Intensive Care Network Podcasts

Pete McCanny gives a talk on the cutting edge management of cardiogenic shock and challenges the conventional approach to mechanical support. 

Thomas & Kass bust some common ICU Myths in a classic Podcast.

David Anderson, intensivist at the Alfred, discusses dementia, death and end of life care in the intensive care unit

WIN October Dinner 2016: Death and Dying in the Intensive Care Unit

learnECMO Roger Pye on cannulation, part 1. This podcast is the first of 2 parts of the Cannulation 101 session from the recent ECMOcannulate course. It is delivered by a true expert in the form of Roger Pye, erstwhile renal physician, intensivist and cardiac anaesthetist with 10 years of ECMO retrieval experience. In part 1 Roger gets right down to the grain on VV cannulation and just how vital cannula configuration is to optimising systemic oxygenation, an essential consideration when bundling ECMO patients up for a 4000km aeromedical retrieval. Look out for part 2 which will cover the Avalon cannula and cannulation for VA ECMO. Thanks for listening. If you're interested in honing your cannulation skills go to learnECMO.com to register your interest for ECMOcannulate in 2017. We will also be in Berlin at the blue riband crit care conference, das SMACC, where we will invite all comers to set the ECMO cannulation world record.

Stroke thrombolysis - why are we still arguing? Summary by Lachlan Donaldson The debate regarding the efficacy of thrombolysis grumbles on… How is it that two different groups (i.e. mostly ED doctors and neurologists) can look at the same set of trials and come to fundamentally different conclusions? To examine this, these authors have attempted to perform an unbiased meta-analysis and systematic appraisal of the evidence supporting the use of thrombolysis in ischaemic stroke (paper available here). Consistent with other meta-analyses, the authors found a moderately increased probability of good functional outcome (OR 1.14) alongside a markedly increased risk of ICH (OR 4.28). However, as discussed, this debate is likely to be driven by the quality of the trials that populate this meta-analysis. For instance, of the 16 studies that nominated a specific primary outcome, only 2 studies reported a significant treatment effect in favour of thrombolysis as their primary outcome- the NINDS trial and ECASS III.

Associate Professor Vincent Pellegrino is a Senior Intensive Care Specialist at The Alfred Hospital and head of the ECMO Clinical Service.  He has had a lead role in the development of ECMO services at The Alfred since 2003. From the ECMO CPR ICN Victoria meeting he discusses how to get patient selection and outcomes right for eCPR.

Peter McCanny is part of the LearnECMO team. In this podcast he explains some of the background and history of ECMO CPR, what evidence there is to support its use and where we're heading in the future.

Basic Science Clinic by Steve Morgan & Sophie Connolly In the words of the 3rd greatest physicist of all time, James Clerk Maxwell: “It is of great advantage to the student of any subject to read the original memoirs on that subject, for science is always most completely assimilated when it is in the nascent state.” Welcome to Basic Science Clinic Raw Science 10. Not before time we are ready to approach the alveolar-capillary membrane to substantiate the factors that determine the reciprocal exchange of biologically operative respiratory gases. For all the demonstrable complexity of transport and signaling mechanisms in the human body, the energetically neutral transaction of simple passive diffusion is culpable for the cascading maintenance of gas exchange homeostasis and oxidative phosphorylation, with its explosive potential for driving the evolution of ostentatious biological complexity. The adaptive imperative to exploit diffusion for gas exchange imposes certain anatomical demands on the respiratory

ECMO Gas Exchange by Steve Morgan & Sophie Connolly This is the first in a series of ECMO podcast from the LearnECMO team - starting with the physiology of ECMO gas exchange.  

Professor Stephen Bernard is an Intensive Care Physician at The Alfred Hospital and Medical Advisor to Ambulance Victoria.   His research interests include the use of therapeutic hypothermia for the treatment of neurological injury after resuscitation from out-of hospital cardiac arrest. Here he provides a presentation on recent advances in the management of refractory cardiac arrest in the out of hospital setting.

Jason Maclure is deputy director of Intensive Care at the Alfred Melbourne. He has strong interests in analgesia and sedation, respiratory failure, ventilation, HFOV and ECMO. From an ICN Victoria 2016 meeting on ECMO CPR he discusses the development of the eCPR protocol at the Alfred.

Huy Tran is a lab and clinical haematologist at Peninsula Health. He has research interests in haemostasis and thrombosis and is a member of the Australasian committee for anticoagulation reversal. This is his presentation from an ICN Victoria meeting where he discusses the new oral anticoagulants and what can be done when they cause critical bleeding

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 dioxi

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.