Essential Critical Care Podcast

CPD Homes will be introduced to Australian-registered doctors in 2024, but what are they for, and what do they mean for you? Chair of the Medical Board of Australia, Dr Anne Tonkin, joins Todd to talk about what lies ahead.See omnystudio.com/listener for privacy information.

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.

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.

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.

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.

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 ICUSee omnystudio.com/listener for privacy information.

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 trialSee omnystudio.com/listener for privacy information.

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.

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.

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, LOGICALSee omnystudio.com/listener for privacy information.

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 ventilationSee omnystudio.com/listener for privacy information.

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 - @tscquizzatoSee omnystudio.com/listener for privacy information.

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.

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.

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 NoosaSee omnystudio.com/listener for privacy information.

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 traumaSee omnystudio.com/listener for privacy information.

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.

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.

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 meansSee omnystudio.com/listener for privacy information.

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-19See omnystudio.com/listener for privacy information.