Podcasts about postoperative

#407: Postoperative Pediatric Airway Emergencies Pediatric airway emergencies in the postoperative setting are high-impact events that can quickly escalate to cardiac arrest, so it's vital you recognize and act on them immediately. In this article, you'll review: Unique features of the pediatric airway  Risk factors for postoperative respiratory complications in children Performing a focused pediatric respiratory assessment Signs of respiratory distress in children Common postoperative respiratory complications including desaturation, upper airway obstruction, laryngospasm, bronchospasm, and oversedation/loss of ventilation ___________________ Full Transcript - Read the article and view references Episode 140 - Listen to episode 140 for an overview of pediatric respiratory distress. FREE CLASS - If all you've heard are nursing school horror stories, then you need this class! Join me in this on-demand session where I dispel all those nursing school myths and show you that YES...you can thrive in nursing school without it taking over your life! Study Sesh - Change the way you study with this private podcast that includes dynamic audio formats including podquizzes, case studies and drills that help you review and test your recall of important nursing concepts on-the-go. Free yourself from your desk with Study Sesh!  Straight A Nursing App - Study on-the-go with the Straight A Nursing app! Review more than 5,000 flashcards covering a wide range of subjects including Fundamentals, Pediatrics, Med Surg, Mental Health, Maternal Newborn, and more! Available for free in the Apple App Store and Google Play Store. Clinical Success Pack - One of the best ways to fast-track your clinical learning is having the right tools. This FREE pack includes report sheets, sheets to help you plan your day, a clinical debrief form, and a patient safety cheat sheet.  20 Secrets of Successful Nursing Students – Learn key strategies that will help you be a successful nursing student with this FREE guide! Conquering Case Studies - Learn how to approach case studies so they feel less overwhelming while honing your clinical judgment skills in the process.

Medial gutter impingement may compromise the results of an otherwise well-fixed total ankle arthroplasty (TAA), but no previous study has assessed predisposing factors. This case-control study sought to investigate potential risk factors and the role of talar component downsizing in decreasing medial impingement.   In conclusion, talar component downsizing correlated with an 82% reduction in the probability of medial gutter impingement. Postoperative varus alignment, an elevated joint line level, and medially translated and internally rotated talar component were more prevalent in patients reoperated for medial impingement.     Click here to read the article.

The safe management of non-cardiac implantable electrical devices during surgery requires careful planning and knowledge of device-specific considerations. We continue our discussion from last week with actionable recommendations for each stage of perioperative care.• Electrocautery poses significant risks including device reprogramming, thermal burns, and damage to neural tissue• Turn off devices or set to safe surgery mode before using electrocautery • Bipolar cautery is safer than monopolar; if monopolar is needed, use lowest power setting• Place grounding pads to minimize current through the device generator• Somatosensory evoked potentials (SSEPs) are relatively safe while motor evoked potentials (MEPs) should be avoided• Newer devices may be MRI conditional but require specific protocols including device interrogation• Regional anesthesia should use ultrasound guidance rather than nerve stimulation techniques• Neuraxial anesthesia is not contraindicated for spinal cord stimulator patients but must be placed below insertion level• ECT can be performed with device turned off and careful electrode placement• Devices should be turned back on before emergence from anesthesia• Postoperative evaluation should include checking for thermal injuries and neurologic changesThanks for joining us for our 253rd episode! Wow, 250 and counting! Go tell a friend or colleague about our show as we work toward 500 episodes. If you enjoy the Anesthesia Patient Safety Podcast, please give us a five-star rating, subscribe, and share with colleagues.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/253-when-electrocautery-meets-implanted-devices-what-every-anesthesia-professional-needs-to-know/© 2025, The Anesthesia Patient Safety Foundation

Postoperative cognitive disorders (POCD) are often misunderstood, underdiagnosed, and underestimated, but they can dramatically affect a patient's recovery and long-term quality of life. We've invited Dr. Christine Detwiler to join us so we can better understand the science behind POCD, the risk factors, and the strategies anesthesia providers are using to protect brain health. Along with guest co-host Dana Pederson, CRNA, we dive into this topic with Christine while it's still very fresh on her mind. She shares the insights she uncovered during her doctoral research, including risk factors, early signs to watch for, and why anesthesia providers play a bigger role in brain health than they might think. Here's some of what we discuss in this episode:

