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.
CME: https://earnc.me/jeCfMt
Reference:
STOP-IT Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1411162
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
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.
CME: https://earnc.me/beqG3N
References:
Crichothyrotomies:
https://www.ncbi.nlm.nih.gov/pubmed/30054081
https://www.ncbi.nlm.nih.gov/pubmed/30726035
Difficult Airway Response Teams:
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).
In this 104th episode I welcome Dr. Pam Lipsett to the show to discuss the diagnosis and treatment of sepsis.
CME: https://earnc.me/DtOhNH
References:
Sepsis-3 guidelines from JAMA: https://jamanetwork.com/journals/jama/fullarticle/2492881
Marik Sepsis cocktail: Marik PE et al. Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock. 2017: 151(6);1229–1238.
ADRENAL trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1705835
APROCCHSS Trial: https://www.nejm.org/doi/10.1056/NEJMoa1705716
SEPSISPAM Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1312173
In this 100th episode I respond to questions, both clinical and personal, from ACCRAC listeners.
CME: https://earnc.me/72ibqj
In this episode, episode 94, I welcome Clint Burns to the show. Clint received a liver transplant in 1994, then went on to go to nursing school, have 4 children, be an ICU nurse, and he now runs the organ and tissue donation program here at Johns Hopkins. We discuss his story, the process of organ donation, and how providers can help make this process a gift for both donor and recipient.
CME: https://earnc.me/FsS3Ar
In the episode, episode 93, I welcome Dr. Tom Metkus back to the show to discuss perioperative considerations for CABG surgery.
CME: https://earnc.me/XJ1pMd
References:
Syntax Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa0804626
STICH Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1100356
ROOBY Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa0902905
CORONARY Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1200388
PREVENT IV Trial: https://www.ncbi.nlm.nih.gov/pubmed/16287955
ART Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1610021
In this episode, episode 92, I welcome Dr. Sapna Kudchadkar to the show to discuss her PICU Up program for early mobility in the PICU. We discuss the benefits of early mobility in general and specifically with pediatric patients, how she started her program, and what has led it to be so successful.
CME: https://earnc.me/zLbZMD
Dr. Kudchadkar can be reached on Twitter at @SapnaKMD and the PICU Up program is at @PICU_Up.
References: Early Mobility References
In this episode, episode 87, I welcome Dr. Tom Metkus to the show. Dr. Metkus is a cardiologist and intensivist and we discuss the etiology, presentation, management and outcomes of acute aortic dissections.
CME: https://earnc.me/K0NTfX
Outline by Brian Park: Aortic Dissection Outline
