Neuro Resus

Dr Sachin Gupta is an intensivist at Peninsula Health with interests including medical education and quality assurance. In this podcast from an ICN Victoria meeting he discusses the difficulties we currently face in predicting bleeding and how this might change in the future.

The role of Liver Replacement Therapies remains undefined. In this podcast, Associate Professor Luke Torre shares his experience and the science and evidence behind Extra-Corporeal Liver Assist Devices (ELAD) Dr Torre is currently working as an Intensivist/Anaesthetist in Perth, Western Australia. This presentation was originally presented at an ICN WA meeting held 2nd December 2015 in conjunction with Hazeldine on Alcoholic Liver Disease.

Basic Science Clinic by Steve Morgan & Sophie Connolly

In the words of the canonical Roman poet Ovid: "Sickness seizes the body from bad ventilation".

Welcome to Basic Science Clinic Raw Science 9. Convective gas flow provides the substrate to interface with alveolar structural and functional adaptation in orchestrating gas exchange. Gas exchange is the serial interconnection of ventilation, diffusion and perfusion. Alveolar gas composition is determined by amount and type of gases delivered by ventilation, the rate and direction of gas diffusion, and the pulmonary blood flow which continuously recalibrates partial pressure gradients to direct oxygen and carbon dioxide movement. Bulk gas volume displacement is the mechanism of ventilation, but how do we conceptualise and quantify its contribution to gas exchange and its associated abnormalities? In this pod we will examine the quantification of ventilation and parse its correspondence with variance in the dead space volume and central role in carbon dioxide homeostasis.

In this podcast we will cover:

How do we define pulmonary ventilation?

What is the relationship between alveolar minute ventilation and alveolar gas composition?

What are the determinants of arterial carbon dioxide partial pressure?

What are the physiological sequelae of hypercapnia?

What is permissive hypercarpnia?

What is dead space?

How do we quantify dead space volume?

What are the factors that affect dead space?

Here are your Raw Science factoids:

Morphological dead space estimates give us volumes of 150mls for dogs, 380mls for cows and 150-300L for whales.

In 1986 in Cameroon a paroxysmal expulsion of carbon dioxide from the volcanic lake Nyos resulted in the asphyxiation of 1700 people and 8000 animals.

The highest documented PaCO2 to be measured in a subsequent survivor weighed in at 501 mmHg in a 16 year old boy swallowed, sequestered and asphyxiated by a rapidly filling grain truck.

For feedback, corrections and suggestions find us on the twitter handles @falconzao and @sophmconnolly or alternatively post on ICN. Check out our new website basicscienceclinic.com where you can access the back catalogue and peruse the real brains behind our elaborate plagiarism by checking out the reference page to go direct to the source material.

Thanks for listening. Next up we'll consummate the journey of inspirate atmospheric gas into the blood phase, as we appraise gas diffusion across the alveolar-capillary membrane and dissect the pulmonary vasculature.

Pulmonary Hypertension and Right Heart Failure remains elusive and challenging to even the seasoned Intensivist. In this post, Playford unravels the mysteries behind Right Heart Failure and ECHO tips and pitfalls. Originally recorded 28th July 2015 at the Inaugural ICN WA meeting Professor Playford is a Cardiologist with a special interest in pulmonary hypertension and has recently authored a chapter in Otto's "The Clinical Practice of Echocardiography"

Claire Cattigan is an Intensivist and Deputy Director of ICU at The University Hospital Geelong. She is interested in the management of paediatric patients in mixed ICUs and gives a fascinating talk on the challenges and rewards of introducing paediatric patient care into a general, adult intensive care unit.

The decision to admit patients with Alcoholic Liver Disease to ICU is polarising. In this podcast, Dr Simon Hazeldine uncovers the evidence behind outcomes and management of these patients and why these patients should be considered for therapy in the ICU.

In this podcast, Mr Larbalestier shares his experiences with cardiac transplantation and guides us through some his POV footage of the first heart transplantation at the new Fiona Stanley Hospital.

Ciaran McKenna and Andy Buck have a pow-wow with Matthew Mac Partlin on 3D Printing - Where it's up to, where it might go and how they are using it.

Dr Steve McGloughlin is an intensivist at the Alfred Hospital. He has a special interest in education particularly the use of simulation and crisis resource management skills in critical care. He is also an infectious diseases specialist and maintains both clinical and research interests in infections in critically ill patients. Here he discusses the ongoing primacy of antibiotics in intensive care and our continuing battle with antibiotic resistance