ACCRAC Podcast

A Podcast for Anesthesia and Critical Care Reviews, Debates and Commentary

ANESTHESIA AND CRITICAL CARE REVIEWS AND COMMENTARY

Episode 77: Reversal of Neuromuscular Blockade

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In this episode, episode 77, I discuss reversal of neuromuscular blockade.  This is a follow up to episode 66 in which I covered neuromuscular blockade.

Outline by Brian Park: NMB Reversal Outline

References:

Miller’s Anesthesia 8th Edition. Reversal (Antagonism) of Neuromuscular Blockade. Murphy GS, de Boer HD, Eriksson LI and Miller RD. Chapter 35, 995-1027.e5.

Appiah-Ankam J, Hunter J.  Pharmacology of neuromuscular blocking drugs.  Cont Educ Anaesthesia Critical Care & Pain.  2004;4(1):2-7.

Hristovska AM, Duch P, Allingstrup M, Afshari A. Efficacy and safety of sugammadex versus neostigmine in reversing neuromuscular blockade in adults. Cochrane Database Syst Rev. 2017 Aug 14;8:CD012763.

Keating GM. Sugammadex: A Review of Neuromuscular Blockade Reversal. Drugs. 2016 Jul;76(10):1041-52.

McLean DJ, Diaz-Gil D, Farhan HN, Ladha KS, Kurth T, Eikermann M. Dose-dependent Association between Intermediate-acting Neuromuscular-blocking Agents and Postoperative Respiratory Complications. Anesthesiology. 2015 Jun;122(6):1201-13.

Schaller S, Fink H.  Sugammadex as a reversal agent for neuromuscular block: an evidence-based review.  Core Evidence.  2013;8:57-67.

Episode 69: Intro to Trauma with Bob Sikorski

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In this episode, Episode 69, I welcome Dr. Bob Sikorski, director of trauma anesthesiology at Johns Hopkins, to the show to discuss a general overview of trauma anesthesia.  We discuss prehospital, ER and OR management and key things to keep in mind when caring for trauma patients.

References: Trauma references list

TEG diagram: 

 

Episode 66: Neuromuscular Blockers

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In this episode, episode 66, I go through an overview of neuromuscular blockers including how they work, how to use them, and what their adverse effects are.  Happy New Year!

Outline by Brian Park: NMB Outline

References:

Miller’s Anesthesia 7th edition: Chapter 29: Pharmacology of Muscle Relaxants and Their Antagonists. Naguib M and Lien C.

Rocuronium vs succinylcholine for rapid sequence induction intubation. https://www.ncbi.nlm.nih.gov/pubmed/26512948

Neuromuscular blockade: what was, is and will be: https://www.ncbi.nlm.nih.gov/pubmed/25622380

Reversal of neuromuscular block: https://www.ncbi.nlm.nih.gov/pubmed/19468024

 

Episode 59: Pulmonary HTN with Jochen Steppan

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In this episode, episode 59, I welcome international pulmonary hypertension expert Dr. Jochen Steppan to the show to discuss pulmonary hypertension and how to manage the preoperative care of patients with this disease.

Outline by Brian Park: Outline

Episode 57: Bugs and Drugs Part 2 With Rachel Kruer

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In this episode, episode 57, I welcome back Rachel Kruer, our amazing SICU pharmacist and we complete our two part series on bugs and drugs in the ICU.  We discuss different infections that are commonly seen in ICUs and how to treat them.

Episode 56: Bugs and Drugs Part 1 with Rachel Kruer

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In this episode, episode 56, I welcome Rachel Kruer to the show.  Rachel is one of our amazing ICU pharmacists and we discuss common bacteria and the drugs we use to treat them.  This is part 1 of a 2 part series that I’ll be doing with Rachel on this topic.

Episode 52: Diastolic Heart Failure with Todd Dorman

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In this episode, episode 52, I welcome Dr. Todd Dorman to the show.  Dr. Dorman is a professor of anesthesiology here at Johns Hopkins, is the Vice Chair for Critical Care, and is the immediate past president of the Society of Critical Care Medicine (SCCM).  Dr. Dorman and I discuss diastolic heart failure or heart failure with preserved ejection fraction (HFPEF), how it differs from systolic heart failure or heart failure with reduced ejection fraction (HFREF), how it presents, and how to manage it perioperatively.

References for peripheral vasopressors:

  1. Medlej K et al. Complications from Administration of Vasopressors Through Peripheral Venous Catheters: An Observational Study. JEM 2018. PMID: 29110979
  2. http://rebelem.com/peripheral-vasopressors-safe-dangerous/

Episode 47: Arterial Lines with Stephen Freiberg

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In this episode, episode 47, I welcome back Dr. Stephen Freiberg, one of our chief residents, to discuss all you ever wanted to know about arterial lines.  We discuss the indications, contraindications, complications, placement technique, and how to interpret the waveform.

Slides with figures mentioned in the podcast can be found here: Arterial Line Podcast Images

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Episode 45: Postop Delirium with Charlie Brown

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In this episode, episode 45, I welcome Dr. Charlie Brown to the show.  Dr. Brown is one of our cardiac anesthesiologists with a research interest in postop delirium.  We discuss risk factors, consequences, prevention and treatment of postop delirium.