Episode 188: Anesthesia for Thoracic Surgery

In this 188th episode I discuss the approach to Anesthesia for patients having thoracic surgery including highly tested concepts for board exams.

Reference:

Clinical Anesthesia. 2017. 8th Ed. Barash, Paul G.; Cullen, Bruce F.; Stoelting, Robert K.; Cahalan, Michael K.; Stock, M. Christine; Ortega, Rafael; Sharar, Sam R.; Holt, Natalie F.
Publisher: Lippincott Williams & Wilkins (LWW).

Episode 187: PEEP for Robotic Surgery with Gabe Tharp

In this 187th episode I welcome Dr. Gabe Tharp to the show to discuss his recent article in Anesthesiology: “Body Habitus and Dynamic Surgical Conditions Independently Impair Pulmonary Mechanics during Robotic-assisted Laparoscopic Surgery.” We discuss his findings and whether we should be using much higher levels of PEEP than we currently do.

Gabe’s group is on Twitter: @uvmanesthesia

References:

Tharp et al. Body Habitus and Dynamic Surgical Conditions Independently Impair Pulmonary Mechanics during Robotic-assisted Laparoscopic Surgery. Anesthesiology 2020. PMID: 32675698

Ball L, et al. Br J Anaesth. 2018. PMID: 30236252 

Ferrando, et al Lancet Respir Med. 2018. PMID: 29371130

PROBESE committee JAMA. 2019. PMID: 31157366.

Grassi et al. Anesthesiology. 2020. PMID: 32011342

Episode 170: Lessons from 40 COVID Patients in the ICU with Brian Garibaldi

In this 170th episode I welcome Dr. Brian Garibaldi to the show to discuss his experience taking care of 40 critically ill COVID patients and what we’ve learned. We got through by system, head to toe, and discuss strategies and approaches.

References:

Lessons from China: https://jamanetwork.com/journals/jama/fullarticle/2762130

Convalescent Plasma: https://jamanetwork.com/journals/jama/fullarticle/2763983?widget=personalizedcontent&previousarticle=2762130

Management of patients with COVID: https://jamanetwork.com/journals/jama/fullarticle/2763879

Episode 166: COVID Airway Management with Aliaksei Pustavoitau

In this 166th episode I welcome Dr. Aliaksei Pustavoitau to the show to discuss management of the hypoxemia COVID-19 patient including initial triage, escalating support, endotracheal intubation, and ventilator management.

References:

Episode 165: COVID with Drs. Scott, Cereda and Nacoti

In this 165th episode I welcome Drs. Scott and Cereda from University of Pennsylvania and Dr. Nacoti from Italy to talk about COVID-19, what it is, what we know about it, what it’s like on the ground in Italy right now, and what we can learn from their experience to try to prevent it from happening here.

References:

 Grasselli G, Pesenti A, Cecconi M. Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: early experience and forecast during an emergency response. JAMA. doi:10.1001/jama.2020.4031 

Episode 142: Driving Pressure and Transpulmonary Pressure with Marcos Vidal Melo

In this 142nd episode I welcome Dr. Marcos Vidal Melo to the show to discuss Driving Pressure and Transpulmonary pressure. We discuss what they are, how they differ from plateau pressure, and how they may help guide safe mechanical ventilation.

References:

  1. Driving Pressure and Transpulmonary Pressure: How Do We Guide Safe Mechanical Ventilation? Williams EC, Motta-Ribeiro GC, Vidal Melo MF. Anesthesiology. 2019 Jul;131(1):155-163. 
  2. Loring SH, Topulos GP, Hubmayr RD: Transpulmonary pressure: The importance of precise definitions and limiting assumptions. Am J Respir Crit Care Med 2016; 194:1452–7
  3. Mauri T, Yoshida T, Bellani G, Goligher EC, Carteaux G, Rittayamai N, Mojoli F, Chiumello D, Piquilloud L, Grasso S, Jubran A, Laghi F, Magder S, Pesenti A, Loring S, Gattinoni L, Talmor D, Blanch L, Amato M, Chen L, Brochard L, Mancebo J; PLeUral pressure working Group (PLUG—Acute Respiratory Failure section of the European Society of Intensive Care Medicine): Esophageal and transpulmonary pressure in the clinical setting: meaning, usefulness and perspectives. Intensive Care Med 2016; 42:1360–73
  4. Akoumianaki E, Maggiore SM, Valenza F, Bellani G, Jubran A, Loring SH, Pelosi P, Talmor D, Grasso S, Chiumello D, Guérin C, Patroniti N, Ranieri VM, Gattinoni L, Nava S, Terragni PP, Pesenti A, Tobin M, Mancebo J, Brochard L; PLUG Working Group (Acute Respiratory Failure Section of the European Society of Intensive Care Medicine): The application of esophageal pressure measurement in patients with respiratory failure. Am J Respir Crit Care Med 2014; 189:520–31

Episode 71: Oral Board Prep 2: part 1

In this episode, episode 71, combined with the next episode, episode 72, I welcome back Drs. Tran and Beaudry to do an oral board prep example.  We got through how not to do it and then how to do it well.  This is part 1, episode 72 will be part 2.

The stem and questions are here: Oral board stem

Episode 59: Pulmonary HTN with Jochen Steppan

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