TopMedTalk

TopMedTalk
  • 4.8 (35)
  • Medicine
  • Updated Weekly

TopMedTalk for the latest medical news surrounding Anaesthesia, Perioperative Care and Enhanced Recovery. Live updates from conferences; Journal Club; Techno Talk and Hot-Topic podcasts. Continuing Medical Education (CME) on the go

  1. 1d ago

    Breaking Trials: ITACS Trial on Preoperative IV Iron for Anaemia Before Cardiac Surgery

    Recorded at the excellent ANESTHESIOLOGY® 2025 in San Antonio. Hear Andy Cumpstey and Mike Grocott interview Paul Myles, a Professor of Anaesthesiology and Perioperative Medicine at Monash University in Melbourne, Australia. Here we focus upon his group's approach to large pragmatic, multicenter international trials and the process of selecting and developing study questions within a clinical trials network. Miles presents the ITACS trial (intravenous iron treatment for anaemia before cardiac surgery), designed because anaemia is common (~30%) in elective cardiac surgery and is associated with increased complications, longer hospital stay, mortality, and greater transfusion requirements, while prior randomized evidence supporting routine preoperative IV iron clinics has been weak despite observational associations. The two-arm randomized controlled trial enrolled about 1,000 patients scheduled for cardiac surgery 1–26 weeks ahead across 33 hospitals in 10 countries; patients with anaemia due to causes unlikely to benefit from iron (e.g., megaloblastic anemia, certain iron storage diseases) were excluded, while non–iron deficiency anaemia was included. Participants received a single 1 g dose of IV iron in the weeks preoperatively, with a primary endpoint of days alive and at home at 90 days to capture patient-centered recovery and the functional impact of complications. Results included a statistically significant one-day improvement in days alive and at home, modestly higher preoperative haemoglobin, markedly improved iron indices, and a marked reduction in red cell transfusions intraoperatively and through 30 days and 3 months; the team estimated saving 44 units of red cells per 100 patients treated. The one-day benefit was mainly driven by fewer readmission days, and a formal cost-effectiveness analysis (with Australian resource-use data) is underway with planned publication within six months. The discussion highlights why mild anaemia matters in major surgery due to postoperative blood loss and recovery, and notes that while extrapolation to other major surgeries with expected blood loss >500 mL may be considered, the hosts and Myles emphasize ongoing equipoise and the need for additional large randomized trials outside cardiac surgery. --

  2. 4d ago

    EBPOM London 2026: European Postoperative Care Pathways

    This presentation was recorded at the Evidence Based Perioperative Medicine (EBPOM) 2026 Annual Global Meeting. It features Nicolai Bang-Foss, Consultant, head of GI and orthopaedic anaesthesia, Hvidovre University Hospital, Denmark His main research field is the perioperative care of the elderly emergency patient. Specific areas of research have been regional analgesia, transfusion thresholds, outreach programs and perioperative logistics as well as perioperative haemodynamics. He describes wide European variation in postoperative pathways driven largely by ICU bed capacity, with Scandinavian countries running lean systems that push PACUs toward 24-hour, higher-acuity perioperative units and preoperative optimization for emergency laparotomy and hip fracture care. He outlines nonstandardized PACU/IMC structures, variable nursing education, and Danish strategies such as bypassing PACU for uncomplicated spinal anesthetic hip/knee replacements to free capacity for high-risk cases. He also reports research suggesting PACU nurses' clinical judgment outperforms discharge scores and highlights deteriorating surgical ward staffing and post-COVID pressures affecting triage and outcomes. If you'd like to hear presentations of this standard - before anyone else - we suggest you investigate our forthcoming EBPOM Ireland conference, being held in the beautiful location of Dingle. World leading experts in perioperative medicine presenting the latest cutting edge research in periperative medicine and enhanced recorvery after surgery. Find more information at EBPOM.org

  3. Aug 13

    Breaking Trials: The VITAL trial on TIVA, volatiles and outcome

    Recorded at the Evidence Based Perioperative Medicine (EBPOM) World Congress in London this episode of TopMedTalk sees Andy Cumpstey speaking with a panel of experts about the VITAL trial: a pragmatic randomised controlled trial about volatile vs total intravenous anaesthesia (TIVA) for major non-cardiac surgery in adult patients. The primary outcome was days alive and out of hospital at 30 days. Despite finding no significant differences in the primary outcome, the trial reveals that patients receiving TIVA anesthesia experience better recovery, with less postoperative nausea and other side effects. The conversation also touches on the trial mechanics, related ongoing studies, and implications for future research and clinical practice. Our guests include Professor Joyce Yeung, Director, Perioperative Medicine Clinical Trials Network, Associate Clinical Professor at University of Warwick and Honorary Consultant in critical care; Professor Shaji Sebastian, IBD Service Lead at Hull University Teaching Hospitals, and Chair of the BSG Research Committee and Professor Bernhard Riedel, Director, Department of Anaesthetics, Perioperative Medicine, and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia The paper is here: https://jamanetwork.com/journals/jama/fullarticle/2852741 For more about EBPOM check out www.ebpom.org

