In this episode I welcome Dr. Amit Prabhakar, one of our critical care fellows, to the show to discuss Sugammadex, a relatively recently approved (in the USA) reversal agent for Rocuronium and Vecuronium.
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.
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 first suggest you take a look at the recently published (ahead of print) VANCS study on the use of vasopressin as a sole agent in the treatment of vasoplegic shock. Then I review the reasons never to use sodium bicarbonate in lactic acidosis.
The Vancs study: https://www.ncbi.nlm.nih.gov/pubmed/27841822
The two articles I recommend on bicarb:
Outline by Brian Park: Outline
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.
In this episode I interview Dr. Joseph Hughes, one of our neuro anesthesiologists, about the history, etiology, pathophysiology and prevention of postoperative visual loss.
We refer to a thromboelastogram which looks like this. It is the fibrinolysis portion that can be prevented with tranexamic acid (TXA):
High Yield Outline by Brian Park can be found here: Outline
In this episode I interview Dr. Chris Wu, professor of anesthesiology and pain medicine and internationally renowned expert in Enhanced Recovery After Surgery (ERAS) pathways. We discuss the different aspects of ERAS pathways and the evidence for improved outcomes.
The ERAS society website can be found here: http://erassociety.org
Check out this fantastic outline of the episode put together by Brian Park: ERAS outline
In this episode I review two methods for managing arterial blood gasses in hypothermic patients, usually during cardiac surgery–pH Stat and Alpha Stat.
Check out this fantastic episode recap put together by Brian Park from Drexel Medical School: Show recap
In this episode I review the receptors that vasoactive drugs act on. I then review the main vasoactive medications used in the OR and the ICU to treat acute hypotension and the ones used to treat acute hypertension.
In this episode I go over some tips and tricks for maximizing your success with peripheral IVs, arterial lines, central venous catheters and pulmonary artery catheters (Swan Ganz catheters).
The New England Journal videos that I recommend you take a look at for detailed reviews of each of these are here:
- Peripheral IV: http://www.nejm.org/doi/full/10.1056/NEJMvcm0706789
- Arterial: http://www.nejm.org/doi/full/10.1056/NEJMvcm044149
- Central: http://www.nejm.org/doi/full/10.1056/NEJMvcm055053
- PA catheter: http://www.nejm.org/doi/full/10.1056/NEJMvcm1212416
And this is a great article from Ausmed on assessing and caring for peripheral IVs: Click Here
In this episode I discuss awake intubation. I discuss the indications, techniques, nerve blocks, sedation and different methods of performing awake intubation.
Slides to go along with the podcast are here: awake intubation slides
The youtube video of the MGH anesthesiologist intubating himself is here: self-intubation