Essential Critical Care Podcast

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.

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.

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.

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.

Up to a quarter of emergency services calls relate to behavioural disturbance or mental health issues.  For many patients, these calls end up in transportation to the emergency department, where the service struggles to meet the patient's needs. David Hardstaff is an experienced paramedic who is part of a novel approach to this problem, a prehospital response team aiming to manage patients predominantly in their own homes.  He joins Todd to talk about the prehospital issues surrounding mental health, and the Co-Responder program. See omnystudio.com/listener for privacy information.

While mechanical ventilation can be life saving, it can also cause its fair share of complications. Dr Kiran Shekar is an intensivist at The Prince Charles Hospital in Brisbane, Australia.  He heads a program of research exploring a range of therapies that may minimise these risks, including the subject of today's discussion, Extracorporeal CO2 removal (ECCOR) See omnystudio.com/listener for privacy information.

We focus a lot on energy and protein delivery in ICU.  But what happens to patients and their nutrition when they get to the wards? Could it be that an intensive approach to feeding throughout the patient's hospital stay is the key to enhancing functional recovery? Eliza Miller is the project manager for the INTENT trial, and she joins us to discuss this important study. See omnystudio.com/listener for privacy information.

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.

Resuscitation of hypotensive patients with sepsis traditionally involves up to several litres of crystalloid fluids before vasopressors are initiated.  While this forms the basis for many sepsis management guidelines, the dogma is being challenged. In this latest podcast from the 2021 ANZICS CTG meeting in Noosa, Stephen McDonald joins Todd to talk about the ARISE FLUIDS 2 trial, which aims to provide more detail on the prioritisation of these two key interventions.   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.

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.

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.

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 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.

Despite the incredible burden of COVID-19, ICU researchers have somehow been able to produce practice changing research at an unprecedented rate. ICU nutrition researchers Lee-anne Chapple and Emma Ridley join Todd on the podcast to discuss their findings regarding the nutritional status and issues for COVID-19 patients admitted to ICU See omnystudio.com/listener for privacy information.

Despite increasing focus and the development of international clinical guidelines, delirium in ICU remains an under-recognised issue. Melissa Ankravs is a senior ICU pharmacist, and she joins Todd on the podcast to discuss the results of a point prevalence study in Australia / New Zealand See omnystudio.com/listener for privacy information.

Aidan Burrell joins the podcast to update our listeners with the progress of the SPRINT SARI project - designed to collect real time data on the COVID-19 pandemic in Australasia. See omnystudio.com/listener for privacy information.

One of the fundamentals of therapy for severe Diabetic Ketoacidosis (DKA) is fluids.  However, it is well known that aggressive fluid replacement with Normal Saline commonly results in a non-anion gap metabolic acidosis as the underlying condition improves. Does this acidosis cause harm?  Can it be avoided? In this edition of the podcast, Todd chats to intensivist Dr Mahesh Ramanan about his recently completed study, SCOPE, which compared the effects of buffered solution Plasmalyte 148 with normal saline in these patients. This is another great podcast interview from the 2021ANZICS Clinical Trials Group meeting in Noosa See omnystudio.com/listener for privacy information.

COVID 19 has ravaged many parts of the world, leaving some patients with persistent symptoms known as "Long COVID". But what about survivors of critical illness due to COVID-19?  How do they compare with other ICU survivors? Professor Carol Hodgson is the Head of the Division of Clinical Trials and Cohort Studies, School of Public Health and Preventive Medicine, Monash University.  Carol's major area of research interest is functional outcomes for survivors of ICU, and she joins Todd to chat about the COVID-RECOVERY study See omnystudio.com/listener for privacy information.

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.

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.