  4. Aug 10

    ANZCA ASM: Emerging Leaders

    At the ANZCA Annual Scientific Meeting in Auckland, Kate Leslie and Andy Cumpstey discuss ANZCA's Emerging Leaders Conference (ELC), a retreat-style program held immediately before the ASM for clinicians within five years of achieving FANZCA, with allowances for career disruptions. Their guests, Dr Saana Taylor FANZCA and Dr Vik Singh FANZCA, co-conveners of this year's ELC, describe shaping this year's New Zealand-hosted ELC with an Aotearoa focus, naming it Te Herenga Matua ("the pursuit of consciousness") and emphasizing collaboration, communication, wellbeing, compassion, and equity. The program included Māori and Pacific health sessions, leadership self-reflection, and an interactive session challenging fixed leadership "styles," alongside strong mentorship and networking with senior college leaders. Highlights included the openness of delegates, relationship-building, and a keynote on leadership "outside the box." Next year's ELC will be in the Adelaide Hills, with applications opening in September. More here: https://www.anzca.edu.au/fellowship/information-for-new-fellows/emerging-leaders-conference -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org

    ANZCA ASM: Emerging Leaders

  5. Aug 6

    SOAP 2026: Ron George on community, partnerships, and expanding peripartum anaesthesia

    From the 58th annual meeting of the Society for Obstetric Anesthesia and Perinatology (SOAP) in Montreal, Mike Grocott and new co-host Joe Larvin speak with SOAP president Ron George about SOAP's growth to over 1,000 attendees and its international, collaborative community. George outlines his career from Dalhousie to UCSF and back to Canada as director of obstetric anesthesia at Mount Sinai Hospital in Toronto, highlighting its high-risk referral practice and large, internationally diverse fellowship program. He reflects on his presidency's focus on mission alignment and partnerships, including work with the New York State Society of Anesthesia, discussions with the California Society of Anesthesia, and a planned memorandum of understanding with the World Federation of Societies of Anaesthesiologists (WFSA) to support evidence-based global education. He also discusses formative work in low- and middle-income settings, advocacy, peripartum anesthesiologist roles, and meeting highlights such as trainees, pain during cesarean delivery panels, and the Gerard W. Ostheimer Lecture. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org

  6. Aug 3

    TopMedTalk Classic: Should direct laryngoscopy be consigned to the history books?

    This classic TopMedTalk piece was originally cast in April 2020. The debate 'Direct laryngoscopes should be consigned to history', was hosted by The Royal College Of Anaesthetists and carried out by our two guests on this piece, where the debate is outlined in advance. We get into the advantages and challenges behind the two techniques; video laryngoscopy and direct laryngoscopy. The conversation explores the fact that these skills are a key part of the job of practitioners, are we "de-skilling" the profession in an overly enthusiastic race toward new technology or are some resisting it simply because it's not what they are used to? Presented by Joff Lacey and Monty Mythen with their two guests; Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath and Dr William Harrop-Griffiths, St Mary's Hospital, Imperial College Healthcare NHS Trust.

  7. Jul 30

    Euroanaesthesia 2026: Hot Topics in General Anaesthesiology with Laszlo Vutskits and Hugh Hemmings

    Live from Euroanaesthesia 2026 in Rotterdam, Kate Leslie and Andy Cumpstey speak with Laszlo Vutskits and Hugh Hemmings ahead of the "Hot Topics in General Anaesthesiology" lecture. Vutskits discusses reports of devastating neurologic outcomes after minor procedures in previously healthy patients, linked in a Spanish series to a shared mitochondrial DNA haplotype traced to Venezuela, including a rare ND4 complex I mutation; cybrid and fibroblast experiments showed clinically relevant sevoflurane rapidly suppresses oxidative phosphorylation but reversibly on washout, while propofol (tested without lipid) did not. Hemmings highlights the DAS 2026 airway management guidance advocating video laryngoscopy as first-line for routine and difficult intubation and emphasizes continuous oxygen delivery during intubation, prompting debate about skill retention and global feasibility. We reference this classic episode of TopMedTalk: https://topmedtalk.libsyn.com/-sunday-special-should-direct-laryngoscopy-be-consigned-to-the-history-books -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org

  8. Jul 27

    Perioperative Profile: Alan Merry

    Recorded live at the ANZCA Annual Scientific Meeting in Auckland, Kate Leslie interviews Professor Alan Merry for a perioperative profile, covering his retirement from clinical practice, ongoing research supervision, and work on environmental sustainability. Merry recounts being raised by a single mother in Zimbabwe, studying medicine at the Godfrey Huggins School of Medicine in Harare, and moving to New Zealand amid the Rhodesian Bush War. He describes entering anaesthesia after initially planning psychiatry, then becoming involved in New Zealand medical manslaughter law reform following prosecutions of clinicians, helping achieve the Crimes Amendment Act 1997's higher "major departure" threshold. He also discusses co-authoring "Error, Medicine and the Law" with Alexander McCall Smith, establishing New Zealand's Health Quality & Safety Commission, and international quality work through WFSA, the Global Oximetry Project, and the WHO surgical safety initiative that produced the surgical safety checklist, including its Auckland implementation. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org

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TopMedTalk for the latest medical news surrounding Anaesthesia, Perioperative Care and Enhanced Recovery. Live updates from conferences; Journal Club; Techno Talk and Hot-Topic podcasts. Continuing Medical Education (CME) on the go

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  • Creator
    TopMedTalk
  • Years Active
    2017 - 2026
  • Episodes
    2K
  • Rating
    Clean
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    © TopMedTalk
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    TopMedTalk

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