ICU playlist

Clinician Educator Incubator program

Mon, 29 Jan 2024 03:10:39 +0000

Clinical medicine has always been taught with a strong emphasis on the master-apprentice model. This relies heavily on clinical educators, many of whom give their time freely.

However, many do so without any formal instruction in education and training.

Our guest on this podcast is Dr Chris Nickson, a world renowned educator and intensivist from the Alfred Hospital in Melbourne. Among his extensive achievements, Chris is Clinical Adjunct Associate Professor at Monash University, a founder of leading educational site Life in the Fast Lane, and the Lead for the Clinician Educator Incubator. He joins me on the podcast to talk about the Incubator Program.

See omnystudio.com/listener for privacy information.

Oesophageal manometry

Mon, 18 Sep 2023 00:18:02 +0000

Mechanical ventilation is indeed a lifesaving intervention. However, it is clear that positive pressure ventilation itself has the potential to cause harm. Novel approaches to ventilation aim to minimise this risk, and one such strategy is the incorporation of oesophageal pressure monitoring.

Tai Pham is a staff intensivist in Paris and an assistant professor at Paris Saclay university. He completed a PhD in public health where he focussed on respiratory physiology and mechanical ventilation, and is a member of the executive committees for Lung Safe and Wean Safe studies.

See omnystudio.com/listener for privacy information.

Weaning induced pulmonary oedema (WIPO)

Mon, 31 Jul 2023 01:15:50 +0000

If you’ve worked in ICU for very long, you’ll recognise the scenario where a patient who is weaning from mechanical ventilation goes into pulmonary oedema. This syndrome is referred to as weaning induced pulmonary oedema, or WIPO.

Dr Rui Shi currently works as an intensivist in the surgical ICU of the First Affiliated Hospital at Sun Yet Sen University in China.

Rui has a strong interest in haemodynamic monitoring in critical care in which she has done a PhD, and she joins Todd to talk about this fascinating clinical problem.

See omnystudio.com/listener for privacy information.

TAME

Mon, 17 Jul 2023 01:54:46 +0000

The ultimate outcome for patients who are resuscitated from cardiac arrest depends heavily on the neurological damage that results from a low flow state. Prevention of further damage during this phase is one of the core goals of post resuscitation care.

In recent years, a multitude of research papers have been produced which examine various aspects of this approach, including oxygenation and blood pressure targets.

One alternative strategy may be to increase cerebral blood flow by allowing mild therapeutic hypercapnoea, an approach studied in the recently released TAME trial. Principle investigator of the study, Glenn Eastwood, joins Todd on the podcast to discuss the key features and results from this important trial.

See omnystudio.com/listener for privacy information.

Excessive treatment

Mon, 24 Apr 2023 00:56:11 +0000

This podcast comes to you from the 2022 LIVES conference in Paris.

In recent years, concerns have been raised that patients may be receiving excessive treatment at the end of their lives, with a cost to patients, their families and the health system in general

But how is it identified, and what can we do to address the issue?

Dominique Benoit is a Belgian Intensivist and he joins Todd to discuss

See omnystudio.com/listener for privacy information.

eCPR and the SHERPA trial

Tue, 18 Apr 2023 08:00:20 +0000

This podcast comes to you from the 2023 ANZICS Clinical Trials Group Noosa meeting.

ECMO (extracorporeal membrane oxygenation) is steadily embedding itself into modern critical care medicine.

Does it have a role in pre-hospital setting for patients with refractory cardiac arrest?

In this podcast, we are joined by Aidan Burrell to talk about the SHERPA trial.

See omnystudio.com/listener for privacy information.

Dexmedetomidine for NIV

Fri, 07 Apr 2023 22:18:46 +0000

Non invasive ventilation is steadily establishing itself as a crucial component of the critical care armoury. While many patients can tolerate it, some require sedation.

Wisam Al-Bassam is a staff specialist at Monash Medical center and Victorian Heart hospital. Wisam is passionate about education and research, and his research interests include mechanical ventilation and sedation in ICU. He joins Todd to talk about the role of dexmedetomidine in patients on non invasive ventilation in the ICU

See omnystudio.com/listener for privacy information.

Fluids in DKA

Sun, 26 Mar 2023 21:48:00 +0000

DKA causes a serious disturbance of fluid and electrolyte balance.

However, it is said that more complications are caused by our management than by the disease itself. This is no more apparent than in our management of the patient's fluids.

Professor Bala Venkatesh is a world renowned intensive care researcher and he joins Todd to discuss the BEST-DKA trial

See omnystudio.com/listener for privacy information.

Inotropes in cardiogenic shock

Thu, 23 Mar 2023 06:22:24 +0000

Sometimes the failing heart needs support, and inotropic agents are often instituted ahead of other measures such as ECMO

But is there a best agent?

Antoine Kimmoun is a professor of Critical Care Medicine at the University of Lorraine, France, and he joins Todd to discuss these important agents.

See omnystudio.com/listener for privacy information.

DIC

Tue, 14 Mar 2023 20:42:49 +0000

This podcast comes to you from the 2022 LIVES Conference in Paris

Disseminiated intravascular coagulation is the endpoint of a range of different conditions, including sepsis. How does this important clinical condition evolve, and what can we do about it?

Mirjam Bachler is a senior post doc researcher in surgery at the Department of Anaesthesiology and Intensive care Medicine at Innsbruck, Austria. Her key interests are coagulation in critical care, particularly after inflammatory diseases.

She joins Todd to talk about DIC in sepsis.

See omnystudio.com/listener for privacy information.

Logical

Sun, 12 Mar 2023 22:11:52 +0000

Cardiac arrest causes neurological injury through a sustained period of hypoxia and ischaemia. It has long been thought that avoiding further hypoxia could save vulnerable brain tissue, leading to the common practice of deliberate hyperoxygenation.

However, recent research has suggested this approach may in fact be harmful.

Paul Young is an Intensivist and critical care researcher from Wellington in New Zealand, and he joins me to discuss an upcoming study which will further explore this issue, LOGICAL

See omnystudio.com/listener for privacy information.