Send us a textDeclining Incidence of Postoperative Neonatal Brain Injury in Congenital Heart Disease.Peyvandi S, Xu D, Barkovich AJ, Gano D, Chau V, Reddy VM, Selvanathan T, Guo T, Gaynor JW, Seed M, Miller SP, McQuillen P.J Am Coll Cardiol. 2023 Jan 24;81(3):253-266. doi: 10.1016/j.jacc.2022.10.029.PMID: 36653093 Free PMC article.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textDiese Woche geht es im Journal Club um die Behandlung von PONV durch Kaugummikauen: Darvall, J; De Silva, A; von Ungern-Sternberg, B et al.  on behalf of the CHEWY Trial Group and the ANZCA Clinical Trials Network. Chewing Gum to Treat Postoperative Nausea and Vomiting in Female Patients: A Multicenter Randomized Trial. Anesthesiology 142(3):p 454-464, March 2025. | DOI: 10.1097/ALN.0000000000005283Mit im Studio dabei: Sophie He, wissenschaftliche Mitarbeiterin der Klinik für Anästhesiologie am UKHD. 

Gara Knudtson, Doctor of Nurse Anesthesia Practice and Certified Registered Nurse Anesthetist with Pullman Anesthesia at Pullman Regional Hospital, explains why some patients experience nausea and vomiting after a surgical procedure, what CRNAs can do to help reduce the likelihood of postoperative nausea and vomiting, and how long anesthesia stays in the body.

This week we review a work from the department of cardiology and department of cardiac surgery at Boston Children's Hospital on late hypertension in patients following coarctation repair. Late hypertension has been associated previously with late transverse aortic arch Z score but can this be predicted by the immediate postoperative transverse aortic arch Z score also? What factors account for late hypertension in the coarctation patient? Should more patients have their aorta repaired from a sternotomy? Dr. Sanam Safi-Rasmussen, who is a PhD candidate at Copenhagen University, shares her insights from a work she performed while a research fellow at Boston Children's Hospital. DOI: 10.1016/j.jtcvs.2024.08.049

Hosted by RAPM Editor Eric Schwenk, MD, this episode of RAPM Focus welcomes RAPM Associate Editor Mark Bicket, MD, PhD, and medical student Sama Ramo following the recent publication of their original research paper, “Risk Factors for Persistent Postoperative Opioid Use: An Entity Distinct from Chronic Postsurgical Pain,” included in the February 2025 special edition of RAPM, titled “Tackling the Challenge of Chronic Postsurgical Pain.” Persistent postoperative opioid use results when patients continue to take prescription opioids well beyond the time their pain after surgery would be expected to resolve. In some cases, this is a couple days; in other cases, this is several weeks. There are many challenges associated with prescription opioid use, including the lack of a truly safe dose, so there is risk across the continuum. Patients facing persistent postoperative opioid use potentially confront worse outcomes, higher rates of health care utilization, and higher rates of mortality compared to patients not enduring persistent postoperative opioid use. Dr. Mark Bicket is an associate professor of anesthesiology with tenure at the University of Michigan and a joint appointment in the Department of Health Management and Policy at the School of Public Health. Additionally, he is co-director of the Overdose Prevention Engagement Network (OPEN). A clinician-scientist and practicing physician anesthesiologist, Dr. Bicket has pioneered evidence-based approaches to reduce opioid-related harms and improve the treatment of persons who experience pain. He currently leads an NIH R01 study examining pain-related outcomes for persons with opioid use disorder who have surgery and serves as PI for two pragmatic trials funded by the Patient-Centered Outcomes Research Institute including the CARES study, an international randomized clinical trial examining commonly prescribed treatments for postoperative pain. He previously served on the National Academy of Medicine ad hoc committee on evidence for opioid prescribing guidelines in 2018-2019 and a workshop on opioid disposal in 2023. Dr. Bicket has advised the White House, FDA, CMS, state governments, and national organizations on pain and opioid issues. His research, which includes 120 peer-reviewed articles, has appeared in JAMA, NEJM, and BMJ, and has been supported by the Foundation for Anesthesia Education and Research (FAER), SAMHSA, and CDC. Sama Ramo is a second-year medical student at Oakland University William Beaumont School of Medicine. She is a Foundation for Anesthesia Education and Research scholar. *The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner's judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others. Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

