The landscape of Intensive care is changing. In the era of evidence based medicine, we try to make best possible decision for our patients based on best available evidence. Every fortnight, Dr Swapnil Pawar & Dr Jose Chacko will bring you one hot topic in Critical care. If you want to stay up to date with recent evidence or learn how to critically evaluate the literature in critical care, this podcast is for you.
This podcast is about Intensive care pharmacology and physiology. This is created to prepare intensive care trainees for their primary CICM exams. However, it will be of benefit to anyone who works in intensive care and keen to acquire new knowledge or want to refresh their memory.
In this podcast series, we will meet educators around the globe to discuss various educational approaches and challenges that we face as an educator. An expert educator shares his/her insight and experience to help upcoming educators to progress in their career. This is a shared learning experience and we will like you to join this community to share your experience with other educators.
In this episode, we discuss the CONTROLLING study which compared the novel strategy of individualised glycemic control vs conventional glucose control.
In this episode, we dive deeper into the controversy around the timing of initiation of RRT in Intensive Care.
In this episode, we discuss the pharmacology of oxygen, the physics behind oxygen sensors in the ventilator and the mechanism of oxygen delivery.
The controversy around the dose of steroid dose in COVID-19 still exists. In this podcast, we discuss the recently published RCT COVID Steroid 2 and dive deeper into this controversy.
In this episode, we discuss some of the key recommendations and the rationale behind them from recently published SSCG 2021.
Hyperventilation has been used to control raised ICP for decades. However, the evidence behind it is very weak. In this podcast, we discuss the recently published study by CENTRE-TBI to address this controversy.
In this episode, we discuss the anatomy of brainstem reflexes along with the pharmacology of mannitol, phenytoin and levetiracetam.
In this episode, we discuss the evidence behind the dogmatic practice of routinely using ICP monitoring in patients with traumatic brain injury admitted to ICU.
The debate over low vs high oxygenation targets continue. In this podcast, we discuss the recently published trial in JAMA which evaluates the effect of high oxygenation on organ failure scores.
In this episode, we discuss the modified Pomodoro technique for bedside Primary exam preparation. We examine the neurointensive care patient to discuss the anatomy of CSF production, Cerebral blood flow regulation and physics of ICP monitoring.
In this episode, we discuss the controversies around the long term sequelae of COVID-19. We dive deeper into the available evidence and suggest the next steps to address this very significant issue.
In this podcast, we discuss another landmark study called BASIC, which evaluated the superiority of balanced salt solution over 0.9% saline in critically ill patients admitted to Brazilian intensive care units.
In this episode, we discuss the modified Pomodoro technique to help Primary candidates prepare for their exams during daily bedside ward rounds. 3 questions were discussed in this episode - Pulse oximeter, Comparison between Noradrenaline and vasopressin, and physiological effects of hypoxia.
The evidence for the use of Remdesivir in COVID-19 is conflicting. Different guidelines have suggested contradictory recommendations on its use in COVID-19. Tocilizumab, although demonstrated mortality benefit in conjunction with steroids, we do not have data on its long term outcomes including quality of life. In this episode, we revisit the contr…
No standard protocol exists to decrease or eliminate preoperative fasting times for adult ICU patients with cuffed endotracheal tubes; however, multiple intensive care units across the globe have implemented their own protocols with adjusted times for the intubated patient. This has led to significant variability in practices along with potential h…
In this episode, we talk about the novel concept called mechanical power in ventilating patients with ARDS. This concept has led to a new debate as to whether we should move away from the dogmatic approach of fixed tidal volume ventilation to an individualised ventilation strategy for patients with ARDS.…
Join us in the latest episode of ICU Primary Prepcast, where Dr Mike Clifford and I discuss how every ICU trainee can prepare for their primary exams on their day to day ward rounds. We suggest using the modified Pomodoro technique i.e - 3 questions at one-bed space per day (25 min total) - One question about the pharmacology of one of the drugs th…
In this episode, we discuss the recently published landmark RCT -TTM2. This trial has answered the important question and forced us to reconsider our management practices around post-out of hospital cardiac arrest management.
