight of the festival. How has perioperative medicine evolved over the years around the world? What's the status of Perioperative Care as a specialty? How does one specialise in this area, in terms of education? Discussing the development of the International Board:- "We decided perioperative education should not only be available for developed countries". We hear that TopMedTalk engaging...info_outline TopMedTalk | The Balanced Anesthesia Study
This piece focuses on The Balanced Anesthesia Study, 'A Prospective Randomized Clinical Trial of Two Levels of Anesthetic Depth on Patient Outcome After Major Surgery'. How can delerium be measured and standardised in a multi-centre trial? More on the study here: More on the Confusion Assesment Method here: The Hospital Elder Life Program (HELP) for Prevention of Delirium is here: We discuss the ENGAGES trial here: More on the Women in Anaesthesia Research, a BJA Symposium, here: Presented by Desiree Chappell and Monty Mythen with Lis Evered, neuroscientist and Head of Research in the...info_outline SCA | The Society of Cardiovascular Anesthesiologists
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 and Jamie Ramsey, Medical Director Cardiac ICU at UCF and Gerald Levy, MD at Duke University.info_outline Prato 2019 | The PREVENTT Trial
This piece focuses on the Preoperative Intravenous Iron To Treat Anaemia in major surgery (PREVENTT) trial; a randomized double-blind controlled phase III study to compare the efficacy and safety of intravenous ferric carboxymaltose with placebo in patients with anaemia undergoing major open abdominal surgery. The main question is if we properly mobilize our patients, feed them and correct their anemia, do they do better? How can we get a patient fitter for surgery? Can we correct anemia before surgery? "We took people prior to major open abdominal surgery [...] and our question was, in two...info_outline EBPOM 2019 | Multi-modal Prehabilitation
This panel discussion includes questions such as: In a prehabilitation service what screening tools should we use to assess nutritional risk? What tools are there related to patient self management? What advice would you give a patient about cannabis smoking cessation? Should denial of surgical procedures be used as a motivator for lifestyle change? Can the questions used in interventions sometimes be open to misinterpretation by patients? How do we assess and treat sleep disorders? If not a psychologist, what team members might handle psychological behaviour change? Does immunonutrition work?...info_outline EBPOM Highlight | ERAS Colorectal surgery
"ERAS in Colorectal Surgery" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 on If you'd like to attend an event like this ensure your next click is here: If you have any comments or questions you'd like to send to the team email: Presented by Anthony Senagore, Professor and Vice Chair Western Michigan University-Homer Stryker MD School of Medicine Borgess Medical Center Kalamazoo, MI.info_outline Prato 2019 | African Surgical Outcomes Study (ASOS-2)
This piece focuses upon the African Surgical Outcomes Study (ASOS-2). More than a thousand people across Africa have combined forces to make this research into perioperative medicine in a resource limited environment happen. We know patients in Africa are twice as likely to die following surgery when compared to the global average, why is this? How does "failure to rescue" play into this? The website mentioned in this piece for more details: Presented by Desiree Chappell with Monty Mythen and their guest Bruce Biccard, consultant anaesthetist at the University of Kwazulu-Natal, Director,...info_outline TopMedTalk | The psychology of change
"There seems to be a little extra buzz in the cardiac community". This conversation focuses upon the psychology of change, specifically regarding the leadership role presented within perioperative medicine to anaesthesiologists. How can perfectionism, as a barrier to change, be overcome? How do practitioners build the confidence to make a difference? Furthermore, how do we engage in 'internal marketing' where we promote success within our own institutions? More information on The Morpheus Consortium here: Check out the article here: Find out more about NorthStar here: The "Masters of Scale"...info_outline EBPOM 2019 | Ernest Henry Starling Plenary Lecure, Andrew Shaw, Fluid therapy in the 2020s
This hugely important talk was the centerpiece of EBPOM 2019 and, appropriately enough, it focuses on a big topic for us here at TopMedTalk; the future of fluid therapy. Originally given as the EBPOM 2019 Ernest Henry Starling plenary lecture the talk is complimented by this piece which was recorded on the same day: Where is the latest thinking on fluid therapy, what new evidence and understandings do we now have? Presented by Dr Andrew Shaw, Chairman, Department of Anesthesiology and Pain Medicine at The University of Alberta, Edmonton, Alberta and Zone Clinical Department Head for...info_outline
This piece ploughs into some of the academic papers that have provoked discussion recently in the perioperative community.
We discuss the following papers:
Risk factors for opioid-induced respiratory depression in surgical patients: a systematic review and meta-analyses.
Increased Postoperative Glucose Variability Is Associated with Adverse Outcomes Following Total Joint Arthroplasty.
Effect of A1C and Glucose on Postoperative Mortality in Noncardiac and Cardiac Surgeries.
Frailty as a Predictor of Death or New Disability After Surgery: A Prospective Cohort Study.
Presented by Desiree Chappell and Monty Mythen with their guest Paul Grant, Hospitalist and Director of Perioperative and Consultant Medicine at the University of Michigan.
Do you have your ticket to the Dallas Master's Course being organised in March by EBPOM USA yet?
Find out more here: https://www.ebpom.org/EBPOM-USA-2019
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