Driving pressures in Acute respiratory failure

Thu, 09 Mar 2023 06:14:35 +0000

This podcast comes to you from the 25th Annual Noosa meeting of the ANZICS Clinical Trials Group.

It is now well recognised that mechanical ventilation, while potentially lifesaving, also causes damage to the lung in its own right. Careful setting of the ventilator is crucial to avoiding lung injury. While plateau pressure ceilings have been recommended for many years, research attention is now turning towards driving pressure.

Neil Ferguson is the head of critical care at the University Health Network and Mt Sinai Health Systems in Toronto, and has an extensive research history in critical care ventilation

See omnystudio.com/listener for privacy information.

Are cardiac arrest outcomes improving?

Tue, 07 Mar 2023 05:02:00 +0000

This podcast comes to you from the 2022 LIVES Conference in Paris

Sudden cardiac arrest in the community has historically had a poor prognosis. Improvements in prehospital care and post resuscitation interventions have raised hopes that overall survival has improved.

But has it?

Tommaso Scquizzato is a researcher in the fields of cardiac arrest and resuscitation science at San Raffaele Hospital in Milan, Italy and member of the European resuscitation council BLS Science and Education Committee

You can follow Tommaso on twitter too - @tscquizzato

See omnystudio.com/listener for privacy information.

Trauma Induced Coagulopathy

Fri, 10 Feb 2023 22:40:18 +0000

Managing bleeding in a patient with severe trauma is a complex process, with multiple interventions occurring in parallel.

Derek Kleinveld is an anesthesiology resident at the Erasmus MC in Rotterdam, The Netherlands, and a post-doc researcher with an interest in Trauma Induced Coagulopathy. He joins Todd to discuss haemostatic resuscitation in trauma.

See omnystudio.com/listener for privacy information.

Nutrition in survivors of critical illness

Mon, 12 Dec 2022 02:09:32 +0000

There has been an intense focus on the nutritional needs of ICU patients in recent years, but what happens to them when they go to the wards?

This important question is now the subject of interest for highly regarded critical care dietitians and researchers Lee-anne Chapple and Emma Ridley.

See omnystudio.com/listener for privacy information.

TEAM

Wed, 07 Dec 2022 06:14:32 +0000

It is well known that critical illness often features a pro-catabolic state, which can lead to muscle atropy and long term functional deficits. Early mobilisation has been thought to slow the rate of muscle loss, and potentially improve these outcomes.

Professor Carol Hodgson is Head of the Division of Clinical Trials and Cohort Studies, School of Public Health and Preventive Medicine, at Monash University in Melbourne, Australia.

She joins Todd on the podcast to talk about the recently released TEAM trial.

This is another great interview from the 2022 ANZICS CTG meeting in Noosa

See omnystudio.com/listener for privacy information.

AKI in trauma

Wed, 30 Nov 2022 22:13:35 +0000

How important is AKI in trauma? Can we predict which patients will be affected? What can we do to stop it?

These questions and many more have troubled intensive care clinicians as they care for patients after severe trauma. Dr Anatole Harrois joins Todd on the podcast to talk all-things AKI in trauma

See omnystudio.com/listener for privacy information.

Ventilation in TBI

Wed, 16 Nov 2022 20:47:17 +0000

In traumatic brain injury, the lung and the brain are caught in a complex interplay, where the challenges of managing one can affect the other.

Chiara Robba is a consultant in Neuro and General Intensive Care at Policlinico San Martino, Genova. She has a PhD in neuroscience and is the current chair of the NeuroICU section of the ESICM. Chiara joins Todd to discuss her thoughts on this important issue.

See omnystudio.com/listener for privacy information.

Patient induced lung injury

Sun, 13 Nov 2022 01:01:33 +0000

Ventilation is known to cause injury to the lungs in its own right, but now it is becoming clear that the respiratory effort of the patient may also contribute to ongoing pulmonary damage.

Antonio Pesenti joins Todd to discuss what we know, and the future of research in this area.

See omnystudio.com/listener for privacy information.

SuDDICU final

Wed, 26 Oct 2022 23:32:44 +0000

The SuDDICU trial is now in print. This long awaited trial explored the merits of Selective Digestive Decontamination (SDD), and in parallel studied its potential impact on the local microbiology resistance patterns.

After over 15 years of work, principle investigator Ian Seppelt joins Todd on the podcast to discuss the trial, the results, and what it all means

See omnystudio.com/listener for privacy information.

Cardiac injury in COVID-19

Fri, 14 Oct 2022 20:35:05 +0000

COVID-19 is a multisystem disease, and cardiac injury has been identified as a major contributor to the pathology.

Antoine Vieillard-Baron is an intensivist and researcher from Boulogne in France, and he joins the podcast to talk about key echocardiographic patterns of disease found in COVID-19

See omnystudio.com/listener for privacy information.

Thrombotic microangiopathy

Tue, 13 Sep 2022 00:13:19 +0000

Thrombotic microangiopathies are uncommon disorders, and can result in significant patient morbidity. With the introduction of effective new therapies, the outlook for those suffering from these diseases is increasingly optimistic.

Elie Azoulay is a professor of medicine, intensivist and board member of the French National Reference Centre for Thrombotic Microangiopathies.

See omnystudio.com/listener for privacy information.

Preventing sternotomy infections

Tue, 06 Sep 2022 23:59:08 +0000

Surgical site infections are a dreaded complication of all surgery, no more so than in cardiothoracics. Antibiotics at the time of surgery has an established role in the prevention of infections, but the duration of therapy remains contentious.

The CALIPSO trial will explore different approaches to this question, and chief investigator Trisha Peel joins Todd on the podcast to discuss the issue.

See omnystudio.com/listener for privacy information.

Fluid responsiveness

Thu, 01 Sep 2022 02:16:01 +0000

Does my patient need bolus IV crystalloid fluids?

This is a conundrum faced on a daily basis for clinicians working in the ICU. As time goes by, more evidence of the harm fluids do becomes available, so how can we be sure the fluids we give benefit our patients?

Xavier Monnet is an intensivist and fluids researcher, and he joins Todd on the podcast to discuss fluid responsiveness.

See omnystudio.com/listener for privacy information.

