Category Archives: Fluids

Anesthesia, Critical Care, Fluids, Physiology, Resuscitation

Episode 223: The Glycocalyx with Marius Fassbinder

February 28, 2022 ACCRAC 3 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 223: The Glycocalyx with Marius Fassbinder

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In this 223rd episode I welcome Dr. Marius Fassbinder back to the show to discuss the glycocalyx. We discuss what it is, what roll it plays in fluid dynamics, and what we need to know about how it influences our fluid management.

CME: Link

Looking to start a podcast? Try RedCircle by clicking here: https://bit.ly/3HK8Qec

References Download

Random Recs:

ASCAR Iphone Ap: Link

A Life From Our Planet: https://attenboroughfilm.com

The Trojan Horse Affair: Link

Anesthesia, Critical Care, Fluids, Physiology

Episode 185: Fluid Responsiveness in the OR with Lee Goeddel

October 13, 2020 ACCRAC Leave a comment

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 185: Fluid Responsiveness in the OR with Lee Goeddel

00:00 / 40:21

In this 185th episode I welcome back Dr. Lee Goeddel to discuss assessment of fluid responsiveness in the operating room.

CME: https://earnc.me/8sA9XN

References:

Michard F. Changes in Arterial Pressure during Mechanical Ventilation. Anesthesiology. 2005;103(2):419-428. doi:10.1097/00000542-200508000-00026

Using Dynamic Variables to Guide Perioperative Fluid Management
Azriel Perel, M.D.
Anesthesiology October 2020, Vol. 133, 929–935. https://doi.org/10.1097/ALN.0000000000003408

Anesthesia, Critical Care, ERAS, Fluids, Physiology, Resuscitation

Episode 143: Fluid management and cardiac output monitors in ERAS with Michael Scott

October 15, 2019 ACCRAC 1 Comment

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 143: Fluid management and cardiac output monitors in ERAS with Michael Scott

00:00 / 55:36

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.

CME: https://earnc.me/wcjdkb

Topmedtalk: https://www.topmedtalk.com

Anesthesia, Critical Care, Fluids, Resuscitation

Episode 129: Vascular Access with Dave Berman

July 14, 2019 ACCRAC 2 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 129: Vascular Access with Dave Berman

00:00 / 46:15

In this 129th episode I welcome Dr. Dave Berman back to the show to discuss vascular access devices. We talk about what kinds of lines exist, how to choose, what the pros and cons are, and how to know what kind of flow you will get with a given catheter.

CME: https://earnc.me/KmE3f4

References are here:

References Download

Anesthesia, Critical Care, Fluids, Resuscitation

Episode 106: Hydroxyethyl Starches with Marius Fassbinder

January 27, 2019 ACCRAC 8 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 106: Hydroxyethyl Starches with Marius Fassbinder

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51:18

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).

Anesthesia, Cardiac, Fluids, Resuscitation

Episode 105: Blood Management Part 1 With Drs. Frank & Cha

January 18, 2019 ACCRAC 2 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 105: Blood Management Part 1 With Drs. Frank & Cha

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1:00:16

In this 105th episode, which will be the first part in a series on blood management, I turn over the mic to Dr. Stephanie Cha who interviews Dr. Steve Frank about blood management in cardiac surgery and how to do “bloodless” surgery for patients who refuse blood transfusions.

CME: https://earnc.me/LixhZj

References:

1. Myles PS, Smith JA, Forbes A, Silbert B, Jayarajah M, Painter T, Cooper DJ, Marasco S, McNeil J, Bussieres JS, McGuinness S, Byrne K, Chan MT, Landoni G, Wallace S, Network AIotACT. Tranexamic acid in patients undergoing coronary-artery surgery. N Engl J Med 2017;376:136-48.

2. Frank SM, Wick EC, Dezern AE, Ness PM, Wasey JO, Pippa AC, Dackiw E, Resar LM. Risk-adjusted clinical outcomes in patients enrolled in a bloodless program. Transfusion 2014;54:2668-77.

3. Cho BC, DeMario VM, Grant MC, Hensley NB, Brown CHt, Hebbar S, Mandal K, Whitman GJ, Frank SM. Discharge hemoglobin level and 30-day readmission rates after coronary artery bypass surgery. Anesth Analg 2018.

4. Pattakos G, Koch CG, Brizzio ME, Batizy LH, Sabik JF, 3rd, Blackstone EH, Lauer MS. Outcome of patients who refuse transfusion after cardiac surgery: A natural experiment with severe blood conservation. Arch Intern Med 2012;172:1154-60.

5. Frank SM, Scott AV, Resar LM. Bloodless medicine and surgery: Top 10 things to consider.Anesthesiology News 2016.

http://anesthesiaexperts.com/uncategorized/bloodless-medicine-surgery-top-10/.

Critical Care, Fluids, Physiology, Resuscitation

Episode 104: Sepsis with Pam Lipsett

January 11, 2019 ACCRAC 8 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 104: Sepsis with Pam Lipsett

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50:42

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

Anesthesia, Critical Care, Fluids, Physiology, Resuscitation

Episode 69: Intro to Trauma with Bob Sikorski

February 2, 2018 ACCRAC 4 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 69: Intro to Trauma with Bob Sikorski

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57:19

In this episode, Episode 69, I welcome Dr. Bob Sikorski, director of trauma anesthesiology at Johns Hopkins, to the show to discuss a general overview of trauma anesthesia. We discuss prehospital, ER and OR management and key things to keep in mind when caring for trauma patients.

CME: https://earnc.me/avWKy7

References: Trauma references list

TEG diagram:

Anesthesia, Critical Care, Fluids, Resuscitation

Episode 31: Massive Transfusion with Dr. Stephen Freiberg

February 2, 2017 ACCRAC 4 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 31: Massive Transfusion with Dr. Stephen Freiberg

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46:20

In this episode, episode 31, I welcome one of our amazing chief residents to the show, Dr. Stephen Freiberg. Stephen has taken an interest in massive transfusion and he goes over the highlights of when to do it, how to do it, what complications you see from it and how to manage those complications.

CME: https://earnc.me/rhLkfr

Anesthesia, ERAS, Fluids, Show Notes

Episode 21: ERAS with Dr. Chris Wu

November 23, 2016 ACCRAC 4 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 21: ERAS with Dr. Chris Wu

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33:34

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.

CME: https://cmefy.com/moment?id=6N5q_p2

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