The recent study published by Golligher et al have challenged the dogma of setting 6-8 ml/kg Vt for all patients with ARDS. In this study, the authors demonstrated that the mortality in ARDS is related to driving pressure and baseline elastance and there is no correlation between mortality and plateau pressure or P/F ratio. In this episode, we disc…
In this episode, Mike Clifford and I discuss how to answer some of the probing vivas.
Oxygen is a precious commodity. COVID-19 pandemic has reminded us of the significance of Oxygen and we need to be mindful that Oxygen is a drug. It has its own side effects and thus warrants cautious use. In this podcast, we discuss controversial but thought-provoking COAST trial in-depth.
COVID-19 pandemic continues to be a major problem across the globe. Various treatment options are emerging and we are desperate to achieve some normalcy in our lives. The recent addition is the use of monoclonal antibodies, which constitute a form of passive immunotherapy. In this podcast, we dive deeper into the available evidence on this novel tr…
Recently published RCTs and various guidelines have given us conflicting results w.r.t optimal dose of thromboprophylaxis in patients with COVID-19. In this episode, we dive deeper into the available evidence on this topic and suggest the rational approach in selecting the dose of thromboprophylaxis in COVID-19 patients.…
In this episode, we explore how the college examiner designs the viva and explores the knowledge on cerebral blood flow and NMDA receptors.
Different Vaccines were developed during the COVID-19 pandemic at unprecedented speed using different platforms. However, recent reports raised concerns regarding thrombotic complications and thrombocytopenia after certain vaccines. In this episode, we discuss the pathophysiology and the treatment of this newly described syndrome.…
In this episode, we discuss another landmark trial that has answered the very relevant question regarding the use of anti-fibrinolytic treatment in subarachnoid hemorrhage.
The use of neuromuscular blockade is not uncommon however, it's associated with many complications such as the increased risk of ICU acquired weakness, prolonged length of ICU stay along with the increased risk of corneal ulceration and VTE. In this episode, we discuss various indications for the use of NMB agents in ICU and review the available ev…
Restrictive Vs Liberal transfusion strategy debate has come to the surface after the publication of the REALITY trial. In this podcast, we dive deeper into proposed transfusion thresholds in intensive care in various subgroups and the evidence behind them.
Hemoglobin targets in patients with myocardial infarction are still debatable. In this episode, we discuss the landmark REALITY trial, which explores the non-inferiority of a restrictive transfusion strategy over a liberal transfusion strategy.
In this episode, we discuss recently published practice-changing trials RECOVERY and REMAP-CAP. These trials have clearly demonstrated the difference in mortality with the use of Tocilizumab in severe COVID-19.
In this episode, college examiner Dr Mike Clifford walks us through the metathinking of constructing vivas and the examiner's expectations with the real-time demonstration.
Join us to dive deeper into the recent controversy around oxygen therapy and its proposed targets in ICU patients. In this episode, we compare 3 landmark trials namely ICU-ROX, LOCO2 and HOT-ICU along with recently published meta-analyses to fully understand the nature of this controversy and discuss our recommendations for the future.…
In this podcast, we discuss the challenges and the evidence behind different technological platforms used to produce COVID-19 vaccines.
In this episode, Primary examiner Mike Clifford from Victoria talks about the common pitfalls in the ICU Primary exam and shares his top tips for exam preparation.
In this episode, we discuss some of the important concepts of Respiratory physiology like FRC, closing capacity and mixed venous oxygen content.
The year 2020 has been a challenging year for most of us. We all are eagerly waiting to get out of this pandemic. Recently published trial on COVID-19 vaccine has offered some hope, however its too soon to predict the outcome.
High lactate levels are uniformly associated with poor clinical outcomes, including mortality. However, there is considerable interest and conflict of opinion regarding the clinical value of using lactate levels to guide resuscitation in critically ill patients. In this episode, we dive deeper into this long-standing controversy.…
In this episode, we discuss the anatomy and basic mechanics of the respiratory system.
Join us in this episode, where we discuss the recently published trial in JAMA. This trial explores the efficacy of regional citrate anticoagulation over systemic heparin anticoagulation for CRRT. This is the largest randomised controlled trial on this topic and has provided very valuable answers on this topic.…