Antimicrobial stewardship

Tue, 23 Aug 2022 22:48:50 +0000

The development of antimicrobial agents is one of the most influential achievements of modern medicine. However, where once we thought the days of sepsis deaths could be numbered, antimicrobial resistance has given us pause for pessimism.

Professor Jan De Waele is a surgery-trained intensivist and clinical researcher from Ghent, Belgium, working on several aspects of optimizing antimicrobial use in the ICU, including Antimicrobial Stewardship.

See omnystudio.com/listener for privacy information.

Gut ischaemia in ICU

Mon, 20 Jun 2022 06:10:35 +0000

The impact of resuscitation strategies on the gut is often neglected, as attention to circulatory and respiratory support takes priority.

Leading ICU dietitian Varsha Asrani joins Todd to chat about the implications of gut ischaemia for the longterm recovery of our patients.

See omnystudio.com/listener for privacy information.

Membrane plasma exchange

Wed, 13 Apr 2022 22:15:07 +0000

Plasmapheresis can be a life saving intervention in a number of ICU conditions. Two potential methods are available – centrifugal plasmapheresis and membrane therapeutic plasma exchange. But what do we know about the applicability, utilisation and complications of the latter?

On this episode, Todd is joined by Mitul Chavda and Alpesh Patel, who recently published 6 years worth of prospective data from their service, run from the Flinders Medical Centre in South Australia.

Baxter Healthcare has provided an educational grant to sponsor this podcast. The content was developed independently of Baxter Healthcare and opinions expressed are those of the presenting healthcare professionals.

See omnystudio.com/listener for privacy information.

CLIP-2 part 2

Tue, 12 Apr 2022 23:38:30 +0000

Part 2 of this interview with CLIP-2 chief investigator Michael Reade explores the structure of CLIP-2, some of the challenges the project has had to overcome, and the workings of a non-inferiority trial.

See omnystudio.com/listener for privacy information.

CLIP-2 part 1

Fri, 08 Apr 2022 23:03:16 +0000

Platelets are a critical component of haemostatic resuscitation, but there are significant challenges involved in their use, most notably, their short shelf life.

Could frozen platelets be the answer?

Michael Reade is an anaesthetist, intensivist and clinical researcher from the University of Queensland and the Australian Defence Force, and he joins Todd to discuss his research program in this area, known as CLIP

See omnystudio.com/listener for privacy information.

Ketamine in ICU

Tue, 29 Mar 2022 02:55:00 +0000

Ketamine is regarded as a bit of a wonder drug in emergency and critical care areas, but is it all that it’s cracked up to be.

Andrew Casamento is an Intensivist / Emergency Physician at the Northern, Austin, Warringal Private and Bendigo Hospitals in Victoria, and is the author of a recent review of the role of ketamine in mechanically ventilated ICU patients. He joins Todd on the podcast to discuss some of the important points.

See omnystudio.com/listener for privacy information.

ProMEDIC - melatonin to prevent ICU delirium

Wed, 16 Mar 2022 03:05:40 +0000

Delirium and sleep deprivation are known to go hand in hand in the ICU.

Could melatonin, a readily available, safe and cheap hormonal therapy, improve sleep, and thereby delirium, in a general population of ICU patients?

Lead investigator of the recently released ProMEDIC study Dr Brad Wibrow joins Todd to discuss the results of his study.

See omnystudio.com/listener for privacy information.

Interstitial Lung Disease in ICU

Thu, 03 Mar 2022 04:01:24 +0000

Interstitial Lung Disease is like a black box for many intensivists. The complexity of the pathology seems to be only matched by the complexity of the diagnostic classification, and the drug names used to treat them.

James Lindstrom is a dual trained intensivist and respiratory physician in Geelong, Australia, and he joins me to explore some of the issues related to ILD in the ICU

See omnystudio.com/listener for privacy information.

Diabetic ketoacidosis

Sun, 09 Jan 2022 23:06:00 +0000

It has been said that more people suffer harm from our management of diabetic ketoacidosis than those that do from the disease itself.

So how do we avoid these pitfalls in the emergency department?

Adan Atriham is an emergency physician from Houston, Texas

See omnystudio.com/listener for privacy information.

Cardioversion

Sun, 02 Jan 2022 04:21:28 +0000

Unstable patients with tachyarrhythmias may need urgent cardioversion in the emergency department.

Dr Eleni Salakidou is a specialist in emergency medicine at the University General Hospital of Heraklion, and she joins Todd on the podcast to share her tips for safe and successful cardioversion.

See omnystudio.com/listener for privacy information.

Necrotising fasciitis

Mon, 13 Dec 2021 21:11:43 +0000

Necrotising fasciitis is a scary disease for even the most experienced of emergency physicians.

Dr Michael Gleenberg is an emergency physician and Residency Director at the Assuta Ashdod University Hospital in Israel, and he joins Todd to discuss the identification and management of this important disease process

See omnystudio.com/listener for privacy information.

Pre-filled syringes

Fri, 03 Dec 2021 05:10:00 +0000

Medication errors are a significant challenge to the safety of patients. Pre-filled syringes represent an opportunity to prevent errors related to medication preparation, and may have additional cost and efficiency savings.

Dr Rhys Thomas is an anaesthetist and the Quality and Safety Fellow at John Hunter Hospital in New South Wales. He joins Todd to share his experiences with pre-filled syringes

See omnystudio.com/listener for privacy information.

Reversing DOACs

Sun, 21 Nov 2021 23:42:04 +0000

The critically ill bleeding patient who is taking novel oral anticoagulant medications is a difficult clinical challenge.

Dr Barbra Backus is an emergency physician from The Netherlands, and she joins Todd to discuss some of the important issues in managing this problem.

See omnystudio.com/listener for privacy information.

NIV for SCAPE

Sat, 13 Nov 2021 00:56:30 +0000

Acute cardiogenic pulmonary oedema is a common presenting complaint in the emergency department.

Dr Roberto Cosentini is an emergency physician from Bergamo in Italy. He joins Todd to discuss the use of NIV in the management of these patients.

See omnystudio.com/listener for privacy information.

