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We return to our Canadian Critical Care Forum series with this episode. In this episode, we delve into the world of Extracorporeal Membrane Oxygenation (ECMO) with Dr. Eddy Fan, a leading expert in critical care and ECMO specialist. Eddy Fan is an associate professor in the Interdepartmental Division of Critical Care Medicine and the Institute of Health Policy, Management, and Evaluation at the University of Toronto and a staff intensivist at the University Health Network/Mount Sinai Hospital. Dr. Fan received his undergraduate degree from the University of Toronto, his medical degree from the University of Western Ontario, and a PhD in Clinical Investigation from Johns Hopkins University. He is currently the Medical Director of the Extracorporeal Life Support Program at the Toronto General Hospital, and the Director of Critical Care Research at the University Health Network/Mount Sinai Hospital. Dr. Fan's research has focused on advanced life support for acute respiratory failure and patient outcomes from critical illness. These include investigations on the epidemiology and use of mechanical ventilation and extracorporeal life support in patients with ARDS, as well as on the development of ICU-acquired weakness, early rehabilitation in ICU patients, and long-term outcomes in survivors of critical illness. Join us as we take on this huge topic.
In this episode, Dr. Zanotti is joined by Dr. Eddy Fan for a discussion about Respiratory Support in ARDS. Dr. Fan is an associate professor in the Interdepartmental Division of Critical Care Medicine and the Institute of Health Policy, Management, and Evaluation at the University of Toronto. He is also a staff intensivist at the University Health Network/Mount Sinai Hospital. Dr. Fan is currently the Medical Director of the Extracorporeal Life Support Program at the Toronto General Hospital and the Director of Critical Care Research at the University Health Network/Mount Sinai Hospital. Dr. Fan's research has focused on advanced life support for acute respiratory failure and patient outcomes from critical illness. He is a co-author of the ESICM ARDS Clinical Guidelines. Additional Resources: ESICM guidelines on acute respiratory distress syndrome: definition, phenotyping, and respiratory support strategies. Intensive Care Med 2023: https://pubmed.ncbi.nlm.nih.gov/37326646/ An Update on Management of Adult Patients with ARDS. Official ATS Clinical Practice Guideline. Am J Respir Crit Care Med 2024; https://www.atsjournals.org/doi/full/10.1164/rccm.202311-2011ST Prone Positioning in Severe Acute Respiratory Distress Syndrome. PROSEVA Clinical Trial. N Engl J of Med 2013: https://www.nejm.org/doi/full/10.1056/nejmoa1214103 Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome. The EOLIA Trial. N Eng J of Med 2018: https://www.nejm.org/doi/full/10.1056/NEJMoa1800385 Books mentioned in this episode: A Portrait of the Artist as a Young Man. By James Joyce: https://bit.ly/49kzmtn
In this “Breathe Easy Critical Perspective” podcast, Dr. Dominique Pepper interviews Dr. Laurent Brochard. They discuss his recent NEJM publication reviewing non-invasive respiratory support in critically ill adults. Dr. Brochard is the Director of the Interdepartmental Division of Critical Care Medicine, University of Toronto, Canada and the Deputy Editor of the Blue Journal.
In brief, “it's okay to not feel okay” and “to do well we ought to feel well”. The problem is that many of us don't feel okay, hence this candid, caring and common-sense podcast. We timed it to coincide with what is- statistically at least- the most depressing day of the year, namely the third Monday of January. Otherwise known as “Blue Monday” it's a day to take a moment, to reach out, to acknowledge that the job can be tough, and to be reminded that we need to care for the carers. There is nobody better than Dr. Shelly Dev to highlight the importance of burnout, wellness and medical culture. Thank you for your time and for the work you do. Take care of yourself. Dr. Dev has been a Staff Intensivist at Sunnybrook Health Sciences Centre in Toronto since 2006, after completing her Internal Medicine residency and Critical Care Fellowship at The University of Toronto, followed by a Fellowship in Multimedia Education at the New England Journal of Medicine. She is a Clinician Educator and Associate Professor of Medicine, Director of Education in the Department of Critical Care Medicine at Sunnybrook and lead for Mentorship and Wellness in the Interdepartmental Division of Critical Care Medicine at the University of Toronto. She is an award-winning medical educator of undergraduate, postgraduate and continuing medical education audiences. In addition to nearly 300 lectures given to national and international audiences about healthcare worker mental health, burnout, resilience and medical culture, Dr. Dev has written and spoken extensively on these topics in the wider media. But, if asked, she would say her most significant accomplishment to date is continuing to convince 14-year-old Nathan and 12-year-old Jack that it is beyond cool to be seen with your mother in public.
