Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 130: Adults with Congenital Heart Disease with Jochen Steppan
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In this 130th episode I welcome back Dr. Jochen Steppan to discuss the perioperative care of adults with congenital heart disease. We discuss the incidence, evaluation and management including the different types of physiology that a provider might see and how to manage each one.
Stoelting’s Anesthesia and Co-Existing Disease, 7th EditionChapter 7 “Congenital Heart Disease” by Jochen Steppan and Bryan Maxwell
Int Anesthesiol Clin. 2018 Fall;56(4):3-20. “When Your 35-Year-Old Patient has a Sternotomy Scar: Anesthesia for Adult Patients with Congenital Heart Disease Presenting for Noncardiac Surgery” By Cheema A, Ibekwe S, Nyhan D, Steppan J.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 129: Vascular Access with Dave Berman
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In this 129th episode I welcome Dr. Dave Berman back to the show to discuss vascular access devices. We talk about what kinds of lines exist, how to choose, what the pros and cons are, and how to know what kind of flow you will get with a given catheter.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 128: Opioid Induced Respiratory Depression (The PRODIGY Trial) with Dr. Ashish Khanna
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In this 128th episode I welcome Dr. Ashish Khanna to the show to discuss his trial, the PRODIGY trial, looking at opioid induced respiratory depression. We discuss the background of the trial, what it took to run a 16 site, 3 continent trial, what the risk factors were that went into the risk prediction model they developed, and where we go from here.
CME: https://earnc.me/jQCZV8
References:
Sun Z, Sessler DI, Dalton JE, et al. Postoperative Hypoxemia Is Common and Persistent: A Prospective Blinded Observational Study. Anesth Analg. 2015;121(3):709–715. doi:10.1213/ANE.0000000000000836
Lee LA, Caplan RA, Stephens LS, Posner KL, Terman GW, Voepel-Lewis T, Domino KB. Postoperative opioid-induced respiratory depression: a closed claims analysis. Anesthesiology. 2015 Mar;122(3):659-65. doi: 10.1097/ALN.0000000000000564.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 124: POCUS with Lee Goeddel
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In this 124th episode I welcome Dr. Lee Goeddel to the show to discuss Point Of Care Ultrasound (POCUS). We discuss what it is, what it covers in the cardiac, pulmonary, abdominal and vascular system, and what next steps are for those interested in taking their skills further.
CME: https://earnc.me/aEbwZG
References:
Anesth Analg. 2017 Mar;124(3):753-760. doi: 10.1213/ANE.0000000000001861.The Nuts and Bolts of Performing Focused Cardiovascular Ultrasound (FoCUS).PMID:28207445
Chest. 2015 Jun;147(6):1659-1670. doi: 10.1378/chest.14-1313.BLUE-protocol and FALLS-protocol: two applications of lung ultrasound in the critically ill.Lichtenstein DA1.PMID: 26033127
Surg Clin North Am. 2011 Feb;91(1):195-207. doi: 10.1016/j.suc.2010.10.008.Focused assessment with sonography for trauma: methods, accuracy, and indications.Patel NY1, Riherd JM. PMID: 21184909
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 123: Surgical Airway with Andrew Merelman
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In this 123rd episode I welcome Andrew Merelman to the show. Andrew is a paramedic and medical student with an interest in emergent surgical airway management. We discuss the human factors involved in the procedure, when it is indicated, how to do it and how to practice.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 121: Difficult Airway Response Team With Lynette Mark
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In this 121st episode I welcome Dr. Lynette Mark to the show. Dr. Mark is the founder of our Difficulty Airway Response Team (DART) here at Hopkins and a founding director for the Society of Airway Management. We discuss the origins of the DART program and how to approach a difficult airway.
Difficult Airway Algorithm and Rescue Cricothyrotomy (DAARC): http://sgschallenge.com/2018daarc/
https://wamm2019.com World Airway Management Meeting, Amsterdam, Netherlands, November, 2019. Drs. Mark and Feinleib will be presenting about the DART program.
Dr. Cooper’s article on surgical airway: https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2724164
Dr. Mark’s article from A&A and the accompanying editorial:
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 119: STOP-IT Trial with Rob Sawyer
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In this 119th episode I welcome Dr. Robert Sawyer to the show. Dr. Sawyer was the PI on the STOP-IT trial comparing a short course of antibiotics versus a longer course for complicated intraabdominal infections. We discuss the trial, the outcomes, and what the future of antimicrobial management in the surgical ICU may look like.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 115: The Contaminated Airway with Steve Freiberg
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In this 115th episode I welcome Dr. Steven Freiberg back to the show to discuss management of the contaminated airway.
CME: https://earnc.me/lDqJUu
References:
Han, S; Fisher, J. Airway Management During Persistent Flooding Of the Oropharyngeal Airway. Anesthesiology News. 2016. March.
Joshi, R; Hypes, C; et al. Difficult Airway Characteristics Associated with First-Attempt Failure at Intubation Using Video Laryngoscopy in the Intensive Care Unit. Ann Am Thorac Soc. 2017 Mar;14(3):368-375
Stockton, E.; Lockey, D; et. al. Contamination of the airway in pre-hospital trauma patients. European Journal of Anaesthesiology. 2008. May; 25:188
Uday, J; McCunn, M; et al. Management of the Traumatized Airway. Anesthesiology. 2016, Vol.124, 199-206
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 111: Tracheostomies, Cricothyrotomies and ENT surgery with Dr. Zandy Hillel
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In this 111th episode I welcome Dr. Zandy Hillel to the show. Dr. Hillel is an otolaryngologist here at Johns Hopkins and we discuss tracheostomies, Cricothyrotomies, laryngeal surgery and difficult airways.
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 106: Hydroxyethyl Starches with Marius Fassbinder
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In this 106th episode I welcome Dr. Marius Fassbinder to the show to discuss the use of hydroxyethyl starches.
CME: https://earnc.me/sFF08C
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).
Anesthesia and Critical Care Reviews and Commentary