Transcutaneous pacing

Thu, 11 Nov 2021 03:51:30 +0000

Transcutaneous pacing is an important emergency skill. In this podcast, senior emergency medicine trainee Dr Tim Balfour joins Todd to discuss the indications for pacing, describe the process of applying and adjusting it, and share some tips and tricks for its use.

See omnystudio.com/listener for privacy information.

Indirect calorimetry

Wed, 20 Oct 2021 03:37:00 +0000

As Indirect Calorimetry becomes more practical at the bedside, how will it influence nutritional prescription?

Oana Tatucu is a senior ICU dietitian and a research fellow at the ANZICS Research Centre. She joins Todd on the podcast to discuss the role of IC now and into the future.

See omnystudio.com/listener for privacy information.

Decompensated pulmonary hypertension

Fri, 15 Oct 2021 00:02:00 +0000

Patients with chronic pulmonary hypertension can present to hospital acutely unwell. What are the principles of managing these patients?

Cardiologist Dr Kavitha Muthiah joins Todd on the podcast to discuss the underlying causes, precipitants, management and rescue options for these patients.

See omnystudio.com/listener for privacy information.

Bronchopleural fistula

Mon, 20 Sep 2021 05:09:00 +0000

Bronchopleural fistula is an important diagnosis to consider in patients with persistent and high volume pneumothoraces.

Dr Izzy Seneviratne is a dual trained Intensivist and Respiratory Physician who joins Todd on the podcast to talk about the diagnosis and management of this important condition.

See omnystudio.com/listener for privacy information.

Targeted temperature management

Fri, 27 Aug 2021 21:44:45 +0000

Targeted temperature management has become a mainstay of treatment for resuscitated patients following cardiac arrest.

Manoj Saxena is an intensivist and clinician researcher from Sydney, Australia, and was part of the team that delivered the TTM-2 trial earlier in 2021. He joins Todd on the podcast to discuss the premise of TTM-2, the results and what comes next.

See omnystudio.com/listener for privacy information.

Vaccine induced thrombotic thrombocytopenia

Tue, 03 Aug 2021 07:32:00 +0000

As the world wrestles with the COVID-19 pandemic, it’s clear that much depends on our ability to vaccinate a large proportion of the population.

Like all medications, vaccines have their side effects, and the most notable at present is an unusual syndrome of intravascular clotting associated with thrombocytopaenia.

Dr Tim Brighton is a consultant haematologist with New South Wales Health, and a participant in a recent working party that developed guidelines for the detection and management of this important condition, known as Vaccine Induced Thrombotic Thrombocytopaenia, or VITT.

See omnystudio.com/listener for privacy information.

Drug dosing in pneumonia

Wed, 28 Jul 2021 00:25:25 +0000

The importance of adequate antibiotic dosing in sepsis and pneumonia is well known. However, changes in the pharmacokinetics and dynamics of antibiotics makes it challenging to ensure the appropriate doses are given.

Dr Jason Roberts is an internationally renowned ICU pharmacist and researcher, and he joins Todd to discuss these important issues, and some potential solutions.

See omnystudio.com/listener for privacy information.

Airway Pressure Release Ventilation

Thu, 15 Jul 2021 23:45:15 +0000

Manipulating the ventilator to protect the critically ill ARDS patient from harm, while simultaneously improving their condition, is one of the dark arts of intensive care practice.

Airway Pressure Release Ventilation is a somewhat novel mode of mechanical ventilation which seeks to enhance lung recruitment while reducing lung injury. Ed Litton is an Intensivist and researcher from the Fiona Stanley Hospital in Perth, Australia, and he joins Todd to chat about his approach to APRV

See omnystudio.com/listener for privacy information.

Critical illness - the patient perspective

Wed, 07 Jul 2021 01:53:44 +0000

Traditionally we’ve measured the performance of the health system machine on hard endpoints such as mortality, and this is particularly so in ICU.

In recent years however, we’ve begun to focus more on the patient experience, including their functional outcomes. Narrative and qualitative research has provided us with a better understanding of the emotional, psychological and physical trauma imposed by critical illness.

Kali Dayton is a nurse practitioner in ICU, and through her podcast “Walking Home from the ICU”, has helped shine the spotlight on this important issue through a series of interviews with survivors of critical illness. She joins Todd on the podcast to share what she's learned.

You can find Kali's podcast here : https://anchor.fm/restoringlife

See omnystudio.com/listener for privacy information.

Referring for ECMO

Tue, 06 Jul 2021 00:47:00 +0000

Extracorporeal membrane oxygenation (ECMO) is an increasingly available therapy, though it remains restricted to tertiary centres. So what does this mean for smaller peripheral units?

Dr Sara Allen is an intensivist and anaesthetist from the Auckland City Hospital in New Zealand, and she joins Todd to discuss referrals for ECMO.

See omnystudio.com/listener for privacy information.

Preventing IV complications

Fri, 02 Jul 2021 05:15:00 +0000

The intravenous cannula may be the most common procedure performed in healthcare. You probably perform several of them a day, without thinking twice.

However, without attention to detail, it’s possible the humble cannula could cause your patient harm.

Gillian Ray-Barruel is an experienced nurse researcher at Griffith University in Australia. Among her numerous research interests, Gillian has extensive experience in prevention of indwelling device-related patient complications.

See omnystudio.com/listener for privacy information.

Bronchopleural fistula

Wed, 30 Jun 2021 22:39:25 +0000

Large and persistent bronchopleural fistulae are one of the more challenging problems to manage in ICU practice.

In this enlightening interview, Intensivist and Respiratory Physician Dr Michael Putt discusses the principles of management, and the role of bronchoscope intervention.

See omnystudio.com/listener for privacy information.

Net Ultrafiltration Rate

Wed, 16 Jun 2021 05:26:00 +0000

Many patients undergoing Continuous Renal Replacement Therapy in ICU require fluid removal.

But how fast can you remove it?

Dr Emily See is a Nephrologist and senior ICU fellow at the Austin Hospital in Melbourne Australia. She joins Todd on this edition of the podcast from the 2021 ANZICS CTG meeting in Noosa to talk about the concept of Net Ultrafiltration Rate, and the upcoming NEPTUNE study.

