Podcast appearances and mentions of john myburgh

Tuutileni Mika, die 49-jarige werknemer van Ondangwa Henning Crusher wat na bewering twee van die bestuurders geskiet het, het vlugtig in die Ondangwa landdroshof verskyn. Hy is aangekla van moord, poging tot moord, diefstal van 'n fiets, afvuur van 'n vuurwapen, en dreigement om dood te maak. Hy is borgtog geweier en sy saak is tot 10 Maart 2025 uitgestel. Een van die bestuurders, die 43-jarige John Myburgh is op slag dood, terwyl Johanna Richter, 44, in 'n kritieke toestand in die Ondangwa-privaathospitaal is. Reaksie is ontvang van Michael Amushelelo, aktivis en lid van die LPM-party.

In this episode, we have the honor of speaking with Professor John Myburgh, a former South African physician and researcher who has dedicated his life to improving the field of critical care medicine. Professor Myburgh has made significant contributions to the field of fluid resuscitation, catecholamines, and microbiomes. In this episode, we will be discussing his early years in medicine, some reflections on medicine in South Africa and how his experiences have shaped his research interests. We will also delve into the latest research on fluid resuscitation, catecholamines, and microbiomes. So sit back, relax, and enjoy this fascinating conversation with Professor John Myburgh. Further Reading: SAFE TBI: Cooper DJ, Myburgh J, Heritier S, et al. Albumin resuscitation for traumatic brain injury: is intracranial hypertension the cause of increased mortality?. J Neurotrauma. 2013;30(7):512-518. doi:10.1089/neu.2012.2573 SAFE Study: Finfer S, Norton R, Bellomo R, Boyce N, French J, Myburgh J. The SAFE study: saline vs. albumin for fluid resuscitation in the critically ill [retracted in: Mayr W, Prowse C. Vox Sang. 2004 Aug;87(2):142]. Vox Sang. 2004;87 Suppl 2:123-131. doi:10.1111/j.1741-6892.2004.00468.x CHEST Study: Myburgh JA, Finfer S, Bellomo R, et al. Hydroxyethyl starch or saline for fluid resuscitation in intensive care [published correction appears in N Engl J Med. 2016 Mar 31;374(13):1298]. N Engl J Med. 2012;367(20):1901-1911. doi:10.1056/NEJMoa1209759 PLUS study: Finfer, S., Micallef, S., Hammond, N., Navarra, L., Bellomo, R., Billot, L., ... & Myburgh, J. (2022). Balanced multielectrolyte solution versus saline in critically ill adults. New England Journal of Medicine, 386(9), 815-826. CAT study: Myburgh JA, Higgins A, Jovanovska A, Lipman J, Ramakrishnan N, Santamaria J, CAT Study Investigators. A comparison of epinephrine and norepinephrine in critically ill patients. Intensive care medicine. 2008 Dec;34:2226-34. SOAP II Trial: De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, Brasseur A, Defrance P, Gottignies P, Vincent JL. Comparison of dopamine and norepinephrine in the treatment of shock. New England Journal of Medicine. 2010 Mar 4;362(9):779-89. Prof. Myburg on Catecholamines at SMACC/CODA: https://youtu.be/90ru25QuGFI

John Myburgh and Ian Seppelt  (Sydney) present the results of the SuDDICU trial at the Critical Care Reviews Meeting 2022, in Titanic Belfast. SuDDICU investigates selective digestive decontamination in critically ill mechanically ventilated patients. Naomi Hammond (Sydney) follows with a presentation of a systematic review and meta analysis also on SDD. John Marshall (Toronto) delivers an editorial. Danny McAuley (Belfast), Bodil Steen Rasmussen (Aalborg) and Victoria Cornelius (London) join the presenters for a panel discussion. The session is chaired by Chris Seymour (Pittsburgh).

Physiological facts:  Haemodynamics are complex and represent a teleological neurohormonal response to stress.   Defence of MAP represents the balance between the afferent and efferent circulations and the compliance of the system.  Monitoring is an aid to an overall assessment that must be considered within the clinical context and patient’s trajectory of illness.  Pharmacological facts:  Catecholamines are hormones that are administered to augment inadequate endogenous responses. Synthetic catecholamines have no established role in clinical practice. Neurohormonal supplementation strategies have limited roles and should be confined to indications established from RCTs. Non-catecholamine inodilators have not been demonstrated to improve patient-centred outcomes in critically ill patients.

