In this 145th episode recorded live from Anesthesiology 2019, the annual ASA meeting, I welcome Dr. Jeanine Wiener-Kronish to the show to discuss the progress we’ve made with mechanical ventilation and how we can personalize the way we deliver it to our patients to improve their outcomes.
Pereira, SM, Tucci, MR, Morais, CCA, Simões, CM, Tonelotto, BFF, Pompeo, MS, Kay, FU, Pelosi, P, Vieira, JE, Amato, MBP Individual positive end-expiratory pressure settings optimize intraoperative mechanical ventilation and reduce postoperative atelectasis. Anesthesiology 2018; 129:1070–81
Kacmarek, RM, Villar, J Lung-protective ventilation in the operating room: Individualized positive end-expiratory pressure is needed! Anesthesiology 2018; 129:1057–9
Nice figure that demonstrates what we know: https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2714239
Additional background articles:
In this 144th episode we record live from Anesthesiology 2019 in Orlando Florida. I welcome Dr. Jeffrey Cooper to the show to discuss the relationship between anesthesiologists and surgeons and what can be done to improve it in a way that will foster patient safety.
Correction: The Center for Medical Simulation is not part of Harvard Medical School. It is an independent non-profit organization.
Dr. Cooper’s talk is available on the APSF website here: https://www.apsf.org/news-updates/watch-jeffrey-b-cooper-ph-d-give-the-anesthesiology-2019-asa-apsf-ellison-c-pierce-memorial-lecture/
Dr. Cooper’s article on the topic: https://www.ncbi.nlm.nih.gov/pubmed/30045093
This is no humbug book: https://www.amazon.com/This-Humbug-Reminiscenes-Department-Massachusettes/dp/0971537607
Thanks for the feedback book: https://www.amazon.com/Thanks-Feedback-Science-Receiving-Well/dp/0143127136/ref=sr_1_1?keywords=thank+you+for+the+feedback&qid=1571603512&s=books&sr=1-1
In this 143rd episode I welcome Dr. Michael Scott to the show to discuss fluid management in ERAS cases and how cardiac output monitoring may help us do that well.
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.
- 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.
- 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
- 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
- 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
In this 141st episode I welcome Dr. Paul Wischmeyer to the show to discuss nutrition for critically ill patients with a focus on the question of whether to give enteral feeds to patients on pressors. You can follow Dr. Wischmeyer on twitter @Paul_Wischmeyer.
Dr. Wischmeyer’s article on enteral nutrition for patients on vasopressors: https://journals.lww.com/ccmjournal/Citation/onlinefirst/Enteral_Nutrition_Can_Be_Given_to_Patients_on.95859.aspx
In this 140th episode I welcome Dr. David Mazer to the show. Dr. Mazer was the PI and first author on the TRICS 3 trial looking at liberal versus restrictive transfusion strategies in moderate to high risk cardiac surgery patients published in the NEJM in 2017.
Dr. Mazer would like to add the following random recommendation: For a great combination of live jazz and good food and drinks in Toronto, check out the Jazz Bistro just up the street from St. Michael’s Hospital.
Dr. Mazer can be reached at David.Mazer@UnityHealth.To
In this 139th episode I welcome Dr. Gillian Isaac back to the show to discuss another 2 ABA keywords, succinylcholine and interscalene brachial plexus block.
In this 138th episode I welcome Drs. Segna and Rayaz back to the show to discuss lower extremity nerve blocks. We cover the ankle block and sciatic nerve block approaches today and will cover the anterior leg in a later episode.
The Medium Article: https://medium.com/@admiralcloudberg/the-near-crash-of-air-canada-flight-759-c61094867d45
In this 137th episode I welcome Steve Kaufman to the show to discuss contracts and negotiation for doctors. Steve is a lawyer with decades of experience helping doctors negotiate contracts.
If you have questions for Steve you can contact him directly at 410-659-1385, or email at SKaufman@wcslaw.com and he’s on twitter at @SKaufmanWCS
In this 136th episode I welcome Dr. Gillian Isaac back to the show to discuss another 2 ABA keywords, Celiac Plexus Block and Dexmedetomidine.