Neuro Resus

Professor Jules Wendon

Jules Wendon is the Professor of Hepatology and Executive Medical Director at Kings College London.

When it comes to the intensive care hepatology there are few people that have done more to shape our knowledge and practice than Jules Wendon. Jules travelled to Australia to share her knowledge at the CICM Annual Scientific Meeting. Sharing is a key theme in this interview as Jules insists on

crediting her team, all of her team, for their part in the success of Kings. Humble yet inspirational, modest yet brilliant. Have a listen to this short conversation recorded in between her lectures at the CICM ASM in Sydney 2017.

Each year the CICM holds its Annual Scientific Meeting. The Meeting has always been focused

upon a single issue or organ system. This year the theme was Gastroenterology entitled "A Gut Reaction; ICU Gastroenterology from beginning to end."

The lectures presented at the meeting have been recorded and will all be shared among the delegates and some will also be shared with all comers via the Intensive Care Network (www.IntensiveCareNetwork.com), the celebrated "#FOAMed" website. (Free Open Access Medical Education.)

The organisers of the ASM invited #FOAMed podcaster/interviewer Dr Doug Lynch to come along to engage some of the leading lights of the meeting in conversation and record them.

These recordings are the latest in a series of podcasts/blogcasts playfully called "Jellybeans". They are entirely spontaneous chats with interesting people; short, completely unscripted, 100% unedited and recorded in one take. It is essentially an uninterrupted live recording. The focus is unapologetically on the quality of the conversation rather than the quality of the audio recording. The host of the interview is a fast talking Irish doctor, a jack of all trades but a master of none, a perpetual student and a trainee of the CICM. The "Jellybean" is an itinerant podcast that regularly appears on www.LifeinTheFastLane.com, www.IntensiveCareNetwork.com and many other websites. Over 100 conversations have been recorded with persons of interest. They will appear on iTunes and Google play once the 100th episode is published later this year.

The CICM ASM Jellybean series each start with a biographical component and then the conversation follows its own path. The subject matter is usually that which dwells upon the fringes of intensive care medicine; human factors, education, ethics, equality, gender, personal histories, possible futures and all the other challenges that we so often face. Being so they compliment the lectures but do not attempt to repeat them. We hope you enjoy finding out a little more about the people behind the CICM Annual Scientific Meeting. The four CICM x Jellybean co-branded recordings are part of a larger collection. It is only these four that are formally associated with the College. Doug Lynch is not a representative of the college and any views expressed are his own.

Associate Professor Charlie Corke

President of the College of Intensive Care Medicine of Australia and New Zealand (CICM).

The CICM is the worlds first stand alone College of Intensive Care Medicine. A/Prof Charlie Corke is the President.

It is not an easy job to do.

It is not an easy job to get. Charlie got there by a path less travelled and he talks about that path, among many other things, in this short interview recorded at the Annual Scientific Meeting of the College.

Each year the CICM holds its Annual Scientific Meeting. The Meeting has always been

focused upon a single issue or organ system. This year the theme was Gastroenterology

entitled "A Gut Reaction; ICU Gastroenterology from beginning to end."

The lectures presented at the meeting have been recorded and will all be shared among the delegates and some will also be shared with all comers via the Intensive Care Network (www.IntensiveCareNetwork.com), the celebrated "#FOAMed" website. (Free Open Access Medical Education.)

The organisers of the ASM invited #FOAMed podcaster/interviewer Dr Doug Lynch to come along to engage some of the leading lights of the meeting in conversation and record them.

These recordings are the latest in a series of podcasts/blogcasts playfully called "Jellybeans". They are entirely spontaneous chats with interesting people; short, completely unscripted, 100% unedited and recorded in one take.

It is essentially a live recording. The focus is unapologetically on the quality of the conversation rather than the quality of the audio recording.

The host of the interview is a fast talking Irish doctor, a jack of all trades but a master of none, a perpetual student and a trainee of the CICM.

The "Jellybean" is an itinerant podcast that regularly appears on www.LifeinTheFastLane.com, www.IntensiveCareNetwork.com and many other websites. Over 100 conversations have been recorded with persons of interest. They will appear on iTunes and Google play once the 100th episode is published later this year.

The CICM ASM Jellybean series each start with a biographical component and then the conversation follows its own path. The subject matter is usually that which dwells upon the fringes of intensive care medicine; human factors, education, ethics, equality, gender, personal histories, possible futures and all the other challenges that we so often face. Being so they compliment the lectures but do not attempt to repeat them.

We hope you enjoy finding out a little more about the people behind the CICM Annual Scientific Meeting. The four CICM x Jellybean co-branded recordings are part of a larger collection.