Baxter Healthcare has provided an educational grant to sponsor the following podcast. The content was developed independently of Baxter Healthcare and opinions expressed are those of the presenting healthcare professional.

See omnystudio.com/listener for privacy information.

Paediatric sepsis trials

Mon, 21 Jun 2021 00:30:00 +0000

While sepsis research in adults has gathered pace in recent years, similar work in paediatrics is lacking.

Among those looking for the elusive "magic bullet" are researchers Sainath Raman and Luregn Schlapbach. In this fascinating podcast, they discuss the limitations of research in paediatric sepsis, the current evidence landscape, and their upcoming RESPOND trial.

See omnystudio.com/listener for privacy information.

Driving pressure to set tidal volume

Thu, 03 Jun 2021 05:55:59 +0000

Limiting tidal volumes to prevent lung injury has been a core plank of ICU care for the past 20 years.

However, is it that simple? Dr Ewan Goligher joins us to discuss how using the driving pressure to set Vt may help tailor ventilation to the patient's needs.

See omnystudio.com/listener for privacy information.

Oncology patients in ICU

Wed, 02 Jun 2021 07:42:00 +0000

While it remains an uncommon event, some patients with cancer require ICU level care.

Dr Tamishta Hensman is a senior ICU fellow at the Royal Darwin Hospital, and holds a Diploma of Palliative Care Medicine. Following her presentation at the recent CICM Annual Scientific Meeting, she joins Todd to discuss the latest data on survival, some common presentations, and some tips for talking to families.

See omnystudio.com/listener for privacy information.

Lung ultrasound in ICU

Tue, 01 Jun 2021 08:01:00 +0000

Lung ultrasound is gradually establishing itself as an invaluable point-of-care investigation in ICU and emergency medicine.

Dr Robert Arntfield is an intensivist and traumatologist from London, Ontario, and he joins Todd to describe how it fits into his clinical practice.

See omnystudio.com/listener for privacy information.

Outcomes for ventilation trials

Mon, 19 Apr 2021 04:02:00 +0000

Professor David Tuxen has had a long and distinguished career as an Intensivist, Director and researcher. Decades of research into mechanical ventilation have given David a unique perspective into trial interpretation, and he has recently raised his concerns about research outcomes in ventilation trials.

He joins Todd on the latest podcast from the 2021 ANZICS CTG Noosa meeting to discuss these issues.

See omnystudio.com/listener for privacy information.

James Winearls - fibrinogen in trauma

Mon, 29 Mar 2021 22:13:57 +0000

Hypofibrinogenaemia is an independent risk factor for mortality after severe trauma. How though should we manage it?

Dr James Winearls is an Intensivist and researcher from the Gold Coast University Hospital. In this special edition podcast from the 2021 Noosa ANZICS CTG meeting, he joins Todd to chat about the issue, and the FIESTY 2 study he leads

See omnystudio.com/listener for privacy information.

Early use of ECMO in respiratory failure

Mon, 15 Mar 2021 22:59:00 +0000

Extracorporeal membrane oxygenation (ECMO) has an established role as a rescue therapy in severe respiratory failure.

But could there be benefit in using it earlier, to avoid the potential complications associated with mechanical ventilation?

Dr Aidan Burrell is an intensivist and researcher from The Alfred Hospital in Melbourne, Australia, and he joins Todd on the first podcast from the 2021 Noosa ANZICS CTG meeting.

See omnystudio.com/listener for privacy information.

Matt Maiden - life limiting illness in ICU

Thu, 11 Mar 2021 02:55:00 +0000

The marvel that is modern Intensive Care has the capacity to save lives, and help survivors live long and satisfying lives. But it comes at a cost, both in terms of patient experience and cost.

Anecdotally, the number of patients with life-limiting illnesses are being referred for management in the ICU. This trend has given some clinicians pause to consider whether traditional ICU is the best place for their care.

Dr Matt Maiden led a team who studied the incidence of life limiting illness in ICU patients, and he joins Todd on the podcast to discuss the results and their implications.

See omnystudio.com/listener for privacy information.

Lise Estcourt - convalescent plasma in COVID 19

Tue, 02 Feb 2021 21:29:00 +0000

As the COVID-19 pandemic continues unabated, the search for meaningful therapies is being led by clinical researchers.

Dr Lise Estcourt is a consultant haematologist who has led major studies into the role of convalescent plasma in the treatment of COVID-19.

She joins Todd on the podcast to summarise the data so far.

See omnystudio.com/listener for privacy information.

Rob Bevan - Intensive Care Medicine

Fri, 08 Jan 2021 02:11:00 +0000

Intensive Care Medicine is a highly exciting and variable specialty, but it also carries with it the stress of caring for patients and their families under enormous duress.

Dr Rob Bevan is an Intensivist and supervisor of training at Middlemore Hospital in Auckland, New Zealand, and the current vice president of the Australia New Zealand College of Intensive Care Medicine

XDJ8eVCAs0ecJIoJq6sf

See omnystudio.com/listener for privacy information.

Andrew Udy - Cardiac arrest after SAH

Thu, 03 Dec 2020 06:23:00 +0000

Sudden cardiac arrest is a common event. Rarely though, it can be a feature of acute Subarachnoid Haemorrhage.

What impact does this have on the patient's prognosis?

A recent review of a binational ICU patient registry set out to explore this question, and one of the authors, Professor Andrew Udy, joins Todd on the podcast to discuss their findings

See omnystudio.com/listener for privacy information.

Lee-anne Chapple - protein metabolism in ICU

Thu, 01 Oct 2020 06:31:00 +0000

Malnutrition is common in ICU, and it stands to reason that it should impact on functional recovery.

Lee-anne Chapple is a senior dietician in critical care at the Royal Adelaide Hospital, and an NHMRC Early Career Fellow at the University of Adelaide. She joins Todd on the podcast to discuss her work in protein metabolism in critically ill patients

See omnystudio.com/listener for privacy information.

Dharshi Karalapillai - low volume ventilation in anaesthesia

Fri, 18 Sep 2020 22:00:00 +0000

Traditionally, anaesthetists have ventilated patients undergoing prolonged surgery with supra physiological tidal volumes to prevent collapse and improve oxygenation. But is this safe? Evidence from the critical care sphere suggests ventilator induced lung injury may be minimised with a more conservative approach.

