In this episode, episode 36, I welcome Dr. Deb Schwengel, one of our pediatric anesthesiologists and our residency program director, to the show to discuss the differences in anatomy and physiology in pediatric versus adult patients.
Outline by April Liu: Outline
In this episode, number 35, I welcome Dr. David Feller-Kopman to the show. Dr. Feller-Kopman is an associate professor of medicine and Otolaryngology and the director of Bronchoscopy and Interventional Pulmonology here at Johns Hopkins. I interview him about pleural effusions including what they are, where they come from, how to categorize them, how to treat them and how to deal with them if they recur.
The NEJM article on the use of TPA and DNAse is here: http://www.nejm.org/doi/full/10.1056/NEJMoa1012740#t=abstract
In this episode I am joined once again by Dr. Scott Stephens as we review advanced ventilator modes, prone positioning, and ventilation of patients on VV ECMO.
Outline by April Liu: Outline
The fantastic review article I mentioned is: Mireles-Cabodevila E. Et al. Alternative Modes of mechanical ventilation: A review for the hospitalist. Cleveland Clinic Journal of Medicine. 2009(75);7:417-430.
Pubmed link here
In this episode I welcome Dr. Scott Stephens, Pulmonary Critical Care Physician at Johns Hopkins to the show. Dr. Stephens and I discuss basic ventilator settings, how to appropriately ventilate patients with hypoxemic vs. hypercarbic respiratory failure and how to think about weaning patients off of the ventilator.
Outline by Brian Park: Outline
In this episode I discuss hyperoxia and review the evidence in regards to the damage it can cause in patients with a wide variety of illnesses.
Slides to accompany the episode can be found here: hyperoxia slides
This is the second and final episode dealing with the management of respiratory diseases. In the first episode I covered the initial evaluation and preop preparation. In this episode I cover intraoperative management, post-operative management, special issues related to one lung ventilation and special issues related to total pneumonectomy.
Slides to go along with the episode can be downloaded here: Management of Respiratory Diseases part 2 slides
This is the first of a two part series of episodes on the management of patients with respiratory disease. In this, part 1, I cover the preoperative evaluation, history and physical exam, and the preoperative planning and optimization of the patient. This includes the key board topics of smoking cessation and cardiac risk assessment.
Here are the slides that go along with this episode: Management of Respiratory Diseases slides part 1
In this episode I review restrictive lung disease. This is meant to be a companion episode to Episode 4 which covered obstructive lung disease. I cover the following topics:
-Definition and diagnosis of restrictive lung disease
-Extra-pulmonary causes (neurologic, musculoskeletal, pleural/mediastinal)
The accompanying slides can be downloaded here: Restrictive Lung Disease slides
Remember to join the mailing list by clicking on the link at the top right on the website. You can leave comments on the website or email firstname.lastname@example.org or email@example.com.
In this episode I mention the new ACCRAC mailing list which you can sign up for with the link right below the show description on the website accrac.libsyn.com. You can also post comments on the website and email questions to firstname.lastname@example.org or email@example.com. I also highlight Rob MacSweeney’s fantastic critical care site called criticalcarereviews.com and his newsletter which you can subscribe to on his site. The weekly newsletter includes the week’s top trials and papers in critical care.
The rest of the episode is a high yield board review of the ABA topic of obstructive lung disease. I cover the following topics:
#Upper airway obstruction including extra thoracic and intra thoracic obstruction
#Flow volume loops and how to interpret them
#Lower airway and parenchymal obstruction including
#Cystic Fibrosis and bronchiectasis
The slides to go along with this episode can be downloaded here: Obstructive_Lung_Disease_slides
And the article that I mentioned about full helmet Bipap can be found here:
Helmet Bipap Article
There are a few announcements I wanted to make including:
Check out pedsanesthesia.net. Dr. Robert Greenberg, a pediatric anesthesiologist here at Johns Hopkins runs it and it has lots of great information and topics in pediatric anesthesiology.
If you have suggestions for a better website than this one please let me know!
If you know a good way to set up an email list serve for these kinds of announcements please let me know that as well.
And, finally, I address a surgeon’s comment to one of our residents that you should always use 100% fio2 when ventilating one lung during a thoracic case. Listen to the podcast for details but the bottom line is you should NOT use 100% oxygen unless you have to in order to prevent hypoxia.
Here is a link to a great review on this topics published last year in Critical Care: https://www.ncbi.nlm.nih.gov/pubmed/26278383