Moderator: BobbieJean Sweitzer, M.D. Participants: Jai Darvall, Ph.D. and Tong J. Gan, M.D., M.B.A., M.H.S. Articles Discussed: Chewing Gum to Treat Postoperative Nausea and Vomiting in Female Patients: A Multicenter Randomized Trial Chewing Gum: A Viable Option as a Rescue Therapy for Postoperative Nausea and Vomiting? Transcript

In this JCO PO Article Insights episode, Harold Nathan Tan summarizes findings from the JCO PO article, “Circulating Tumor DNA as a Prognostic Biomarker for Recurrence in Patients With Locoregional Esophagogastric Cancers With a Pathologic Complete Response.” TRANSCRIPT Harold Nathan Tan: Welcome to JCO Precision Oncology Article Insights where we explore cutting-edge discoveries in the world of cancer treatment and research. I'm Harold Nathan Tan, your host for today's episode. Let's dive into a fascinating study published in JCO Precision Oncology entitled, “Circulating Tumor DNA as a Prognostic Biomarker for Recurrence in Patients With Locoregional Esophagogastric Cancers With a Pathologic Complete Response.” This study led by Dr. Eric Michael Lander and colleagues examines a critical question: Can circulating tumor DNA help predict recurrence in patients with esophagogastric cancer who have achieved a favorable pathologic response after treatment? Esophagogastric cancer ranks as the seventh leading cause of cancer-related deaths worldwide. Despite aggressive treatment including neoadjuvant therapy followed by surgery, recurrence remains a grim reality for many patients. Interestingly, even those who achieve a pathologic complete response face a recurrence risk of up to 25%. This highlights a need for better tools to identify high-risk patients post-treatment. Circulating tumor DNA, or ctDNA for short, is emerging as a powerful biomarker in oncology. This minimally invasive blood-based test detects fragments of tumor DNA in the bloodstream, potentially signaling molecular residual disease before any radiographic evidence of recurrence appears. In this study, researchers focused on patients with locoregional esophagogastric cancer who had undergone neoadjuvant therapy followed by surgery, achieving either a complete or near complete pathologic response. Blood samples were collected postoperatively within a 16-week molecular residual disease window and during routine surveillance. The aim is to determine whether ctDNA positivity correlates with recurrence-free survival. The study analyzed 309 plasma samples from 42 patients across 11 institutions. Detectable ctDNA within the 16-week postoperative window was associated with a significantly higher recurrence risk. Among those with detectable ctDNA, 67% experienced recurrence compared to only 15% for those with undetectable ctDNA. This corresponds to a hazard ratio of 6.2, an alarming figure that underscores the potential for ctDNA as a prognostic tool. But the story doesn't end there. Postoperative surveillance ctDNA testing more than 16 weeks after surgery also proved to be a powerful prognostic indicator. Every patient with detectable ctDNA during surveillance eventually experienced recurrence, while only 7.4% of those with undetectable ctDNA relapse. These findings suggest that ctDNA testing could provide a critical lead time, enabling earlier interventions and personalized treatment strategies. Now let's talk about the clinical implications. Currently, patients who achieve a pathologic complete response often aren't considered for adjuvant therapies as the absence of visible disease is taken as a sign of remission. However, this study challenges that assumption. By integrating ctDNA testing into routine post-treatment surveillance, clinicians could identify high-risk patients who might benefit from additional therapy even when traditional imaging shows no signs of recurrence. This brings us to the bigger picture. Esophagogastric cancer treatment is evolving rapidly, with trials like CheckMate 577 and ESOPEC offering new insights into perioperative strategies. However, this study highlights a critical gap, the need for personalized, biomarker-driven approaches in the adjuvant setting. ctDNA could fill that gap, offering a non-invasive, dynamic way to monitor patients and guide clinical decisions. Of course, no study is without its limitations. The authors acknowledge the relatively small sample size and the retrospective nature of their analysis. They also note the variability in ctDNA testing and imaging schedules across institutions. However, the robust association between ctDNA positivity and recurrence-free survival makes a compelling case for further research in larger prospective cohorts. Looking ahead, what's the next step? The authors call for prospective validation of ctDNA as a prognostic tool, emphasizing its potential to refine risk stratification and optimize treatment strategies. Imagine a future where a simple blood test could dictate not only the need for additional therapies, but also the timing and type of intervention. As we wrap up, let's reflect on the broader impact of the study. By integrating ctDNA into routine cancer care, we could move closer to a world where treatments are not just effective, but also precisely tailored to each patient's unique biology and disease dynamics. Thank you for tuning into JCO Precision Oncology Article Insights. Don't forget to subscribe and join us next time as we explore more groundbreaking research shaping the future of oncology. Until then, stay informed and stay inspired.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

