TopMedTalk

Recorded at the recent American Association of Nurse Anesthesiology meeting this piece focuses upon the importance of addressing intraoperative hypotension (IOH) and its broader implications for patient outcomes, such as surgical site infections (SSI), postoperative cognitive dysfunction, and other complications. We also discuss the need for continuous education and the use of goal-directed therapy (GDT) to improve patient care.

Presented by Desiree Chappell and Monty Mythen with their guest Amy Yerdon, DNP, CRNA, Assistant Professor of Nursing, Nursing Acute, Chronic & Continuing Care, University of Alabama, Birmingham.

Our guest previously featured on TopMedTalk here: https://www.topmedtalk.com/podcasts/intraoperative-hypotension-killing-them-softly-topmedtalk-at-the-aana/

TopMedTalk broadcasted from the annual meeting of the American Association of Nurse Anesthesiology in San Diego.

This wide-ranging conversation explores the challenges and dynamics of the field, including staffing issues, hospital efficiency, and the financial pressures on healthcare providers. The discussion also delves into the evolving anesthesia market, the impact of COVID-19, and the importance of efficient management and collaboration, even among competitors.

The episode is presented by Desiree Chappell, TopMedTalk’s Co-Editor-in-Chief and Lead Anchor, as well as Vice President of Clinical Quality for NorthStar Anesthesia, alongside Randy Moore, DNP, MBA, CRNA, Chief Anesthetist Officer at NorthStar Anesthesia. Their guests include Adam Spiegel, Chief Executive Officer of NorthStar Anesthesia, and Tracy Young, MBA, CRNA, Co-Founder and Chief Operating Officer of Essential Anesthesia Management.

Guideline evolution is driven by ongoing research; recent studies like PeriOperative ISchemic Evaluation-3 Trial (POISE-3) and trials such as OPtimisation of Peri-operaTive CardIovascular Management to Improve Surgical outcomE II (OPTIMISE II) trial may influence recommendations on hemodynamic management and the use of tranexamic acid. Future guidelines are expected to integrate machine learning models for risk prediction, addressing complex patient phenotypes and interactions. Discontinuation vs. continuation of renin–angiotensin system inhibition before non-cardiac surgery: the SPACE trial has challenged existing practices regarding the discontinuation of ACE inhibitors or ARBs, highlighting the dynamic nature of medical guidelines and the continuous incorporation of new evidence to enhance patient care.

Presented by Andy Cumpstey and Joff Lacey with Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine, University Hospital Southampton Honorary Senior Clinical Lecturer, University of Southampton and John Whittle, Clinical Academic working in Perioperative Translational Medicine at UCL and Honorary Consultant in Perioperative Medicine, Anaesthesia and Critical Care at University College Hospitals London.

--

More on POISE-3 here: https://clinicaltrials.gov/study/NCT03505723

More on OPTIMISE II here: https://optimiseii.org/

More on the SPACE trial here: https://doi.org/10.1093/eurheartj/ehad716

Euroanaesthesia is one of the most important and influential annual congresses in anaesthesiology and intensive care. This year, TopMedTalk was there in Munich, Germany, bringing you exclusive coverage.

In this piece we find out how laryngoscopy has moved forward, where AI might take us and why sustainability important in medicine.

Presented by Desiree Chappell with Sam Azijian, Chief Medical Officer, Acute Care & Monitoring, Medtronic.

This episode underscores the evolution of perioperative medicine, the importance of innovation, teamwork, and data. The conversation reflects on past achievements and looks forward to future advancements in medical care. Our guest, a seasoned medical professional with a 40-year career, reflects on his journey from a young doctor in London to a consultant in Sydney. His plenary session at the Evidence Based Perioperative Medicine (EBPOM) congress highlighted key experiences and innovations in his career.

Presented by Andy Cumpstey with Ross Kerridge, Senior Staff Anaesthetist at the John Hunter Hospital, Newcastle, Australia and Associate Professor at the University of Newcastle.

In this piece our guest shares her journey from general anesthesiology to focusing exclusively on obstetrics, driven by her training as a sexual assault counselor. She highlights the prevalence of trauma among patients and the need for trauma-informed care practices.

Presented by Desiree Chappell with her guest Tracey Vogel, Obstetric Anesthesiologist, Allegheny Health Network and Founder of The Empowerment Equation, LLC.

More here: https://www.theempowermentequation.com/

More from our coverage of the 7th Collaborative Clinical Trials in Anaesthesiology Conference, Prato, Italy.

The South African Perioperative Research Group (SAPORG) is a multidisciplinary group of researchers interested in improving perioperative outcomes in South Africa, through collaborative research

Presented by Monty Mythen and Desiree Chappell with their guest Bruce Biccard, Professor and Second Chair at Groote Schuur Hospital and University of Cape Town, Chair of the South African Perioperative Research Group (SAPORG).

Bruce’s book is here: https://www.amazon.co.uk/Safer-Surgery-Africa-Challenges-Solutions/dp/0796153116

Earth Cast is here: https://podcasts.apple.com/gb/podcast/earth-cast/id1548400137

Freedom Challenge is here: https://www.freedomchallenge.org.za/

More from our coverage of the 7th Collaborative Clinical Trials in Anaesthesiology Conference, Prato, Italy.

This piece discusses trials in the wake of COVID-19 specifically we focus upon the PROTECT Platform Trial.

Presented by Monty Mythen and Kate Leslie with their guests Tom Abbott, anaesthetist and clinical lecturer at Queen Mary University of London and James Glasbey, NIHR Academic Clinical Lecturer in Global Surgery, University of Birmingham and General Surgery Registrar.

This piece looks at the DanGer Shock Trial which examines the efficacy of the Impella device in reducing mortality in patients with acute myocardial infarction and cardiogenic shock. We explain how the device works, its implantation process, and the significant findings from the trial, including a notable reduction in six-month mortality with a number needed to treat (NNT) of eight. Despite higher rates of bleeding and renal filtration therapy in the Impella group, the trial provides strong evidence supporting its use in high-volume centers with trained personnel, emphasizing the importance of careful patient selection and timely intervention.

Presented by Andy Cumpstey and Joff Lacey with their guest Vasileios Panoulas, an interventional cardiologist at Brompton and Harefield Hospitals and an honorary senior clinical lecturer at Imperial College London. 

This year TopMedTalk were at Euroanesthesia 2024, Munich, Germany.

In this piece we discuss anesthesia leadership, sustainability in healthcare, and innovations like Portrait Mobile and low-flow anesthesia. Our guest also shares her personal story as an immigrant and woman in industry, emphasizing the importance of mentorship, sponsorship, and balancing one’s personal and professional life.

Presented by Desiree Chappell and Kate Leslie with their guest Alla K. Woodson, Global GM, Anesthesia, Respiratory Care, and PCS Services, GE Healthcare.