TopMedTalk

At the Evidence-Based Perioperative Medicine (EBPOM) World Congress in London, Andy Cumpstey interviews Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton and consultant in critical care medicine at University Hospital Southampton NHS Foundation Trust and Nicolai Bang-Foss, Professor, Chair in Acute Perioperative Medicine and Pathophysiology at the University of Copenhagen and Consultant & Head of Department of gastrointestinal and orthopaedic anaesthesia at Copenhagen University Hospital
The discussion comes after a hemodynamic therapy debate on fluid and blood pressure management. Grocott argues that while clinicians aim to optimize circulating volume, tissue perfusion, and avoid fluid overload, current monitoring makes these goals difficult and evidence for goal-directed fluid/hemodynamic therapy is mixed; low flow/pressure is harmful but raising them doesn't reliably improve outcomes. Bang-Foss emphasizes that vasoconstrictors can normalize blood pressure without improving flow or organ perfusion and that preload responsiveness is not a marker of hypovolemia because it can reflect vasoplegia. He proposes using the peripheral perfusion index (PI) from standard pulse oximeter plethysmography as a real-time surrogate of perfusion, citing associations between low PI (e.g., TopMedTalk is the broadcasting arm of EBPOM.org

At ANZCA and the Faculty of Pain Medicine's Annual Scientific Meeting 2026 in Auckland, TopMedTalk hosts Kate Leslie and Andy Cumpstey interview anesthetists and diving medicine researchers Simon Mitchell (Head of the Department of Anaesthesiology at the University of Auckland, Anaesthesiologist at Auckland City Hospital) and Tom Scott (aeromedical doctor with the Royal Flying Doctor Service Western Operations, based out of Perth, Western Australia) about studying extreme physiology in free diving and technical diving.
Scott and Mitchell describe expeditions measuring arterial blood gases in elite free divers (including world-record-level depths), using an arterial line and a closed sampling system to collect samples at depth and on surfacing. They explain shallow water blackout as a rapid fall in PaO2 during ascent due to lung re-expansion and oxygen consumption, reporting examples such as PaO2 rising to 42 kPa at 60 m and falling to 8 kPa at the surface, and average post–80 m PaO2 of 4.6 kPa.
They discuss logistics, ethics, safety implications for divers, distinctions between hyperoxia risks for compressed-gas technical divers versus hypoxia for free divers, and the role of mentorship in building such research programs.

ANESTHESIOLOGY® 2026, in San Diego, TopMedTalk hosts Kate Leslie and Andy Cumpstey speak with Dr Damon Kamming, Clinical Instructor within the Stanford University Department of Anesthesiology, Perioperative, and Pain Medicine and Michel Struys, Professor of Anesthesiology and Clinical Pharmacology at the University of Groningen and the University Medical Center Groningen (UMCG) about target-controlled infusion (TCI) for intravenous anesthesia.
They explain how TCI uses pharmacokinetic/pharmacodynamic models and patient covariates beyond weight (age, sex, height, fat-free mass) to target and maintain drug concentrations, commonly for propofol and opioids, reducing clinician pump adjustments and drug accumulation when paired with effect monitoring (e.g., EEG) and cardiovascular signs. They discuss newer broad models such as Eleveld, limits at extremes of body size, and practical safety issues like dedicated IV access.
Kamming links wider TIVA/TCI adoption to improved recovery and lower global warming potential versus volatile agents, citing UCLH's shift toward more TIVA, use of 2% propofol to reduce plastic waste, and desflurane reduction. The group notes TCI is not yet available in the US, attributing this mainly to the need for a company to invest in FDA submission and adoption efforts within departments.
LISTEN TO THE PODCAST MENTION ABOUT OPIOIDS HERE: https://topmedtalk.libsyn.com/anesthesiology-2026-opioid-overdose-prevention-and-treatment

This moving piece was originally released Mar 23, 2020 with the title: Epidemiology revisited - a case for virtual meetings | COVID 19
It's taken from TopMedTalk's extensive archive and represented here as an encouragement for you to explore our FREE back catalogue of medical conversations.
Hear the team's reaction to the outbreak of the disease from the perspective of healthcare workers in Italy. Focusing on the community health approach to controlling this pandemic, our guest emphasizes the importance of understanding the epidemiology of COVID- 19.
Mirco Nacoti, Department of Anesthesia and Intensive Care, Pediatric Intensive Care Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy, was subsequently featured in the New England Journal of Medicine where he along with Andrea Ciocca and Maurizio Cereda wrote this excellent article: https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0080
Presented by Monty Mythen and Desiree Chappell.
This podcast was originally released as part of a longer podcast which you can listen to here: https://www.topmedtalk.com/covid-19-you-must-learn-the-epidemiology/

ANESTHESIOLOGY® 2026 meeting in San Diego, TopMedTalk hosts Kate Leslie and Andy Cumpstey interview Mike Scott (University of Rochester; Lifebox co-founder) and LaToya Mason (University of Mississippi; SOAP state representative) about a maternal health forum held alongside the United Nations General Assembly.
They discuss worsening global maternal mortality, missed WHO 2030 targets, and that many deaths are preventable, with contributors including rising cesarean rates, older maternal age, and increasing comorbidities; Brazil's cesarean rate and complications like accreta and concealed hemorrhage are highlighted.
Mason shares her personal experience of postpartum peripartum cardiomyopathy detected via smartwatch data, underscoring the need for patient education, listening to patients, and earlier recognition. The panel advanced a mandate that no woman should die during childbirth, emphasizing country-specific approaches, government buy-in, training, scalable monitoring (pulse oximetry, continuous blood pressure), low-fidelity risk tools, and engaging technology and industry to improve outcomes globally and in the US.
The Global Surgery Foundation is here: https://www.globalsurgeryfoundation.org/