Show notes at pharmacyjoe.com/episode988. In this episode, I'll discuss neostigmine plus anticholinergics vs sugammadex and the incidence of postoperative delirium. The post 988: Sugammadex vs. Neostigmine and Postoperative Delirium – If the Findings Were Reversed, There’s No Way This Abstract Would Be Written the Same Way appeared first on Pharmacy Joe.

Host Dr. Amanda Redfern welcomes oculoplastic surgeons Drs. Davin Ashraf and Natalie Hoesly to discuss their approaches to postoperative pain management, with the help of a pain and addiction medicine specialist, Dr. Pat Liu. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Moderator: James P. Rathmell, M.D. Participants: Nicholas Joseph Douville, M.D., Ph.D. and Vesela P. Kovacheva, M.D., Ph.D. Articles Discussed: Polygenic Score for the Prediction of Postoperative Nausea and Vomiting: A Retrospective Derivation and Validation Cohort Study Polygenic Risk Scores: Coming to Your Operating Room? Transcript

What are the steps involved in Functional Crown Lengthening? Which scenarios/teeth are best for this type of surgery? What is biologic width and why should we care? Is Bone sounding a diagnostic test, or just a genre of music? The answer to these questions and a lot more can be found in this packed episode with Dr Hiten Halai. We cover the right protocols when crown lengthening and understand the difference between aesthetic and functional crown lengthening.  https://youtu.be/KRlEtz16I8c Watch PDP207 on Youtube Protrusive Dental Pearl - Bone Sounding Using a periodontal probe, go into the depth of the sulcus, pushing deeply until you hit bone, all while recording the measurement with the probe. This measurement will then guide you on how to carry out your crown lengthening procedure. Push hard to pass the connective tissue and ensure you are touching the bone. Not using AI to write your notes and letters for you yet? Save hours every day and save money using this affiliate link for DigitalTCO: Click Here  Highlights of this Episode:03:19 Protrusive Dental Pearl06:10 Introduction - Dr Hiten Halai12:56 Functional Crown Lengthening15:41 Understanding Crown Lengthening Types18:42 University of Dental Instagram22:38 Biologic Width aka Supra-crestal Tissue Attachment25:51 Functional Crown Lengthening: Practical Considerations31:09 Assessments & Keratinised Tissue35:47 Understanding Tissue Phenotypes39:16 Case Study: Premolar Treatment43:17 Bone Sounding and Biologic Width46:58 Shape of Gingivectomy50:31 Flap Designs52:37 Burs for Crown Lengthening56:13 Healing and Restoration Timelines58:31 Learning and Training Opportunities Key Takeaways: Hiten's journey began with a passion for periodontics during dental school. Managing time effectively is crucial for specialists with busy schedules. Functional crown lengthening is often underutilized in practice. Aesthetic crown lengthening can lead to complications if not done correctly. Understanding biologic width is essential for successful crown lengthening procedures. Preoperative assessments are critical for determining candidacy for crown lengthening. The type of gingival tissue affects surgical outcomes and healing. Proper surgical techniques can prevent complications and ensure better healing. Postoperative care is vital for achieving desired aesthetic results. Continuous education and mentorship are important for dental professionals. This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcome C. ADG Code: 490 PERIODONTICS (Mucogingival management)  Aim: To enhance knowledge and practical understanding of crown lengthening procedures, with a focus on distinguishing between aesthetic and functional crown lengthening, and the importance of biologic width in achieving predictable clinical outcomes. Learning Outcomes: Identify the key differences between aesthetic and functional crown lengthening and the clinical scenarios in which each is most appropriate. Demonstrate an understanding of biologic width and its significance in the success of crown lengthening procedures, including the impact on long-term periodontal health. Apply the principles of bone sounding to accurately assess the need for crown lengthening and ensure optimal restoration outcomes, minimising risks such as gingival recession and bone loss. If you liked this episode, check out: PDP079 - Crown Lengthening