The optimal treatment of vulnerable, critically ill patients depends primarily on two factors: the patient's innate response to the insult (host response) and minimising secondary insults (iatrogenesis). The host response is primarily genetically determined, but the adequacy of this response is influenced by associated co-morbidities and environmental factors such as access to effective health care. In this context, the greatest impact on human survival has evolved from advances in preventive medicine, public health initiatives, universal health access, and medical technology. While Intensive Care Medicine has resulted in major improvements in the care of critically ill patients, many of the fundamental interventions have evolved through physiologically-based paradigms, often predicated on normalising short-term variables, clinical measurements, or surrogate clinical endpoints. When many of these strategies are tested in comparative effectiveness studies, evidence of adverse impacts on patient-centered outcomes has emerged that is often attributed to iatrogenic injury. While some technological advances have delivered substantial benefits, the safety and efficacy of these technologies have not been evaluated by high-quality studies. This technological imperative is associated with inexorable indication creep, overuse, and misapplication of related strategies that are applied with little consideration of adverse down-stream consequences that independently affect patient-centered outcomes. Coupled with non-validated management bundles and clinical practice guidelines, the art and science of medicine is lost, so that effective treatment directed at augmenting the innate host response over the course and trajectory of critical illness becomes obscured.

John Myburgh gives a philosophical talk about what life (and death) is really about and what the new challenges are in critical care. Modern critical care has so many potential interventions. John challenges whether doing more is always the right thing to do and gives a good argument for doing less being best.

Here we feature a central figure in the ongoing Great World Fluid debate. He was sadly unable to attend EBPOM 2018 so we wanted to get a very important contribution from him: What are the big takeaways from some of the larger trials such as Saline versus Albumin Fluid Evaluation (SAFE)? What about the long term implications of Crystalloid versus Hydroxyethyl Starch Trial (CHEST)? What new trials should be on the horizon - given the information we now have? Monty Mythen speaks with his guest Professor John A Myburgh, Intensive Care Medicine, University of New South Wales; Director of the Division of Critical Care and Trauma at the George Institute for Global Health and Senior Intensive Care Physician at the St George Hospital, Sydney.   He holds honorary Professorial appointments at the University of Sydney and Monash University School of Public Health and Preventive Medicine.

Dr John Myburgh discusses a reanalysis by Levin and colleagues of the FEAST trial, which looked at the adverse effects of the administration of saline or albumin fluid bolus in resuscitation.

Here we feature a central figure in the ongoing Great World Fluid debate. He was sadly unable to attend EBPOM 2018 so we wanted to get a very important contribution from him: What are the big takeaways from some of the larger trials such as Saline versus Albumin Fluid Evaluation (SAFE)? What about the long term implications of Crystalloid versus Hydroxyethyl Starch Trial (CHEST)? What new trials should be on the horizon - given the information we now have?   Monty Mythen speaks with his guest Professor John A Myburgh, Intensive Care Medicine, University of New South Wales; Director of the Division of Critical Care and Trauma at the George Institute for Global Health and Senior Intensive Care Physician at the St George Hospital, Sydney.   He holds honorary Professorial appointments at the University of Sydney and Monash University School of Public Health and Preventive Medicine.

Session ‘Evidence Based Treatment of Sepsis II’ from the 2nd World Sepsis Congress. Featuring Peter Hjortrup, Naomi Hammond, Yasser Sakr, John Myburgh, Anders Perner, Didier Payen, and Markus Weigand as chair. More info: www.worldsepsiscongress.org

Here we feature a central figure in the ongoing Great World Fluid debate. He was sadly unable to attend EBPOM 2018 but we still wanted to get a very important contribution from him. What are the big takeaways from some of the larger trials such as Saline versus Albumin Fluid Evaluation (SAFE)? What about the long term implications of Crystalloid versus Hydroxyethyl Starch Trial (CHEST)? What new trials should be on the horizon - given the information we now have? Monty Mythen speaks with his guest Professor John A Myburgh, Intensive Care Medicine, University of New South Wales; Director of the Division of Critical Care and Trauma at the George Institute for Global Health and Senior Intensive Care Physician at the St George Hospital, Sydney. He holds honorary Professorial appointments at the University of Sydney and Monash University School of Public Health and Preventive Medicine.