Critical illness occurs frequently after a new diagnosis of hematologic malignancy and has high associated mortality. Baseline characteristics at diagnosis can help identify those patients at the highest risk of critical illness. Original article: https://doi.org/10.1007/s00134-021-06502-2 (Critical illness in patients with hematologic malignancy: a population-based cohort study) Speakers: Bruno L. FERREYRO. Interdepartmental Division of Critical Care Medicine, University of Toronto (CA). Laveena MUNSHI. Interdepartmental Division of Critical Care Medicine, University of Toronto (CA). Gaetano SCARAMUZZO. Department of Translational medicine, University of Ferrara (IT).
In this “Breathe Easy Critical Perspective” podcast, Dr. Dominique Pepper interviews Dr. Eddy Fan. They discuss the diagnosis and management of ARDS in COVID-19: Insights one year into the pandemic. Dr. Fan is an Associate Professor in the Interdepartmental Division of Critical Care Medicine and the Institute of Health Policy, Management and Evaluation at the University of Toronto.
In this episode of Critical Matters, we discuss the management of COVID induced ARDS. Our guest is Dr. Eddy Fan, an associate Professor in the Interdepartmental Division of Critical Care Medicine and the Institute of Health Policy, Management and Evaluation at the University of Toronto and a Staff Intensivist at the University Health Network/Mount Sinai Hospital. He is currently the Medical Director of the Extracorporeal Life Support Program at the Toronto General Hospital, and the Director of Critical Care Research at the University Health Network/Mount Sinai Hospital. During our conversation, we discuss phenotypes within ARDS, the best available evidence for the management of ARDS, and other topics. Additional Resources: COVID-19-Associated Acute Respiratory Distress Syndrome: Is a Different Approach to Management Warranted?: https://bit.ly/3fMkYOp American Thoraic Society - Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome: https://bit.ly/2CQTIju Management of COVID-19 Respiratory Distress: https://bit.ly/2WuwFCw Previous Episodes of Critical Matters on COVID-19 Induced ARDS/Respiratory Failure: - https://bit.ly/2OGWF8T - https://bit.ly/32yO2p7 Books Mentioned in this Episode: A Portrait of the Artist as a Young Man by James Joyce: https://amzn.to/2OJyiHM
In this “Breathe Easy Critical Perspective” podcast, Dr. Dominique Pepper interviews Drs. Bruno Ferreyro and Federico Angriman . They discuss the role of non-invasive ventilation for acute hypoxemic respiratory failure, published online June 4, 2020 by JAMA. Drs. Ferreyro and Angriman are affiliated with the Interdepartmental Division of Critical Care Medicine at the University of Toronto, Ontario Canada.
In this “Breathe Easy Critical Perspective” podcast, Dr. Dominique Pepper interviews Dr. Eddy Fan. They discuss diagnosis and management of ARDS in the era of COVID-19. Dr. Fan is an Associate Professor in the Interdepartmental Division of Critical Care Medicine and the Institute of Health Policy, Management and Evaluation at the University of Toronto.
Brian Cuthbertson is Chief of the Department of Critical Care Medicine at Sunnybrook Health Sciences Centre and Professor in the Interdepartmental Division of Critical Care Medicine at the University of Toronto. He is also an Honorary Professor of Critical Care Medicine at the University of Aberdeen and an Honorary Professorial Fellow at the George Institute of Global Health in Sydney. His research interests include improving outcomes from critical illness and major surgery. He has over 100 peer-reviewed publications and $10million of research grants as well as playing a leading role in a number of key clinical guidelines.