Editor's Summary by Preeti Malani, MD, MSJ, and Chris Muth, MD, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from November 23-December 6, 2024.

Postoperative pain control is an essential aspect of patient recovery and satisfaction. While pain management is important in all surgical settings, C-sections, hysterectomies, and myomectomies are particularly frequent, accentuating the need for reliable non-opioid alternatives in OBGYN. Dr. Steven McCarus and Dr. Paula Bilica discuss the efficacy of multimodal pain control options in gynecologic and obstetric surgeries, including Exparel, a non-opioid liposomal bupivacaine. The doctors highlight the opioid epidemic and the need for alternative pain relief methods. They share insights on how the introduction of Exparel has transformed their practices by reducing the reliance on opioids, enhancing patient recovery post-surgery, and improving overall patient outcomes. Specific techniques and procedures for using Exparel in various types of surgeries such as C-sections, hysterectomies, and myomectomies are detailed, along with the benefits observed in clinical practices. TIMESTAMPS 00:00 - Introduction 00:42 - The Opioid Epidemic and Pain Management 02:46 - The Role of Exparel in Pain Management 04:53 - Multimodal Pain Control 06:12 - Techniques for Using Exparel 10:08 - Patient Outcomes and Benefits CHECK OUT THE FULL EPISODE OBGYN Ep. 67: https://www.backtable.com/shows/obgyn/podcasts/67/non-opiod-pain-management-in-gyn-surgery

In this episode of the ESCRS IME podcast series on refractive IOLs, Prof. Thomas Kohnen and Dr. Basak Bostanci discuss the critical role of precise preoperative measurements in cataract surgery with presbyopia-correcting lenses to prevent postoperative refractive surprises. They explain how residual refractive errors can have a significant impact on patient vision and satisfaction. The discussion also covers common pitfalls that can lead to postoperative refractive issues and offers practical strategies for avoiding them. Be sure to listen to the other informative podcasts in this series! Independent medical education supported by Alcon (Platinum), J&J Vision (Bronze) and Zeiss (Bronze).

The Medial Meniscus is a known secondary stabilizer to the ACL in terms of anterior tibial translation in the knee. So what happens after ACL reconstruction if the medial meniscus is deficient? Dr. Andrew Fithian, MD joins us to discuss his study addressing this very question. Coming to us from Kaiser Permanente San Diego, Dr. Fithian and his team investigated postoperative anterior tibial translation in autograft ACL patients with an intact medial meniscus, a repaired medial meniscus, or a partially resected medial meniscus. The results may guide decision making when facing a situation with an irreparable medial meniscus tear in the setting of an ACL tear, particularly with graft choice.

