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Podcasts on topics relevant to intensive care medicine

Podcasts on topics relevant to intensive care medicine
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Location:

United States

Description:

Podcasts on topics relevant to intensive care medicine

Language:

English


Episodes

Immune diseases - What about all those MABs

10/10/2018
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Monoclonal antibodies (MAbs), guided by molecular studies and personalised medicine are changing the face of clinical medicine. They hold the promise of controlling diseases and improving survival whilst reducing the side effects of some ‘traditional’ therapies. MAbs are being used in conditions familiar to intensivists such as asthma, invasive candidiasis, RSV infection, reversal of novel anticoagulants and clostridium difficile infection as well as in those less commonly seen by...

Duration:00:28:12

Malignancy

10/10/2018
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The incidence of cancer is increasing in line with our ageing population, with a greater number of patients requiring ICU admission for support managing complications of their malignancy, it’s therapy, or conditions unrelated to their underlying cancer. Despite these indications, the presence of a cancer diagnosis has been a common reason for refusal of ICU admission, or admission with treatment limitations. This session will present the current epidemiology, characteristics and outcomes of...

Duration:00:26:15

Massive Stroke

10/10/2018
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There have been significant developments in the diagnosis and management of ischaemic stroke. This started with trials showing a benefit for decompressive craniectomy after a malignant hemispheric stroke in patients under 60 undergoing surgery within 48 hours. The evolution of CT and MRI have enabled us to better image not only the ischaemic core of the stroke, but also the surrounding hypo-perfused brain at risk of ischaemic death; the penumbra. CT and MR angiography now allow rapid,...

Duration:00:21:25

HIV and Hepatitis C

10/10/2018
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People living with HIV in 2018 now have normal life expectancy if receiving Anti-Retroviral Therapy (ART) and often require only one co-formulated pill every day to remain well. However there are still people living with HIV who are unaware of their diagnosis; who may present with a critical illness. Knowing who to test is essential. The population living with HIV are also ageing and often have comorbidities. It is vital that clinical conditions associated with HIV are recognised and for...

Duration:00:21:52

Blood Pressure Targets

10/10/2018
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Blood Pressure (BP) is one of the vital hemodynamic parameters that we often aim to optimize for critically ill patients. Our decisions regarding BP targets, and ensuing use (or avoidance) of vasopressor agents, may directly impact on outcomes for these patients. Despite being a fundamental tenet of critical care, there is a lack of quality evidence to suggest optimal BP targets or to guide the use of vasopressors for individual patients with shock. A mean arterial BP (MAP) of 65-70 mmHg is...

Duration:00:20:59

Diabetes Management: new drugs and new approaches

10/10/2018
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Recently, several novel glucose-lowering targets have had drugs developed. This has resulted in several new drugs that have been approved for the local market to treat hyperglycaemia in patients with type 2 diabetes. This presentation will attempt to provide:

Duration:00:21:41

Frailty: a better reflection of long term outcome?

10/10/2018
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Frailty is a state of reduced physical, physiological and cognitive reserve. Tools to measure frailty which were developed in geriatric medicine practice, have over recent years been applied to patients admitted to the Intensive Care Unit (ICU). Studies in the ICU suggest that frailty is associated with reduced reduced likelihood of discharge home and reduced survival at one year. Survivors also report lower quality of life measures on both physical and mental assessments. The most common...

Duration:00:15:46

Choosing Wisely Campaign: what’s been happening?

10/10/2018
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This presentation will outline current Choosing Wisely projects happening in ICUs around Australia. It will also discuss the Choosing Wisely Australia campaign and its direction.

Duration:00:21:00

Lung Recruitment in ARDS - To be or not to be

9/24/2018
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Lung Recruitment in ARDS - To be or not to be by Dr Swapnil Pawar

Duration:01:00:55

Training and QA for your regional unit

9/24/2018
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International outcomes of centres performing ECLS (extracorporeal life support) are highly variable due to differences in patient selection, cannulation technique, practitioner experience and hospital volume. We describe the experience of one of the first regional intensive care units in Australia to provide both VV (veno-venous) and rescue VA ECMO (veno-arterial extra-corporeal membrane oxygenation). Methods Review of internal registry and description of processes and procedures in an 11...