Dharshi Karalapillai is an Intensivist-Anaesthetist from Melbourne's Austin Hospital, and is lead author of a paper which explored the role of a low volume ventilation strategy.

See omnystudio.com/listener for privacy information.

Tomoko Fujii - metabolic acidosis

Mon, 07 Sep 2020 01:08:00 +0000

Does metabolic acidosis cause harm to critically ill patients? Or is it just an epiphenomenon of severe illness?

In this podcast, lead investigator of the VITAMINS trial, Tomoko Fujii, joins Todd to discuss her latest program of research, the SODIBIC trial.

See omnystudio.com/listener for privacy information.

Colin McArthur - REMAP-CAP steroids

Wed, 02 Sep 2020 19:35:00 +0000

Colin McArthur is an Intensivist and director of research at Auckland City Hospital in New Zealand, and is the Co-lead for the Australia-New Zealand arm of the REMAP-CAP study, which today releases the results of its first domain study, corticosteroids.

Colin joins Todd on the podcast to discuss the results of this important trial

See omnystudio.com/listener for privacy information.

David Cooksley - Retrieval medicine

Fri, 14 Aug 2020 04:09:00 +0000

David Cooksley is an experienced Emergency and Retrieval Physician who currently works in the Emergency Department at the Sunshine Coast University Hospital and for LifeFlight Retrieval Medicine at their Maroochydore helicopter base. He has worked for four different retrieval services including twice with the London’s Air Ambulance, which is widely regarded as the world’s best pre-hospital trauma service. He is also a Wing Commander in the RAAF Specialist Reserve and is the Air Force’s Principal military critical care aeromedical transport team instructor and has successfully completed overseas training in military pre-hospital combat critical care.

Today David joins Todd on the podcast to share his experiences in retrieval medicine.

See omnystudio.com/listener for privacy information.

Lina Bergman - transporting ventilated patients

Wed, 29 Jul 2020 02:20:00 +0000

Transporting the ventilated patient is one of the highest risk processes critically ill patients will face

Lina Bergman is a critical care nurse and researcher from Gothenberg in Sweden, and she joins Todd on the podcast to discuss her research into this delicate process.

See omnystudio.com/listener for privacy information.

Tony Gordon - convalescent serum for COVID-19

Fri, 10 Jul 2020 06:17:00 +0000

As the COVID-19 pandemic surges ahead, researchers are desperately seeking evidence to support a range of potential disease modifying treatments.

On this episode, Prof Tony Gordon from Imperial Hospitals in London joins me to discuss one such potential therapy, convalescent serum. Tony is a prominent intensivist researcher and is the UK chief investigator for the REMAP-CAP study.

See omnystudio.com/listener for privacy information.

Carol Hodgson - disability after ICU and the PREDICT trial

Mon, 15 Jun 2020 03:56:00 +0000

Critical illness can have an overwhelming effect on the long term quality of life of survivors of ICU.

On this thought provoking interview, Professor Carol Hodgson joins Todd on the podcast to discuss the latest publication in her research program, the PREDICT trial, which was presented at the 2020 ANZICS Clinical Trials Group meeting in Noosa.

See omnystudio.com/listener for privacy information.

Colin McArthur - Hydroxychloroquine in COVID-19

Tue, 09 Jun 2020 07:25:00 +0000

The unfolding COVID-19 pandemic has seen an unprecedented sharing of information to support clinicians in making clinical decisions at the coal-face. But has this pressure to publish data come at the cost of lower standards of governance?

Colin McArthur, co-lead of the ANZ arm of the REMAP-CAP study joins Todd on the podcast to discuss the trials and tribulations of hydroxychloroquine, and THAT observational study.

See omnystudio.com/listener for privacy information.

Rinaldo Bellomo - volume control during CRRT

Mon, 01 Jun 2020 02:57:00 +0000

Research in the past decade has helped clarify dosing and indications for renal replacement therapy. But what about the management of volume status in a critically ill patient with acute anuric renal failure?

Professor Rinaldo Bellomo is one of the world's leading critical care nephrologists and researchers, and he presented his thoughts on this issue at the most recent Australia-New Zealand Intensive Care Society (ANZICS) Clinical Trials Group meeting in Noosa. He joins Todd to discuss the concept, and his plan for a research program to answer these questions.

See omnystudio.com/listener for privacy information.

Ben Moran - chronic pain in ICU

Mon, 25 May 2020 21:27:00 +0000

Chronic pain in survivors of ICU is remarkably frequent, yet remains poorly researched and managed. Dr Ben Moran is an anaesthetist and intensivist from New South Wales in Australia, and a PhD candidate at the George Institute in Sydney. He joins Todd on the podcast to discuss his research.

See omnystudio.com/listener for privacy information.

Ed Litton - High flow nasal oxygen therapy post cardiothoracic surgery

Mon, 04 May 2020 06:18:00 +0000

High flow nasal oxygen therapy is rapidly establishing itself as a low cost, low side effect treatment option in respiratory failure.

In this, another great podcast from the 22nd Annual Meeting of the Australia-New Zealand Intensive Care Society (ANZICS) Clinical Trials Group in Noosa, Australia, Todd is joined by Dr Ed Litton to talk about the upcoming NOTACS trial, an international study exploring its role in preventing complications post cardiothoracic surgery.

See omnystudio.com/listener for privacy information.

Mark Nichols - ANZICS COVID19 guidelines update

Mon, 27 Apr 2020 23:59:00 +0000

As the COVID-19 outbreak unfolds, increasing experience with the disease has allowed much to be learned.

Dr Mark Nichols joins Todd on the podcast to discuss the updated COVID-19 guidelines from the Australia-New Zealand Intensive Care Society (ANZICS).

See omnystudio.com/listener for privacy information.

Steve Warrilow - complex decision making

Wed, 22 Apr 2020 06:03:00 +0000

As the pandemic crisis grows, there is considerable anxiety among clinicians who may be required to make difficult decisions about the management of an overwhelming number of patients.

Former ANZICS president Stephen Warrilow chaired a working group which developed consistent guidelines to support these decisions and he joins Todd to discuss them in this essential podcast.