In this podcast, Dr. Valentin Fuster reviews a groundbreaking study on intraoperative conduction mapping to prevent postoperative atrioventricular block (AVB) in children with complex congenital heart disease. The study highlights how mapping the His bundle during surgery significantly reduces the need for pacemakers, particularly in high-risk populations like those with Heterotaxy syndrome and non-Transposed Great Arteries, offering a promising tool to improve long-term outcomes for these patients.

In this episode, we discuss recent findings on the potential risks of left atrial appendage closure (LAAC) in cardiac surgery patients without prior atrial fibrillation. The study highlights an increased risk of new-onset postoperative AF and prolonged hospital stays without clear benefits in mortality or stroke prevention. The Vasopressor & Inotrope HandbookAmazon: ⁠⁠https://amzn.to/3UvFFVf⁠⁠ (affiliate link) Signed Copy: ⁠⁠https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook⁠ Movember Link: ⁠https://movember.com/m/eddyjoemd?mc=1⁠ Citation: Shuhaiber JH, Abbas M, Morland T, Kirchner HL, El-Manzalawy Y. Atrial appendage closure is associated with increased risk for postoperative atrial fibrillation. J Cardiothorac Surg. 2024 Nov 2;19(1):619. doi: 10.1186/s13019-024-03119-6. PMID: 39488696. --- Support this podcast: https://podcasters.spotify.com/pod/show/eddyjoemd/support

We are seeing a 42F in the emergency room who underwent a laparoscopic sleeve gastrectomy 11 days ago. The operation was uneventful, and she had a negative airleak test. She had an uneventful postoperative course and was discharged on POD 1.   Her medical history is significant for hypertension and hyperlipidemia, and he has no other surgical history. She has been able to keep up with her clear liquid diet. She complains that this morning she experienced abdominal and palpitations. You note her vitals show a mildly elevated blood pressure and her latest heart rate is 120s.  Join Drs. Matthew Martin, Adrian Dan, Crystall Johnson-Mann, and Paul Wisniowski on a discussion about initial evaluation and management of bariatric patients with internal hernias.  Show Hosts: Matthew Martin Adrian Dan Crystal Johnson-Mann Paul Wisniowski Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

In this episode, Tom Varghese, MD, MS, MBA, FACS, is joined by Anai N Kothari MD, FACS, MS, FSSO, from the Medical College of Wisconsin. They discuss Dr Kothari's recent article, “Association of Daily Step Count and Postoperative Complication among All of Us Research Participants,” in which the authors used preoperative wearable device data from 475 patients to investigate the link between daily step counts and postoperative complications. Patients with fewer than 7,500 daily steps had a higher risk of complications, supporting the use of wearables for surgical risk assessment and preoperative fitness measurement. Disclosure Information: Drs Varghese and Kothari have nothing to disclose. To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date. Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more. #JACSOperativeWord

