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Anesthesia, Cardiac

Episode 48: TAVRs with Clint Tippett

2 Comments
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 48: TAVRs with Clint Tippett
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In this episode, episode 48, I welcome Dr. Clint Tippett to the show.  Dr. Tippett is a cardiac anesthesiologist with an interest in anesthesia for Transcutaneous Aortic Valve Replacement (TAVR) and we discuss the approach to anesthesia for these cases including preoperative planning, intraoperative management, and post-operative concerns.

CME: https://earnc.me/NVVNUT

Regarding stroke risk here is an editorial (Thanks to Stephen Freiberg for providing this link): http://circinterventions.ahajournals.org/content/8/6/e002801

And Dr. Tippett wanted to add that early studies of the 1st and second generation valves had higher stroke rates than SAVR, however the most current genreration valves(Edwards Sapien 3 and Medtronic Evolut R) both have been shown to have not significantly different stroke rates from TAVR.(Surtavi trial and this observational study http://thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)30073-3.pdf).

Finally, when discussing benefits of TAVR, we should have mentioned a significantly lower risk of post-op AFib in addition to lower bleeding risk and lower rates of AKI.

Anesthesia, Critical Care, Procedures

Episode 47: Arterial Lines with Stephen Freiberg

11 Comments
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 47: Arterial Lines with Stephen Freiberg
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In this episode, episode 47, I welcome back Dr. Stephen Freiberg, one of our chief residents, to discuss all you ever wanted to know about arterial lines.  We discuss the indications, contraindications, complications, placement technique, and how to interpret the waveform.

CME: https://earnc.me/P5Z6j5

Slides with figures mentioned in the podcast can be found here: Arterial Line Podcast Images

If you are a regular listener to the show please consider becoming a patron at patreon.com/accrac to help support the costs of making the show.  Even just a dollar or two makes a big difference.  Thanks so much.

Anesthesia, OB, Pharmacology, Show Notes

Episode 46: Obstetric Pharmacology and Fetal Assessment with Mike Hofkamp

8 Comments
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 46: Obstetric Pharmacology and Fetal Assessment with Mike Hofkamp
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In this episode, episode 46, I welcome back Dr. Mike Hofkamp to discuss obstetric pharmacology and fetal assessment.

CME: https://earnc.me/xnT8gE

Outline by Brian Park: Outline

Anesthesia, Critical Care, Neuro, Physiology

Episode 45: Postop Delirium with Charlie Brown

1 Comment
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 45: Postop Delirium with Charlie Brown
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In this episode, episode 45, I welcome Dr. Charlie Brown to the show.  Dr. Brown is one of our cardiac anesthesiologists with a research interest in postop delirium.  We discuss risk factors, consequences, prevention and treatment of postop delirium.

CME: https://earnc.me/Ckgf63

Anesthesia, Cardiac, Show Notes

Episode 44: Intro to cardiac anesthesia with Megan Kostibas

8 Comments
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 44: Intro to cardiac anesthesia with Megan Kostibas
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In this episode, episode 44, I welcome Dr. Megan Kostibas to the show.  Dr. Kostibas is trained in cardiac anesthesia and critical care medicine and is an assistant professor here at Hopkins.  She is also the associate program director for the cardiac anesthesia fellowship.  We discuss the basics of how to prepare, induce and manage difference cardiac pathology as well as how to go on and off cardiopulmonary bypass.

CME: https://earnc.me/WRnhvH

Show Notes by Dr. Brian Park

Anesthesia, OB, Physiology, Show Notes

Episode 43: Maternal Physiology with Mike Hofkamp

5 Comments
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 43: Maternal Physiology with Mike Hofkamp



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In this episode, episode 43, I welcome Dr. Mike Hofkamp to the show.  Dr. Hofkamp is Director of OB Anesthesia at Baylor Scott & White Memorial Hospital and Clinical Associate Professor of Anesthesiology at Texas A&M Health Science Center College of Medicine.  We discuss the changes to women’s physiology when they become pregnant and the implications of those changes for anesthetic management.

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

Outline by April Liu: Episode 43

Anesthesia, Pharmacology, Show Notes

Episode 42: Post-op Nausea and Vomiting (PONV)

2 Comments
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 42: Post-op Nausea and Vomiting (PONV)



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In this episode, episode 42, I discuss Post-op Nausea and Vomiting (PONV).  I discuss risk factors, complications, treatment and prevention and side effects.

CME: https://earnc.me/31KodT

Outline by April Liu: Outline

UPDATE April, 2018: In this episode I mention that the evidence is not good for Midazolam in preventing PONV.  However, a good friend and colleague, Dr. Michael Grant, did a nice meta-analysis of available trials which concluded that it actually does work fairly well.  Check out his study:

Grant MC, Kim J, Page AJ, et al. The Effect of Intravenous Midazolam on Postoperative Nausea and Vomiting: A Meta-Analysis. Anesthesia & Analgesia: 2016:122(3); 656–663.

Anesthesia, Anesthetic agents, Critical Care, Pharmacology, Show Notes

Episode 41: Local Anesthetics

10 Comments
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 41: Local Anesthetics



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In this episode, episode 41, I review local anesthetics including the mechanism of action, commonly used agents, pharmacodynamics and kinetics, toxicity and treatment, and common blocks.

CME: https://earnc.me/rbqGL8

Outline by April Liu: Outline

Anesthesia, Pulmonary, Show Notes

Episode 40: OR Vent modes

7 Comments
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 40: OR Vent modes



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In this episode, episode 40, I go over the basics of Vent modes and settings in the operating room and how they differ from the ICU.  I also discuss a few common special cases and how to adjust the vent to deal with them.

CME: https://earnc.me/LPbeCp

Outline by April Liu: Episode 40

Anesthesia, Critical Care, Physiology

Episode 39: Liver Transplant with Dr. Steve Frank

8 Comments
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 39: Liver Transplant with Dr. Steve Frank



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In this episode, episode 39, I interview Dr. Steve Frank, Professor of Anesthesia and Critical Care Medicine at Johns Hopkins, Medical Director of Blood Management for Johns Hopkins Health System and Chief of Adult Anesthesiology about anesthesia for liver transplants.

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