The guidelines can be found here

See omnystudio.com/listener for privacy information.

David Brewster - intubation for COVID-19

Mon, 06 Apr 2020 20:28:00 +0000

One of the most daunting tasks during the COVID-19 outbreak is intubation. Not only are the patients extremely sick and fragile, but the risks to staff and the strategies employed to prevent them add extra complexity.

Associate Professor David Brewster is an intensivist and anaesthetist and Melbourne's Cabrini Hospital, and a board member of the Safe Airway Society. He joins Todd to chat about the recently released SAS guideline for intubation of the COVID-19 patient.

The guidelines can be found here -

https://www.mja.com.au/journal/2020/consensus-statement-safe-airway-society-principles-airway-management-and-tracheal

During the interview David refers to the Intubate COVID study, which can be found here - http://bit.ly/intubatecovid

See omnystudio.com/listener for privacy information.

Steve Webb - REMAP-CAP

Thu, 02 Apr 2020 20:39:00 +0000

In the midst of the COVID-19 pandemic, researchers are working overtime to provide data to clinicians at the bedside. Among them is Professor Steve Webb from Monash University's School of Public Health and Preventative Medicine. Steve is the principal investigator of the REMAP-CAP study, a multi-factorial research program designed to provide meaningful results on potential interventions in real time.

See omnystudio.com/listener for privacy information.

Aidan Burrell - SPRINT SARI

Fri, 27 Mar 2020 04:47:00 +0000

In these uncertain early phases of the pandemic, it is critical that clinicians and policy makers alike have access to data to inform decisions. SPRINT SARI, established after the 2009 H1N1 outbreak, will collect demographic and management data from COVID-19 patients admitted to over 50 ICUs.

Aidan Burrell is an intensivist at Melbourne's Alfred Hospital, and is an Adjunct Senior Lecturer at Monash University. He joins Todd to share more on the SPRINT-SARI study

See omnystudio.com/listener for privacy information.

Anthony Holley - ANZICS COVID-19 guidelines

Mon, 23 Mar 2020 07:44:00 +0000

As the COVID-19 pandemic gathers pace, the Australia New Zealand Intensive Care Society has released guidelines for preparation, resource allocation and management of patients with COVID-19

In this special edition podcast, Anthony joins Todd to discuss the guidelines, which can be found here

See omnystudio.com/listener for privacy information.

Emma Ridley - Novice Investigators Group

Wed, 18 Mar 2020 22:36:00 +0000

Emma Ridley is the Manager of the ICU Nutrition Program at the Monash University ANZICS Research Centre. She joins Todd on the podcast to chat about another role she fills, as chair of the ANZICS CTG Novice Investigators Group

You can find more information about the group here

See omnystudio.com/listener for privacy information.

Glenn Eastwood - hypercapnoea after cardiac arrest

Fri, 13 Mar 2020 05:12:00 +0000

In this Osler special edition podcast from the 22nd annual Australia New Zealand Intensive Care Society (ANZICS) Clinical Trials Group meeting from Noosa, Todd chats to TAME-Cardiac Arrest lead investigator Glenn Eastwood about therapeutic permissive hypercapnoea in resuscitated cardiac arrest patients.

See omnystudio.com/listener for privacy information.

Shailesh Bihari - 20% albumin in sepsis

Thu, 05 Mar 2020 04:50:00 +0000

In this latest Osler podcast from the 22nd annual ANZICS Clinical Trials Group meeting from Noosa, Shailesh Bihari chats with Todd about his work with 20% albumin in sepsis resuscitation

Shailesh is an Associate Professor at Flinders University in Adelaide, and an NHMRC Early Career Fellow

See omnystudio.com/listener for privacy information.

Todd Rice - Pragmatic trials

Thu, 05 Mar 2020 02:12:00 +0000

In this special edition Osler podcast, live from the 22nd annual ANZICS Clinical Trials Group meeting in Noosa, Australia, renowned critical care trials Todd Rice joins us to chat about Pragmatic Clinical Trials.

Todd is an Associate Professor of Medicine in the Division of Allergy, Pulmonary and Critical Care Medicine at Vanderbilt University in Nashville, Tennessee

See omnystudio.com/listener for privacy information.

Albertina Pol and Stephane Bouchoucha - workplace violence in ICU

Sun, 09 Feb 2020 23:29:00 +0000

Violence in healthcare staff is anecdotally increasing. A recently released paper casts further light on this important issue, and explores whether the National E Admission Target (NEAT) is a new factor in triggering such episodes against ICU staff.

Authors Albertina Pol and Stephane Bouchoucha join Todd on the podcast to discuss their findings

The reference for the paper discussed in this podcast is found here:

Pol, Albertina & Bouchoucha, Stephane & Carter, Melody. (2018). Violence and aggression in the intensive care unit: What is the impact of Australian National Emergency Access Target?. Australian Critical Care.

See omnystudio.com/listener for privacy information.

Stephen Warrilow - acute liver failure

Fri, 13 Dec 2019 07:52:00 +0000

Patients with acute liver failure are relatively rare, but they can be spectacularly unwell.

In this enlightening interview, Dr Stephen Warrilow from Melbourne's Austin Hospital joins Todd to discuss the outcomes and management of this important group of patients.

See omnystudio.com/listener for privacy information.

Paul Secombe - ICU outcomes for Indigenous Australians

Thu, 28 Nov 2019 05:39:00 +0000

Paul Secombe is an intensive care physician at the Alice Springs Hospital in Australia. He is the lead author of a recent review of the presentation, resource needs and outcomes of indigenous Australians admitted to an intensive care unit.

He joins Todd on the podcast to explore the findings of this review, and what it means for the care of his patients.

See omnystudio.com/listener for privacy information.

Jocelyn Lowinger - coaching in health

Mon, 11 Nov 2019 22:28:00 +0000

Dr Jocelyn Lowinger initially trained as a GP before working in health, where she first came into contact with professional coaching. Fascinated by the idea, she undertook further training, and now offers this service across the healthcare industry.

She joins Todd on the podcast to discuss coaching and how it applies to the modern health paradigm.