Duration:00:18:22

Coordinating an ECMO service with retrieval

9/24/2018
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Since the H1N1 influenza pandemic of 2009 there has been a dramatic increase in the number of patients receiving ECMO and in the number of hospitals that provide it. Data from the Extracorporeal Life Support Organisation (ELSO) suggests that over the last decade the number of adult patients receiving ECMO for respiratory support has increased at least 12-fold and the number of centres submitting data to the ELSO registry has tripled. The approach to the provision of ECMO in NZ and...

Duration:00:21:05

Optimising support

9/24/2018
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Optimising support by Dr Susanna Price

Duration:00:14:51

Extracorporeal Membrane Oxygenation (ECMO) for all?

9/24/2018
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I will consider this question in two parts; From a patient perspective, ECMO is a highly invasive intervention and like every other intervention that we consider, the benefits it provides must outweigh its risks for it to be worthwhile. Clearly, veno-venous and veno-arterial ECMO supports are very different beasts – the patient profile, physiology, complications and outcomes differ considerably. At the extreme of the VA-ECMO spectrum is ECMO-CPR (e-CPR). Whilst ECMO centres...

Duration:00:21:44

VAD & transplanted patient with non-cardiac critical illness

9/19/2018
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Use of Ventricular Assist Devices (VAD) and heart transplantation (HT) for end stage cardiac failure have increased significantly in recent decades. These support strategies hold inherently different risks in the face on non-cardiac critical illness, and require multidisciplinary team management. According to INTERMACS, more than 2500 VADs/year are implanted the USA. Most implanted devices are continuous flow left-VADs (75%) which deliver systemic cardiac output directly related to pump...

Duration:00:18:17

Transplant or durable mechanical support

9/19/2018
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Both cardiac transplantation and durable mechanical support with ventricular assist devices (VADs) have a parallel history – poor results to begin with followed by progressively improving results with more targeted immunosuppression, better recipient selection, improved diagnosis and treatment of rejection and opportunistic infections (cardiac transplantation) and a major step forward with replacement of pulsatile pumps by continuous flow devices (VADs). Heart transplantation continues to...

Duration:00:22:14

A new heart – who gets one and what next?

9/19/2018
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This talk with discuss the indications for, contraindications to, and expected outcomes after heart transplant with a focus on the New Zealand and Australian experience. I will discuss the transplant assessment process and listing criteria. Perioperative and long term management of heart transplant patients will be covered. Post heart transplant outcomes (morbidity and mortality) will be discussed. I will discuss organ donation with a focus on the donor heart, covering what criteria we use...

Duration:00:26:56

ECLS in adults – where are we now?

9/19/2018
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Talk will discuss the use of ECMO as advanced cardio-pulmonary resuscitation in the setting of refractory cardiac arrest. The aim will be to provide useful information for those already experienced in ECPR as well as those with no experience but an interest in establishing an ECPR in their adult centre. Topics covered will include the rationale for the use of ECPR , the evidence base and current Australasian practice. Practical issues re patient selection , cannulation , post cannulation...

Duration:00:23:07

ECLS – where are we now? Young ones

9/19/2018
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Extracorporeal membrane oxygenation assisted cardiopulmonary resuscitation (ECPR) is an effective therapy to improve outcomes for children who experience cardiopulmonary arrest. Survival after ECLS varies between 60% and 75%. For ECPR survival is lower, with 40% to 50% of children surviving ECPR. After ECPR good neurological outcomes are seen in 40% to 60% of children. This contrasts with adult patients where neurological outcomes after ECPR are poor. Given these findings the American Heart...

Duration:00:20:17

We have ROSC. What next?

9/19/2018
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Patients admitted to the ICU after cardiac arrest have, by definition, achieved ROSC. In such patients the major issues remain those of ongoing support hemodynamic and cardiorespiratory support, cerebral protection, aetiological diagnosis, and rapid intervention to deal with the underlying trigger (coronary angiography and stenting of coronary artery disease or CT pulmonary angiography and anticoagulation/thrombolysis for PE). Once the aetiological diagnosis has been made and its cases...

Duration:00:18:53

Resuscitation update

9/19/2018
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The good news in resuscitation is that there have not been any new advances that mandate a change in practice since the 2016 ANZCOR Guidelines. The bad news is that despite our best intent, the ever-increasing research appears unable to demonstrate improved outcomes with any particular approach. Two of the most exciting areas (eCPR and post-resuscitation care) are being covered in detail at separate talks at this meeting. This presentation will focus on updating the audience on the more...

Duration:00:23:58