A year ago there was no such thing as the Mastering Intensive Care podcast. Now there are 21 separate interviews, each of which have helped me and seem to have helped many of you to make improvements at delivering more compassionate, thoughtful and patient-centred intensive care. Without fail my guests throughout 2017 were excellent and I really enjoyed doing the interviews. And I promise to bring you the best content I can over 2018 too. Here are the final five of the best 2017 guests, to follow on from the first five in the last episode. This has been difficult as I have seriously enjoyed every one of my guests. I will upset some guests by not including them and I will upset some of you for not including your favourite guest. But nevertheless I have taken the five most downloaded episodes and mixed them with the five I enjoyed the most. Then I took what I considered the best excerpt of the conversation and put them in no particular order over two episodes. So enjoy listening to the best excerpts of the best episodes over the first year of Mastering Intensive Care. I hope it will inspire you to a fresh start in 2018 with some great perspectives for bringing your best self to work. If you’ve missed a few episodes over the year here is a chance to catch up with them and if you are totally new to the podcast here is a glimpse of what Mastering Intensive Care is all about.   Andrew Davies   -----------------   Resources from people, organisations and things mentioned in this episode: MIC Episode 9 with John Myburgh: http://masteringintensivecare.libsyn.com/episode-9-john-myburgh-the-importance-of-the-intensive-care-clinical-ward-round   MIC Episode 12 with Julia Wendon: http://masteringintensivecare.libsyn.com/episode-12-julia-wendon-making-the-patient-the-centre-of-everything   MIC Episode 20 with Jack Iwashyna: http://masteringintensivecare.libsyn.com/episode-20-jack-iwashyna-icu-adventure-camp-time-limited-life-support-trials-and-regular-talks-with-families-dassmacc-special-episode   MIC Episode 10 with Imogen Mitchell: http://masteringintensivecare.libsyn.com/episode-10-imogen-mitchell-an-intensivist-and-dean-of-medicine-focused-on-communication-and-clinical-decision-making   MIC Episode 2 with John Botha: http://masteringintensivecare.libsyn.com/episode-2-john-botha-exemplary-leadership-in-the-icu   Mastering Intensive Care podcast on Libsyn: http://masteringintensivecare.libsyn.com/   Mastering Intensive Care podcast on Life In The Fast Lane: https://lifeinthefastlane.com/?s=mastering+intensive+care   Mastering Intensive Care on Facebook: https://www.facebook.com/masteringintensivecare/   Andrew Davies on Twitter: @andrewdavies66   Email Andrew Davies: andrew@masteringintensivecare.com

This is the oration John Myburgh gave at the College of Intensive Care's Annual Scientific meeting when he was awarded the College Medal for a career's worth of contributions. This was actually recorded a couple of days after the event by Lily Foster & Oli Flower, but it still contains all the emotions and sentiments that were there on the night when it was delivered at Doltone house on 27th May 2017.

How important is the main daily ward round we do each day in the Intensive Care Unit? Is the ward round in your ICU focused and concise? Do you adequately communicate the plans you generate on the ward round to the whole ICU team? John Myburgh, AO, an experienced Australian intensivist, who began his life and career in South Africa, is Professor of Intensive Care Medicine at St George Clinical School, University of New South Wales and Director of Critical Care at the George Institute, Sydney. He has an international research profile and is a Foundation Member and Past-Chairman of the ANZICS Clinical Trials Group. In this episode, John gives a very insightful commentary on how much attention he puts on the clinical ward round as our key tool in intensive care practice. We might do more than one ward round a day but John says the main daily ward round is where it should all happen. Where we try and think about how the patient, with their individual characteristics of life and disease, is actually progressing through their critical illness. Whether they are on an upward trajectory to improvement, whether they are on a downward trajectory that may lead to death, or whether they are stuck on the flat “curve” which we often don’t have our eyes open to. John also tells us to be careful of using too many “toys” (machines) and focusing too much on the test results. And he warns us that we are at point in the development of intensive care medicine where we save the lives of more people, but forget to realise that many of these have a greater disease burden from their chronic critical illness than they did when they were admitted to the ICU. This podcast was created to help and inspire intensive care clinicians to improve the care we give to our patients by providing interesting and thought-provoking conversations with highly respected and experienced clinicians. In each episode, Andrew Davies, an intensivist from Frankston Hospital in Melbourne, Australia, speaks with a guest for the purpose of hearing their perspectives on the habits and behaviours that they believe are the most important for improving the outcomes of our patients. Things like bringing our best selves to work each day, optimal communication, coping with stress and preventing burn out, working well in a team, and interacting with patient’s families and the many other health professionals we deal with on a daily basis. The podcast is less about the drugs, devices and procedures that can be administered and more about the habits, behaviours and philosophies that can help intensive care clinicians to master the craft of intensive care. Please send any comments through the Life In The Fast Lane website, facebook (masteringintensivecare), twitter (@andrewdavies66) or by simply emailing andrew@masteringintensivecare.com.