Interested listeners can find more information at Jocelyn's website : https://coachgp.com.au/

See omnystudio.com/listener for privacy information.

Paul Young : Mitigating the risk of hyperoxia - the ICU-ROX trial

Wed, 16 Oct 2019 09:44:00 +0000

Is hyperoxia harmful in ICU patients? Does a restrictive approach to prescription of FiO2 in ventilated patients improve patient centred outcomes?

These questions have led to the ICU-ROX trial, which was recently released at the World Congress of Intensive Care in Melbourne, Australia. Principle investigator Dr Paul Young presented the paper, and joins Todd on the podcast to discuss the results, and where we go from here.

See omnystudio.com/listener for privacy information.

Daryl Jones - In hospital cardiac arrest

Wed, 02 Oct 2019 06:51:00 +0000

Associate Professor Daryl Jones is an intensivist from The Austin Hospital in Melbourne, Australia. He joins Todd on the podcast to discuss the nature of in-hospital cardiac arrest in the era of a modern Rapid Response Team.

See omnystudio.com/listener for privacy information.

Nellie Dick - acute pain management

Mon, 23 Sep 2019 23:02:00 +0000

Managing acute pain is a common task faced by all junior doctors. With a range of analgesics available, and a seemingly endless variety of conditions to apply them to, this task can become quite complex.

In this podcast, Todd chats with Dr Nellie Dick, an anaesthetist with a special interest in the management of acute pain.

See omnystudio.com/listener for privacy information.

Daniel Cudini - prehospital antibiotics in sepsis

Thu, 19 Sep 2019 04:38:00 +0000

Ensuring patients get the right treatment at the right time is a core ambition of a modern healthcare system, and there is no better example of this than the early administration of antibiotics in patients with severe sepsis.

Daniel Cudini is an Intensive Care Paramedic and Clinical Support Officer with Ambulance Victoria, and is a noted prehospital researcher. He joins Todd on the podcast to chat about the PASS study - Paramedic Antibiotic administration in Severe Sepsis.

See omnystudio.com/listener for privacy information.

Rob Dickson - remote and rural medicine

Sun, 15 Sep 2019 01:07:00 +0000

Dr Rob Dickson is a 6th year trainee of the Australian College of Remote and Rural Medicine in the tiny Tasmanian hamlet of Queenstown, and recently ventured to the Southernmost continent as an Antarctic Medical Practitioner.

He joins Todd on the podcast today to chat about the appeal of remote and rural medicine, and his time practicing medicine in the world's most isolated practice.

See omnystudio.com/listener for privacy information.

Andrew Casamento -analgesic agents in critically ill patients

Wed, 11 Sep 2019 07:05:00 +0000

Dr Andrew Casamento is an emergency medicine and intensive care physician from Melbourne, Australia. He joins Todd to discuss the use of 2 commonly used narcotic infusions in critically ill patients, fentanyl and morphine, and challenges the research community to investigate this surprisingly evidence-free zone.

See omnystudio.com/listener for privacy information.

Andrew Udy : Hypothermia in Sepsis - a dire prognosis?

Tue, 03 Sep 2019 06:13:00 +0000

Sepsis is usually associated with fever. This highly conserved response has a range of theoretical benefits, including enhanced immune functioning and increased microbial response to antibiotics.

But what happens when patients are hypothermic on presentation? Professor Andrew Udy joins Todd on the podcast to discuss the impact of hypothermia in sepsis, and the results of a recent review of such patients at Melbourne's Alfred Hospital.

The review can be found here

See omnystudio.com/listener for privacy information.

Adam Holyoak - traumatic cardiac arrest

Fri, 09 Aug 2019 06:13:00 +0000

Traumatic cardiac arrest is associated with a terrible prognosis - or is it?

In this fabulous Osler Podcast, Todd is joined by ED, Pre-hospital and ICU physician Dr Adam Holyoak to talk about the presentation, outcomes and management of patients who arrest after trauma.

See omnystudio.com/listener for privacy information.

Kath Maitland - transfusion in septic African children

Thu, 01 Aug 2019 05:44:00 +0000

Blood is a precious commodity at the best of times, but no where more so than on the African continent.

The incidence of children presenting with sepsis and critical anaemia is frightening, and overwhelms the availability of blood. There is some contention that adherence to the World Health Organisation guidelines may ultimately waste this scarce resource.

Kath Maitland, author of the renowned FEAST trial, led her research group in trying to determine whether or not a highly restrictive approach to transfusion in this group compared with the WHO standard was safe in a trial known as TRACT.

Kath joined Todd to discuss the results and implications of this extremely important trial.

See omnystudio.com/listener for privacy information.

Bala Venkatesh - Capacity to train in ICU

Fri, 19 Jul 2019 04:24:00 +0000

Is the capacity to train new Intensivist reaching a tipping point? What is the capacity of the current system to train ICU trainees?

Professor Bala Venkatesh is a former president of the College of Intensive Care Medicine of Australia / New Zealand, and recently published the results of a binational survey of Directors of ICU, Supervisors of Training and CICM trainees.

He joins Todd on the podcast to discuss the findings, and how they potentially impact on the future training program.

See omnystudio.com/listener for privacy information.

Tomoko Fujii - Thiamine, Vitamin C and sepsis

Mon, 01 Jul 2019 23:18:00 +0000

The role of vitamin C and thiamine in the management of vasoplegic septic shock has been a highly controversial and topical issue in modern critical care in the past 2-3 years.

Tomoko Fujii, research fellow at the Monash-ANZICS Research Centre and clinical intensivist, joins Todd in this fascinating podcast to discuss the ongoing VITAMINS trial, a feasibility study seeking to set the ground work for a major trial in this area.

See omnystudio.com/listener for privacy information.

Michael Toolis - Intubation in critically ill patients

Sat, 22 Jun 2019 20:57:00 +0000

Michael Toolis is an ICU fellow at St Vincent's Hospital in Melbourne. He recently published a survey of Australasian intensivists, aimed at exploring the variation in intubation practice, and the need for regional guidelines and refresher training.

He joined Todd on the podcast to review the survey, and the current guidelines on managing intubation in critically ill patients.

See omnystudio.com/listener for privacy information.