Oral health and postoperative infective complications by AORNJournal

You're the new intern on your first night of night float. First page, right off the bat – AFib with rates into the 150s. What's your next move?! Dr. Nathan Anderson takes the anxiety out of approaching Atrial Fibrillation in the post-operative patient. Join him and Dr. Elizabeth Maginot as they discuss this very common post-operative you're guaranteed to see on the wards.  Hosts:  - Dr. Nathan Anderson, Internal Medicine Associate Professor and Hospitalist, University of Nebraska  - Dr. Elizabeth Maginot, General Surgery Resident and BTK Surgical Education Fellow, University of Nebraska Medical Center, Twitter: @e_magination95 Learning Objectives:  - Discuss the underlying pathophysiological mechanisms that contribute to the development of atrial fibrillation in the postoperative setting.  - Critically approach the different management options for atrial fibrillation in the post-cardiac and non-cardiac surgery settings, including rate versus rhythm control, indications for cardioversion, and the role of anticoagulation.  - Identify common risk factors for atrial fibrillation in the post-operative setting.  - Discuss long-term management and follow-up strategies for patients who develop atrial fibrillation after surgery. References:  1. Bhave PD, Goldman LE, Vittinghoff E, Maselli J, Auerbach A. Incidence, predictors, and outcomes associated with postoperative atrial fibrillation after major noncardiac surgery. AmericanHeart Journal. 2012;164(6):918-924. doi:10.1016/j.ahj.2012.09.004 https://pubmed.ncbi.nlm.nih.gov/23194493/ 2. Gialdini G, Nearing K, Bhave PD, et al.. Perioperative Atrial Fibrillation and the Long-term Risk ofIschemic Stroke. JAMA. 2014;312(6):616. doi:10.1001/jama.2014.9143 https://pubmed.ncbi.nlm.nih.gov/25117130/ 3. Snow V, Weiss KB, LeFevre M, McNamara R, Bass E, Green LA, Michl K, Owens DK, Susman J, Allen DI, Mottur-Pilson C; AAFP Panel on Atrial Fibrillation; ACP Panel on Atrial Fibrillation.Management of newly detected atrial fibrillation: a clinical practice guideline from the AmericanAcademy of Family Physicians and the American College of Physicians. Ann Intern Med. 2003 Dec16;139(12):1009-17. doi: 10.7326/0003-4819-139-12-200312160-00011. PMID: 14678921. https://pubmed.ncbi.nlm.nih.gov/14678921/ 4. A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation. NewEngland Journal of Medicine. 2002;347(23):1825-1833. doi:10.1056/nejmoa021328 https://pubmed.ncbi.nlm.nih.gov/12466506/ Learn more about our Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship course and preview a full chapter here: https://app.behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  DOMINATE THE DAY 

Send us a textReady to revolutionize your understanding of equine anesthesia? Join us as we challenge conventional practices with groundbreaking insights from Drs. Charlie Barton and Rachel Hector. Discover how their controlled randomized trial reveals that fasting horses before surgery doesn't offer the anesthetic benefits we've long believed. Instead, it delays postoperative manure output, causing unnecessary stress on our equine patients. Tune in to explore the innovative advancements in equine anesthesia with Charlie and Rachel. We dive deep into their research, discuss the future steps for further studies, and reflect on the potential impacts on equine veterinary care. Don't miss this chance to gain cutting-edge knowledge and share your thoughts with us—let's reshape the way we approach equine anesthesia and postoperative care together!JAVMA article: https://doi.org/10.2460/javma.24.04.0235INTERESTED IN SUBMITTING YOUR MANUSCRIPT TO JAVMA ® OR AJVR ® ? JAVMA ® : https://avma.org/JAVMAAuthors AJVR ® : https://avma.org/AJVRAuthorsFOLLOW US:JAVMA ® : Facebook: Journal of the American Veterinary Medical Association - JAVMA | Facebook Instagram: JAVMA (@avma_javma) • Instagram photos and videos Twitter: JAVMA (@AVMAJAVMA) / Twitter AJVR ® : Facebook: American Journal of Veterinary Research - AJVR | Facebook Instagram: AJVR (@ajvroa) • Instagram photos and videos Twitter: AJVR (@AJVROA) / Twitter JAVMA ® and AJVR ® LinkedIn: https://linkedin.com/company/avma-journals

Are you having a BRAT summer, because we sure are here on the NAVAS podcast! By BRAT, we mean Best Remedies for Analgesic Therapy! We're excited to continue our discussion on post-operative pain control for dogs and cats. If you haven't listened to part one of this conversation, please go back and listen before diving into this episode. We're going to finish up our conversation on surgical pain management by discussing the nuances of NSAID use in cats, confronting some controversial opinions on Gabapentin, rave about local anesthetic agents, and introduce some pharmacologic and non-pharmacological therapies to help tackle acute pain for our patients. Joining us again is Dr. Melina Zimmerman, veterinary anesthesiologist and owner of The Doggy Gym, where she provides pain management therapies for all kinds of species. Pain management is so much more than “set and forget”, and we hope to convince you of that right here on the NAVAS podcast.References are made to the following resources in the episode:Our previous short episode on Nocita with Dr. Tammy Grubb.2022 ISFM consensus guidelines on managing acute pain in cats that has been endorsed by the American Association of Feline Practitioners (AAFP): 2024 ISFM & AAPF consensus guidelines on long-term NSAID use in catsBuprenorphine as an additive agent with bupivacaine for certain dental blocks in dogsIf you like what you hear, we have a couple of favors to ask of you:Become a member of NAVAS for access to more anesthesia and analgesia educational and RACE-approved CE content. Spread the word. Share our podcast on your socials or a discussion forum. That would really help us achieve our mission: Reduce mortality and morbidity in veterinary patients undergoing sedation, anesthesia, and analgesia through high-quality, peer-reviewed education.As a reminder, the ACVAA Annual Meeting is happening in Denver, CO from September 25-27 later this year. Registration rates are discounted for NAVAS members. We hope to see you there! Sign up today!Thank you to our sponsor, Dechra - learn more about the pharmaceutical products Dechra has to offer veterinary professionals, such as Zenalpha.If you have questions about this episode or want to suggest topics for future episodes, reach out to the producers at education@mynavas.org.All opinions stated by the host and their guests are theirs alone and do not represent the thoughts or opinions of any corporation, university, or other business or governmental entity.

