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

TopMedTalk

Release Date: 11/23/2020

EBPOM London 2020 | Perioperative care: A new paradigm for the next decade show art EBPOM London 2020 | Perioperative care: A new paradigm for the next decade

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"Patients undergo surgery for important reasons, we need to improve surgical outcomes to the point where anyone can have surgery - and I believe that is do-able; we need to implement what we know, we need to avoid missed opportunities and we need to conduct more research. We should learn from the history of anesthesiology and how intraoperative care so dramatically improved outcomes" This powerful data based talk sets a bold standard for the year, a highlight from the momentous (Evidence Based Perioperative Medicine) EBPOM 2020 - Live From London, it featured as this year's Ernest Henry...

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Dingle 2020 | Talks to ... Bob Thiele show art Dingle 2020 | Talks to ... Bob Thiele

TopMedTalk

This piece is a chance to hear more about the work of our guest, who made a big impact as a guest on a recent edition of TopMedTalk: The Perioperative Quality Initiative (POQI) is here: This piece covers cerebral oximetry with near-infrared spectroscopy (NIRS), often used during the perioperative period of cardiovascular operations. Article here: "American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on the Role of Neuromonitoring in Perioperative Outcomes" We're celebrating Evidence Based Perioperative Medicine's (EBPOM) Dingle conference...

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TopMedTalk | Hemodynamics - State of the Science show art TopMedTalk | Hemodynamics - State of the Science

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This piece explores the current thinking on hemodynamics, get ready for a deep dive into the conversation and controversies. Originally streamed live from www.topmedtalk.com as part of our coverage of The EBPOM USA Dallas Master's Course 2019. This panel discussion is chaired by Desiree Chappell, CRNA from Louisville Kentucky and Board Member of ASER. It features Monty Mythen, TopMedTalk Editor In Chief, Smiths Medical Professor of Anaesthesia and Critical Care at University College London, Tim Miller, from Duke University Medical Centre and Dr Simon Davies, Consultant Anaesthetist at York...

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TopMedTalks to ... | Paul Grant show art TopMedTalks to ... | Paul Grant

TopMedTalk

This piece ploughs into some of the academic papers that have provoked discussion 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...

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COVID 19 | Roneet Lev, San Diego show art COVID 19 | Roneet Lev, San Diego

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This piece took a look at the San Diego front line of the global fight against COVID 19 on March the 30th at the start of the crisis. What unique pressures were there; the large homeless population is a particular challenge, how do psychiatric patients further the conundrum. Also, what about the assumption that patients are likely to be carrying the virus so should all be treated as if that is the case, does that apply here? Presented by Desiree Chappell with Roneet Lev, MD FACEP, Chief Medical Officer, White House Office of National Drug Control Policy Director of Operations, Scripps Mercy...

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TopMedTalk | Research and development during COVID and beyond show art TopMedTalk | Research and development during COVID and beyond

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This piece is a conversation with friends of ours at Medtronic. Now is an interesting and resource-scarce time for everyone in medicine; Medtronic made huge waves here with their support of the Ventilator Training App, today we ask them about where it's at and how things are changing in the world of medical technology. How does product development actually work these days? How important have standards of proof become? Should we celebrate the fact hardware appears to be being pushed toward a similar evidence standard needed to take a new drug to market? How are research and development...

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AANA | Outcome criteria associated with residual neuromuscular blockade show art AANA | Outcome criteria associated with residual neuromuscular blockade

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"The more I learn about this, the more my eyes are opened to how much opportunity we have to improve in this area" This piece covers the "perennial topic" of whether paralysis is bad for breathing, here with a focus upon outcome criteria associated with residual neuromuscular blockade. It's a piece based in part upon a recent talk at the American Association of Nurse Anesthetists annual conference which was this year held virtually. Presented by Desiree Chappell with her guest Brent Dunsworth, CRNA, DNP, Director of Advanced Practice for the Department of Anesthesiology at Vanderbilt...

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EBPOM 2020 London | Extending roles: what is the future? show art EBPOM 2020 London | Extending roles: what is the future?

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"Just having more staff doesn't always equate to better care, especially when the staff do not have the skills required." Perioperative medicine has the opportunity to lead the way in advanced practice; the extended role of the practitioner within the perioperative pathway can be done with nurses, allied health professionals or physician associates. As we evolve these roles, we must be mindful and recognise not all services will be the same. How can you tailor your service to your specific needs? How do you construct a business case which provides a better quality of value based care within...

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DINGLE 2020 | Covid 19 - ventilation strategies show art DINGLE 2020 | Covid 19 - ventilation strategies

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This vital piece deals with a variety of issues related to COVID-19; what we know and what we know we do not know: - Similarities and differences between COIVD-19 and Aqute Respiratory Distress Syndrome (ARDS) - The most useful information observed by practitioners at the bedside, conscious of the lack of Randomised Controlled Trials (RCTs) in this area - The controversy regrading early invasive ventilation versus non-invasive ventilation - What are the aerosolization risks? - Pragmatic patient prioritization - The role of anti-coagulation - The role of continuous positive airwave pressure...

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TopMedTalk | Henrik Kehlet and Nick Scott show art TopMedTalk | Henrik Kehlet and Nick Scott

TopMedTalk

"It's all about safety and recovery, it's not about speed"; this conversation focuses on enhanced recovery, are we getting it right and where are people getting it wrong? How reliable and well understood is the data behind it? Also, what are the current thoughts on perioperative steroids? How do we refocus and move back to enhanced recovery after surgery rather than "enhanced discharge" after surgery. Presented by Monty Mythen and Desiree Chappell with Sol Aronson, tenured Professor at Duke University, and their guests Henrik Kehlet, a gastrointestinal surgeon and former professor of surgery,...

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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: https://bjanaesthesia.org/article/S0007-0912(19)30443-X/abstract

This paper here "Perioperative goal directed therapy using automated closed-loop fluid management: the future?" is also referenced: https://www.ncbi.nlm.nih.gov/pubmed/26578397

You may also find this piece, which our guest is also part of, here interesting: https://www.ncbi.nlm.nih.gov/pubmed/29068831

Presented by Desiree Chappell and Monty Mythen with their guest Alexandre Joosten, Anesthetist at Hospital Erasme.