TopMedTalk

This is the third presentation - originally streamed live on www.topmedtalk.com - taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum".

Hear the full presentation from Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania.

If you like the sound of this and think you and your practice would benefit from attending such a course don't worry, just go to The EBPOM website: https://www.ebpom.org/EBPOM-USA-2018

This is the third presentation - originally streamed live on www.topmedtalk.com - taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum".

Hear the full presentation from Dr Lee A. Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania.

If you like the sound of this and think you and your practice would benefit from attending such a course don't worry, just go to The EBPOM website: https://www.ebpom.org/EBPOM-USA-2018

This is the second presentation - originally streamed live on www.topmedtalk.com - taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum".

Hear the full presentation from our Editor In Chief, Professor Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London.

If you like the sound of this and think you and your practice would benefit from attending such a course don't worry, just go to The EBPOM website: https://www.ebpom.org/EBPOM-USA-2018

EBPOM USA Part 2| A Perioperative Practicum with Professor Monty Mythen

This is the second presentation - originally streamed live on www.topmedtalk.com - taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum".

Hear the full presentation from our Editor In Chief, Professor Monty Mythen, chair at University College London (UCL) and National Lead for Enhanced Recovery in The UK.

If you like the sound of this and think you and your practice would benefit from attending such a course don't worry, just go to The EBPOM website: https://www.ebpom.org/EBPOM-USA-2018

This is the opening address and first presentation - originally streamed live on www.topmedtalk.com - taken from the hugely successful "EBPOM-USA: Masters Course, A Perioperative Care Practicum".

Hear the full presentation from Professor Sol Aronson, a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology.

If you like the sound of this and think you and your practice would benefit from attending such a course don't worry, just go to The EBPOM website: EBPOM-USA Chicago Masters Course A Perioperative Care Practicum

How and where do you measure a patient's temperature? This is a detailed answer to a frequently asked question, various methods are discussed.

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-1/

This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum.

The conversation features Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for theraputic purposes. There are also questions from the audience.

How and where do you measure a patient's temperature? This is a detailed answer to a frequently asked question, various methods are discussed.

This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-1/

This edition of TopMedTalk was recorded at The Institute of Sport Exercise and Health (ISEH) live from an Enhanced Recovery After Surgery (ERAS) leadership forum.

The conversation features Professor Monty Mythen and his two guests; Dr Simeon West, consultant anaethetist at (University College London Hospitals) UCLH who sits on the board at Regional Anaesthesia UK (RAUK) and Mark Harper Consultant Anaesthetist at Brighton and Sussex University Hospitals, with a research interest in the prevention of perioperative hypothermia and the use of cold water adaptation for theraputic purposes. There are also questions from the audience.

This is another excerpt from "Controversies in perioperative medicine"; "The Great Fluid Debate". A fascinating piece containing Dr Tim Miller's enthusiastic advocation of goal directed fluid therapy and then the subsequent debate that follows.

It ends up moving into the subject of 'enhanced recovery after cardiothoracic surgery' and what lessons we can learn from excessive hemofiltration during on bypass surgery.

Chaired by Professor Monty Mythen and featuring a presentation by Dr Tim Miller, anaesthsiologist from Duke University Medical Centre and followed by a debate featuring members of the audience and the panel; Professor Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton; Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University and Professor Stuart Grant, MB ChB, FRCA Director, Medical Student Education, Duke University School of medicine.

Join in the debate! Email us your thoughts for inclusion in a future podcast: [email protected]

This is another excerpt from "Controversies in perioperative medicine"; "The Great Fluid Debate". A fascinating piece containing Dr Tim Miller's enthusiastic advocation of goal directed fluid therapy and then the subsequent debate that follows.

It ends up moving into the subject of 'enhanced recovery after cardiothoracic surgery' and what lessons we can learn from excessive hemofiltration during on bypass surgery.

Chaired by Professor Monty Mythen and featuring a presentation by Dr Tim Miller, anaesthsiologist from Duke University Medical Centre and followed by a debate featuring members of the audience and the panel; Professor Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton; Professor Paul Wischmeyer from the Department of Anesthesiology, Duke University and Professor Stuart Grant, MB ChB, FRCA Director, Medical Student Education, Duke University School of medicine.

Join in the debate! Email us your thoughts for inclusion in a future podcast: [email protected]

Effect of intraoperative hyperoxia on the incidence of surgical site infections: a meta-analysis

B. Cohen, Y.N. Schacham, K. Ruetzler, S. Ahuja, D. Yang, E.J. Mascha, A.B. Barclay, M.H. Hung, D.I.

BACKGROUND Whether supplemental intraoperative oxygen reduces surgical site infections remains unclear. Recent recommendations from the World Health Organization and Center for Disease Control to routinely use high inspired oxygen concentrations to reduce infection risk have been widely criticized. We therefore performed a meta-analysis to evaluate the influence of inspired oxygen on infection risk, including a recent large trial.

METHODS A systematic literature search was performed. Primary analysis included all eligible trials. Sensitivity analyses distinguished studies of colorectal and non-colorectal surgeries, and excluded studies with high risk of bias. Another post-hoc sensitivity analysis excluded studies from one author that appear questionable.

RESULTS The primary analysis included 26 trials (N=14,710). The RR [95%CI] for wound infection was 0.81 [0.70, 0.94] in the high vs. low inspired oxygen groups. The effect remained significant in colorectal patients (N=10,469), 0.79 [0.66, 0.96], but not in other patients (N=4,241), 0.86 [0.69, 1.09]. When restricting the analysis to studies with low risk of bias, either by strict inclusion criteria (N=5,047) or by researchers' judgment (N=12,547), no significant benefit remained: 0.84 [0.67, 1.06] and 0.89 [0.76, 1.05], respectively.

CONCLUSIONS When considering all available data, intraoperative hyperoxia reduced wound infection incidence. However, no significant benefit remained when analysis was restricted to objective- or investigator-identified low-bias studies, although those analyses were not as well-powered. Meta-analysis of the most reliable studies does not suggest that supplemental oxygen substantively reduces wound infection risk, but more research is needed to fully answer this question.

DOI: https://doi.org/10.1016/j.bja.2018.02.027