Today we have the distinct pleasure to welcome Neill Adhikari, MDCM, M.Sc., one of the world’s experts on critical care management in resource limited settings. Dr Adhikari is currently practicing as an intensivist at Sunnybrook Health Sciences Centre in the Interdepartmental Division of Critical Care at the University of Toronto. He also acts as an Associate scientist, Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program, at the Sunnybrook Research Institute where he focuses on critical care delivery in low-resource settings. Over his brief academic career Dr. Adhikari has been incredibly prolific in academic production, publishing over 180 peer-reviewed journal articles and accepting speaking engagements from around the globe. This afternoon we were fortunate to lure him down from Canada to speak on an exceedingly important topic: how can we address the devastation of sepsis in areas of the world where basic labs and clean water can often be a luxury and not a guarantee?
Do you think your procedural skills are more important than your ability to lead and to mentor? Do you have a department head who talks about your personal wellness with you? How do you maintain and improve your skills in leading a family meeting? Professor Brian Cuthbertson believes that our non-technical skills, those human factor aspects like leadership, mentoring, communication and leading meetings with patient’s relatives, are more important than our clinical procedural skills as we evolve in our careers. But do we talk enough about them? In this episode Brian discusses several of these important non-technical skills giving some powerful insights as a highly experienced clinician and leader in the field of intensive care. Brian is Chief of the Department of Critical Care Medicine at Sunnybrook Health Sciences Centre and Professor in the Interdepartmental Division of Critical Care Medicine at the University of Toronto in Toronto, Canada. He is also an Honorary Professor of Critical Care Medicine at the University of Aberdeen and an Honorary Professorial Fellow at the George Institute of Global Health in Sydney. Brian’s research interests include improving outcomes from critical illness and major surgery. He has over 135 peer-reviewed publications and $17 million of research grants as well as playing a leading role in a number of key clinical guidelines. Brian was very keen to talk about how much he values the human factors we all need to concentrate on to be the best we can be. Some of the main topics of discussion include: Brian’s love for intensive care, which began with the machines and is now much more about humans The benefits he has realised from having high-class mentors in different areas His role as a mentor to others and how there needs to be some structure to this relationship How leadership at the bedside is like conducting an orchestra where everyone needs to be heard The need for senior trainees to stay in charge of resuscitation teams even when the consultant arrives How being a good team-player often requires us to drop our egos The value of good habits at the start of a ward round The need for department heads to address their team member’s personal wellness requirements to maximise vitality and balance The importance of family members being at the bedside on clinical rounds to represent the values of the patient The fact that the highest level skill we can have is the ability to lead a family meeting, especially in culturally-diverse cities Placing the patient’s values and needs at the centre of any inter-professional discussions, particularly differences in opinion The requirement for greater academic study of all of these non-technical skills With this podcast, and the previous episodes, please help me in my quest to improve patient care, in ICUs all round the world, by inspiring all of us to bring our best selves to work to more masterfully interact with our patients, their families, ourselves and our fellow healthcare professionals so that we can achieve the most satisfactory outcomes for all. It would be much appreciated if you could help to spread the word by simply emailing your colleagues or posting on social media. If you wish to send a comment or respond to something Brian said on this episode, feel free to email me andrew@masteringintensivecare.com, leave a comment on the Mastering Intensive Care podcast page on LITFL or on Facebook, or post on twitter using #masteringintensivecare. Please take the very best care of your patients, their families and your colleagues. And above all, consider that taking care of yourself might actually be the best thing you can do for your patients. I hope you have a great week. ____________________________________________________________________________________________ Show notes (people, organisations, resources or links mentioned in the episode) Sunnybrook Health Sciences Centre: http://sunnybrook.ca/ Brian Cuthbertson: http://sunnybrook.ca/team/member.asp?t=17&page=2780&m=407 Malcolm Fisher: http://www.nslhd.health.nsw.gov.au/newsevents/Pages/MalcolmFisherICU.aspx Nigel Webster: https://www.abdn.ac.uk/ims/profiles/n.r.webster Marion Campbell: https://www.abdn.ac.uk/hsru/people/m.k.campbell/ Mentorship in Academic Medicine – Author Sharon Strauss: http://www.mentorshipacademicmedicine.com/ Atul Gawande: http://atulgawande.com/