John Myburgh (Sydney) describes how he manages IV fluids at the Critical Care Reviews Meeting 2017, in Titanic, Belfast.

Prof John Myburgh (Sydney) discusses the difficulties with performing critical care research in his talk "The Path to Truth"

The second of my series of podcast interviews with keynote speakers from the 2016 ANZICS CTG meeting in Noosa is with Professor John Myburgh. John needs little introduction to anyone in the critical care field, with a PhD in catecholamine physiology and a co-author / principle investigator on a number of practice changing papers including the CHEST and SAFE fluid trials. John joins me to chat about his latest ground-breaking project, the PLUS trial (PlasmaLyte 148 versUs Saline) in ICU patients.

PRO: Medicine is a complex craft. Acute medicine is more complex. Excellence is delivering effective acute care depends on recognising the broad base of basic sciences, clinical experience, and results of clinical trials. Central to all decisions has to be how these will benefit the patient – both in the short term as well and longer term so that survivors of acute illness are left with the best possible outcome for that patient, their caregivers and the community at large. This is a daunting concept under time-limited, information-limited conditions. Clinicians are often left with uncertainty about the impact of decisions and rely on short-term surrogate measurements to justify treatment options. Consequently, assessing outcomes are invariably confounded by associations that bear little relationship to causation or biological plausibility. Such confounders are often demonstrated in observational studies and RCTs with low levels of internal validity, particularly those conducted in single centres and/or driven by protagonists of a particular intervention. Carefully conducted RCTs with high levels of internal validity – those that produce believable results from rigorous study design and those that produce results that are generalisble to specific patient populations remain the only way to mitigate bias and produce clinically-relevant answers to improve patient-centred outcomes. Critical Care Medicine leads the way in producing high-fidelity RCTs that have fundamentally changed clinical practice, not only in terms of producing better patient-centred outcomes, but also by producing unequivocal evidence to stop or avoid using of previously harmful treatments that had been enthusiastically embraced by clinicians and guideline developers. Such examples of benefit include the CRASH-2 and ARDS-net trials, and of preventing harm, the SAFE, NICE-SUGAR, RENAL, CHEST, DECRA and FEAST studies among others. The net impact of these pivotal trials has been the prevention of millions of deaths and the saving of millions of dollars. Such is the basis of GOOD clinical practice and these trials must be seen as a source of knowledge, science and pride … that ultimately improve patient outcomes .   CON:  

John Myburgh takes us through 200 years of fluids therapy in critical care in one powerful presentation. He discusses the essential moments from history that changed the way we practice today and puts this long an bizarre story into context. He covers the key aspects of relevant physiology and, inspired by Kipling, the what, where, when, how, why and whom of this intervention that has become synonymous with critical care. He tackles starch controversies with his unique perspective on the subject, as well as the very topical chloride debate and the upcoming SPLIT trial. Best watched with John's superb slide deck. WARNING: this may leave you questioning something you prescribe every day and feeling disturbed that something you assumed to be simple and sorted is far from it. Other talks from John Myburgh include: Beta Blocker and Sepsis Fluid Resuscitation 2013 Decompressive Craniectomy   Catecholamines, resuscitation & resurrection

John Myburgh on the misunderstood craniectomy. The management of raised ICP and what we do when our options run out.

John Myburgh on the emerging evidence for the use of beta-blockade in sepsis. Direction for future research.

The erudite John Myburgh condenses fluid resuscitation data down to a palatable brew. 

John Myburgh brings his experience and analysis to bear upon the use of catecholamines in the crashing patient. The second talk in the Resuscitation plenary.

Listen to Professor John Myburgh's fantastic lecture on one of the hottist topics in critical care right now: Fluid Therapy.