TopMedTalk

This piece focuses on the article "The malnourished surgery patient, a silent epidemic in perioperative outcomes?" which you can find here: https://journals.lww.com/co-anesthesiology/Abstract/2019/06000/The_malnourished_surgery_patient__a_silent.23.aspx

The Perioperative Quality Initiative is here: www.poqi.org

Presented by Desiree Chappell with Monty Mythen and their guests Jeroen Molinger, Clinical Medical Exercise Physiologist at Duke University Medical Center, Department of Anesthesiology & ICU and John Whittle, assistant Professor at Duke University Medical Centre.

This podcast covers the physiological principles of goal directed fluid therapy, fluid responsiveness, the stressed system and the glycocalyx.

Originally streamed live on www.topmedtalk.com

Presented by Dr Joff Lacey with his guest Dr Randall Dull of the University of Illinois, live from the ASA in 2017.

This piece takes a look at some of the big areas we expect to see over the next twelve months as Desiree Chappell and Monty Mythen are joined in the studio by TopMedTalk favourite Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton.

Could political change and necessity improve things in the UK? Hopefully this time next year will be a "champagne moment" rather than a "sham moment". As expected, the interest in prehabilitation over this year has been huge and the momentum seems likely to continue in 2020. Find out more about the Prehabilitation World Congress soon on the EBPOM website: https://www.ebpom.org

New listeners are encouraged to listen to the wide range of discussions we've had on this fascinating topic by going here: https://www.topmedtalk.com/?s=prehabilitation

Also, oxygen therapy has been a growing topic and we expect to hear more over the year; check out our work so far here: https://www.topmedtalk.com/?s=oxygen

The article we mention in this piece is here: "Hidden pandemic of postoperative complications—time to turn our focus to health systems analysis" https://bjanaesthesia.org/article/S0007-0912(18)30654-8/abstract

Learn here about The 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care provision after Surgery (SNAP-2: EpiCCS).

Is anxiety the worst thing about an operation? How common a problem for patients is feeling thirsty? What about pain, how do we best manage it?

In the second part of the piece we a focus on "Women in Anaesthesia"; Is there an 'opportunity gap'? How do we correct imbalances in the profession? Most importantly, how do we avoid "tokenism"?

Is there room for a 'name and shame' strategy if we attend a meeting where there is a clear lack of gender balance or is that likely to be unhelpful?

Check out the Athena SWAN (Scientific Women's Academic Network) charter here: https://www.ecu.ac.uk/equality-charters/athena-swan/

The edition of the BJA which has inspired this series is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext

This piece was originally recorded live at the 5th Collaborative Clinical Trials in Anaesthesiology Meeting, Prato, Italy.

Presented by Desiree Chappell with Monty Mythen and Ramani Moonesinghe, Professor of Perioperative Medicine at University College London (UCL).

"The predominant emotion was fear..."; this piece is essential listening for every TopMedTalk listener who really cares about the experience of their patients. Hear what it was like to participate in the pioneering, tailored exercise training programme, The Encourage Trial. Also, find out about "the Buddy Scheme" and how becoming a member of a local support group: SPICOS (Support for People Impacted by Cancer of the Oesophagus and Stomach) led to it.

Could a 'Buddy', volunteers who have been in a similar situation and have agreed to be a point of contact for patients and their families, be able to offer reassurance and support at your practice?

Someone your patient can rely on who can honestly say to them; 'Yes, I know exactly what you mean, I know exactly how that feels'.

The Macmillan Cancer Support website is here: https://www.macmillan.org.uk/

Presented by Mo Cottrell, a retired nurse who underwent a 5 week course of Chemoradiotherapy followed by successful surgery for Oesophageal Cancer at Southampton General Hospital in January 2017.

Hear how evidence based practices can reduce costs and improve outcomes. What are the key areas most institutions can work on to get the best and most rapid return on time invested? Neuro, atrial fibrillation, acute kidney injury (AKI) and blood management are big key areas.

The article discussed in this piece is here: https://www.scahq.org/Portals/0/Documents/Clinical%20Practice%20Guidelines/SCA_EACTA%20Practice%20Advisory.pdf

This piece was recorded live at 'The Society of Cardiovascular Anesthesiologists' (SCA) annual conference, 2019. The SCA website is here: https://www.scahq.org

Also in this piece, what's the future for the SCA? Where will their focus be as they increase the value of being an SCA member?

The Perioperative Quality Initiative (POQI) is here: https://thepoqi.org/

Presented by Desiree Chappell with her guests Andy Shaw, President of The Society of Cardiovascular Anesthsiology and Nanette Schwann, Cardiothoracic Anesthesiology, Critical Care Medicine, Professor and Vice Chair of Research and Education at Lehigh Valley Health Network.

Enhanced Recovery After Surgery, (ERAS) is a familiar concept to the typical TopMedTalk listener but what is ERAS+?

How can you target high risk surgery patients with a comprehensive plan for them to help themselves get a better outcome? From managing expectations, to breathing exercises all the way up to significant lifestyle changes such as exercise and smoking cessation.

The ERAS+ website is here: https://www.erasplus.co.uk/

Presented by Joff Lacey with Desiree Chappell with their guest Daniel Conway, Consultant in Anaesthesia and Critical Care, Perioperative Medicine lead, Manchester Biomedical Research Centre.

Frailty is a common condition which has been topical in geriatric medicine for some time but now it is appearing in the surgical and anaesthetic literature. This talk explores how our understanding and discussion has improved regarding a condition that is still yet to have a clear, universally accepted, definition. How do we build a patient's physical reserve? What is the best way to conceptualise frailty? Are there any universal treatments available?

Presented by Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust.

Should prehabilitation be thought of also as "primary prevention" and used to avoid health problems occuring in the first place? If "exercise is real medicine" how do we change the culture so GPs are comfortable prescribing physical activity to patients? How can we get people to exercise more when the political mood is turning against Government interference and the so-called "nanny state"? What is 'the business case' for prehabilitation?

Co-chaired by Mike Grocott and Stefan van Rooijen and featuring: Graciela Martinez-Palli, Consultant in the Department of Anaesthesia and Perioperative Care at Hospital Clinic, Barcelona; Anna Lowe, Programme manager, National Centre for Sport and Exercise Medicine, Lead Allied Health Physical Activity Clinical Champion at Public Health, England; John Moore, Clinical Head of the Division of Anaesthetics, Peri-operative medicine and Critical Care at Manchester University Hospital NHS Foundation Trust; Sarah Ruane, Sport England's national lead for health, she joined in January 2016 from local government where she oversaw public health, leisure and cultural services.

This is TopMedTalk's first in a our series 'Women in Anaesthesia': a celebration of the women who drive academic research and perioperative practice around the world. Inspired by the British Journal of Anaesthesia's March edition of the same name this series will profile some of the women who take frontline roles in our profession, all of them contributors to TopMedTalk.

Angela Bader features on TopMedTalk here: https://www.topmedtalk.com/perioperative-medicine-summit-2019-1-03-angela-bader/

Carolyn Johnston features here: https://www.topmedtalk.com/ebpom-2018-12-the-importance-of-cpet-and-nela/

Ramani Moonsinghe's interview in this piece will be released next week but if you'd like to hear one of her other appearances go here: https://www.topmedtalk.com/ebpom-highlight-1-03-sprint-national-anaesthesia-project-snap/

Presented by Desiree Chappell.

The British Journal of Anaesthesia article, which inspired this series, is here: https://bjanaesthesia.org/article/S0007-0912(20)30003-9/fulltext