It is only these four that are formally associated with the College.

Doug Lynch is not a representative of the college and any views expressed are his own.

This is the oration John Myburgh gave at the College of Intensive Care's Annual Scientific meeting when he was awarded the College Medal for a career's worth of contributions. This was actually recorded a couple of days after the event by Lily Foster & Oli Flower, but it still contains all the emotions and sentiments that were there on the night when it was delivered at Doltone house on 27th May 2017.

But they have not stopped proving their point. Next there was "Women in Leadership in Intensive Care Medicine" published in Jean-Louis Vincents open access e-journal "ICU Management and Practice".

There have been only four presidents of the College of Intensive Care, all male. However the pre-cursor to the College was the Joint Faculty of Intensive Care Medicine (JFICM), which was the body that actually created the college. The first leader of JFICM was the one and only Dr Felicity Hawker. Hopefully soon to be published will be a presentation from the Noosa ANZICS CTG (Australia & New Zealand Intensive Care Society Clinical Trials Group) by Dr Naomi Yarwood about the lack of women in the ANZICS CTG studies over the last 20 years.

Next Issue; Training. After competing her Fellowship exams Sarah got involved in the Critical Care Collaborative and went on to found the Victorian Primary Examination Course for CICM (VPECC). Running that

is a big job in itself. It's popular too and the July 2017 edition is already full. Sort of. Importantly the candidate stream is full for 2017 but there is a teaching stream too. Have a look at this if you are an aspiring educationalist.

See the Post on Intensivecarenetwork.com

Ash Banerjee talks about the history of ventilation and where we are today. He discusses in particular current concepts about lung protective ventilation strategies and how we can ventilate with the least amount of harm.

For more details on how to select the ideal PEEP for a patient, or how one would set up the ventilator for an ARDS patient, have a look at Alex Yartsev's site Deranged Physiology, where there's a great post on the Optimal PEEP for Open Lung Ventilation in ARDS which specifically mentions Gattinoni's recent review paper.

Cannulation Part 2

by Roger Pye

Welcome to learnECMO podcast series. This instalment is the second part of Roger Pye's meditations on ECMO cannulation, this time focusing on Avalon, VA and the duplicitous art of backflow cannulation.

On the subject of cannulation, places for SMACCannulate are going fast so head to the SMACC website if you fancy a crack at the title of world fastest cannulator and sign-up. Now we do realise that optimal procedural ergonomics does not prioritise speed and we have had lots of enquiries about actually learning to cannulate. As such we will be offering sessions at the pop-up SMACCannulate station where all comers will be welcome for hands-on cannulation teaching. We will teach you how to finesse and troubleshoot each element of ECMO cannulation from ultrasound guided seldinger technique to mitigating the perceived disaster of a bent wire. Go to the SMACC website to register for either of these sessions.

If you are not able to join us in berlin then we will be co-hosting a cannulation workshop at ST. Thomas's hospital in London with the GSTT ECMO team, one of the highest volume centres in the world with a highly sophisticated intensivist led ECMO retrieval service. learnECMO London will be on Monday 3rd July and you can register via learnECMO.com, come and learn some high fidelity cannulation chicanery from some proper experts.

Associate Professor Neil Orford is the director of the intensive care unit at University Hospital Geelong. In his time as director he has overseen some major developments within his unit, including the introduction of a paediatric service. Here he shares some of his strategies on what it takes to be an effective leader.

by Steve Morgan & Sophie Connolly

Today we are going to cover the essentials of ECMO haemodynamics. Haemodynamics literally means blood movement and thus is the physical study of flowing blood and the structures through which it flows. In bedside vernacular we tend to use haemodynamics to refer to accessible surrogate measurements of cardiovascular performance, such as vascular and chamber pressures or quantifications of macrocirculatory blood flow.

To understand the haemodynamic effects of ECMO we will consider the effects of the in-parallel VA circuit and the in-series VV circuit separately. The effect on cardiac performance can be best approached and compartmentalised by examining the impact of ECMO on each of the determinants of stroke volume: preload, afterload and contractility.

This podcast covers:

How can we best describe ventricular function and the effect of ECMO?

What factors influence the net effect of VA ECMO on patient haemodynamics?

What are the general primary haemodynamic effects of VA ECMO?

How does cannulation site influence the haemodynamics of VA ECMO?

What do you do about a non-ejecting heart on VA ECMO?

What about the RV? How does the unique functional anatomy and physiology contribute to RV failure?

What are the haemodynamic effects of VA ECMO on the RV?

What are the haemodynamic effects of VV ECMO?