Episode 106: Hydroxyethyl Starches with Marius Fassbinder

In this 106th episode I welcome Dr. Marius Fassbinder to the show to discuss the use of hydroxyethyl starches.

References:

1. Woodcock, T. E. & Woodcock, T. M. Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an

improved paradigm for prescribing intravenous fluid therapy. British Journal of Anaesthesia 108, 384–394 (2012).

2. Westphal, M. et al. Hydroxyethyl starches: different products–different effects. Anesthesiology 111, 187–202 (2009).

3. Brunkhorst, F. M. et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N. Engl. J. Med. 358, 125–139

(2008).

4. Perner, A. et al. Hydroxyethyl Starch 130/0.42 versus Ringer’s Acetate in Severe Sepsis. N. Engl. J. Med. 367, 124–134 (2012).

6. Myburgh, J. A. et al. Hydroxyethyl Starch or Saline for Fluid Resuscitation in Intensive Care. N. Engl. J. Med. 367, 1901–1911

(2012).

7. Annane, D. et al. Effects of fluid resuscitation with colloids vs crystalloids on mortality in critically ill patients presenting with

hypovolemic shock: the CRISTAL randomized trial. JAMA 310, 1809–1817 (2013).

8. Joosten, A. et al. Crystalloid versus Colloid for Intraoperative Goal-directed Fluid Therapy Using a Closed-loop System: A

Randomized, Double-blinded, Controlled Trial in Major Abdominal Surgery. Anesthesiology 128, 55–66 (2018).

9. Gillies, M. A. et al. Incidence of postoperative death and acute kidney injury associated with 6% hydroxyethyl starch use: systematic review and meta-analysis. British Journal of Anaesthesia 112, 25–34 (2014).

Episode 105: Blood Management Part 1 With Drs. Frank & Cha

In this 105th episode, which will be the first part in a series on blood management, I turn over the mic to Dr. Stephanie Cha who interviews Dr. Steve Frank about blood management in cardiac surgery and how to do “bloodless” surgery for patients who refuse blood transfusions.

References:

1.         Myles PS, Smith JA, Forbes A, Silbert B, Jayarajah M, Painter T, Cooper DJ, Marasco S, McNeil J, Bussieres JS, McGuinness S, Byrne K, Chan MT, Landoni G, Wallace S, Network AIotACT. Tranexamic acid in patients undergoing coronary-artery surgery. N Engl J Med 2017;376:136-48.
2.         Frank SM, Wick EC, Dezern AE, Ness PM, Wasey JO, Pippa AC, Dackiw E, Resar LM. Risk-adjusted clinical outcomes in patients enrolled in a bloodless program. Transfusion 2014;54:2668-77.
3.         Cho BC, DeMario VM, Grant MC, Hensley NB, Brown CHt, Hebbar S, Mandal K, Whitman GJ, Frank SM. Discharge hemoglobin level and 30-day readmission rates after coronary artery bypass surgery. Anesth Analg 2018.
4.         Pattakos G, Koch CG, Brizzio ME, Batizy LH, Sabik JF, 3rd, Blackstone EH, Lauer MS. Outcome of patients who refuse transfusion after cardiac surgery: A natural experiment with severe blood conservation. Arch Intern Med 2012;172:1154-60.
5.         Frank SM, Scott AV, Resar LM. Bloodless medicine and surgery: Top 10 things to consider.Anesthesiology News 2016.

Episode 104: Sepsis with Pam Lipsett

In this 104th episode I welcome Dr. Pam Lipsett to the show to discuss the diagnosis and treatment of sepsis.

References:

Sepsis-3 guidelines from JAMA: https://jamanetwork.com/journals/jama/fullarticle/2492881

Marik Sepsis cocktail: Marik PE et al. Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock. 2017: 151(6);1229–1238.

ADRENAL trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1705835

APROCCHSS Trial: https://www.nejm.org/doi/10.1056/NEJMoa1705716

SEPSISPAM Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1312173

Episode 103: Neuromonitoring with Drs. Ritzl and Russo

In this 103rd episode I welcome Dr. Eva Ritzl and Dr. Alyson Russo to the show to discuss intraoperative neuromonitoring.

Reference: Solt K and Froman S. Correlating the clinical actions and molecular mechanisms of general anesthetics. Curr Op in Anaes. 2007:20(4);300-306.