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.

Episode 102: Life Lessons with Dan Lowenstein

In this 102nd episode I welcome Dr. Dan Lowenstein to the show.  Dr. Lowenstein is a professor of Neurology and the Executive Vice Chancellor and Provost at University of California San Francisco (UCSF).  We discuss his lessons and advice for how to be successful professionally and personally.

The Three Marriages book: http://www.davidwhyte.com/the-three-marriages/

Episode 101: Coming off Bypass with Stephen Freiberg

In this 101st episode I welcome back Dr. Stephen Freiberg to the show to discuss how to successfully come off bypass when doing cardiac surgery with cardiopulmonary bypass.

References:

-Barash Anesthesia for Cardiac Surgery
-Barry AE, Chaney MA, London MJ. Anesthetic management during cardiopulmonary bypass: a systematic review. Anesth Analg 2015; 120:749.
-Denault AY, Tardif JC, Mazer CD, et al. Difficult and complex separation from cardiopulmonary bypass in high-risk cardiac surgical patients: a multicenter study. J Cardiothorac Vasc Anesth 2012; 26:608.
-Lomivorotov VV, Efremov SM, Kirov MY, et al. Low-Cardiac-Output Syndrome After Cardiac Surgery. J Cardiothorac Vasc Anesth 2017; 31:291.
-McKinlay KH1, Schinderle DB, Swaminathan M, Podgoreanu MV, Milano CA, Messier RH, El-Moalem H, Newman MF, Clements FM, Mathew JP.JPredictors of inotrope use during separation from cardiopulmonary bypass.  Cardiothorac Vasc Anesth. 2004 Aug;18(4):404-8.

Episode 99: Substance Abuse in Anesthesia Providers with Mike Fitzsimons

In this episode, episode 99, I welcome Dr. Mike Fitzsimons from MGH to the show to talk about substance abuse in anesthesia providers and his recent article in Anesthesiology detailing their program to decrease rates of abuse.

References:

https://www.ncbi.nlm.nih.gov/pubmed/30020101

 

Episode 98: Update on Bicarb: BICAR-ICU

In this episode, episode 98, I discuss the BICAR-ICU trial and what it tells us about using sodium bicarbonate to treat metabolic acidosis.

References:

BICAR-ICU Trial: https://www.ncbi.nlm.nih.gov/pubmed/29910040

BICAR-ICU Editorial: https://www.ncbi.nlm.nih.gov/pubmed/29910039

Forsythe: https://www.ncbi.nlm.nih.gov/pubmed/10631227

Sabatini: https://www.ncbi.nlm.nih.gov/pubmed/18322160

Pulmcrit post: https://emcrit.org/pulmcrit/bicar-icu/

 

Episode 96: Peds difficult airway with Nick Dalesio

In this episode, episode 96, I welcome Dr. Nick Dalesio to the show.  Dr. Dalesio is the director of the pediatric difficult airway program here at Johns Hopkins.  We discuss the pediatric difficult airway response team, consult service, and how to anticipate and manage difficult airways in kids, both anticipated and unanticipated.

Reference:

Planning Prevents Poor Performance: An Approach to Pediatric Airway Management