Jim Reichmann, MBA, joins us to discuss the evidence surrounding amputee post-operative care. Jim has a Master of Public Health degree from Georgia State University and has published on amputee post-operative care in the Journal of Vascular Nursing, PM&R Journal, and Current Physical Medicine and Rehabilitation Reports. Jim has served on a Technical Expert Panel for the Agency for Healthcare Research and Quality, worked with the Food and Drug Administration to discontinue the use of a dangerous drug in pregnancy, and contributed to various evidence-based guidelines for payers. Explore Jim's published research and connect on LinkedIn.Many thanks to Thuasne USA for sponsoring this episode! Explore their innovative SpryStep AFO today.  We've added 12 new products to the SPS Rewards Program from College Park, Proteor, WillowWood, Össur, Ottobock, Nabtesco, and Trulife! Click here to view additions. Visit spsco.comAlso, email us! The O&P Check-in is a bi-monthly podcast featuring the latest orthotics and prosthetics news, trends, best practices, regulations and policies. Designed for O&P professionals, join Brendan Erickson and a rotating co-host as they interview guests and share the latest advancements in the industry. 

In this episode, we're focusing on a critical aspect of post-surgical care: creating a plan to control postoperative pain once our canine or feline patients leave the hospital. We know that managing pain effectively during this period is vital for the recovery and well-being of our patients. With so many medications to choose from, costs to consider, and non-compliance to worry about, how can we optimize our patients pain control at home when there are so many variables to balance? In this episode, we're thrilled to have Dr. Melina Zimmerman lead us through this important discussion. As a veterinary anesthesiologist with additional training in companion animal rehabilitation, Dr. Zimmerman specializes in pain management for surgical and non-surgical conditions at her clinic, The Doggy Gym. In the first part of this two-part episode, we will focus our discussion on opioids and NSAIDs, with an emphasis on ancillary medications and non-pharmaceutical treatment options in our next episode. Have you ever wondered: What oral opioid options do we know are effective analgesics for dogs and cats? Is buprenorphine a great opioid or the greatest opioid? How do you get a fentanyl patch to stick? What's with all this hype about Galliprant and Tylenol for dogs? If you're curious about leveling up your analgesia game, we hope you give this episode a listen.References are made in this episode to analgesic and sedative agents from previous NAVAS episodes. Check out our episode on Zenalpha and Zorbium for more information.If you like what you hear, we have a couple of favors to ask of you:Become a member of NAVAS for access to more anesthesia and analgesia educational and RACE-approved CE content.Spread the word. Share our podcast on your socials or a discussion forum. That would really help us achieve our mission: Reduce mortality and morbidity in veterinary patients undergoing sedation, anesthesia, and analgesia through high-quality, peer-reviewed education.As a reminder, the ACVAA Annual Meeting is happening in Denver, CO from September 25-27 later this year. Registration rates are discounted for NAVAS members. We hope to see you there! Sign up today! Thank you to our sponsor, Dechra - learn more about the pharmaceutical products Dechra has to offer veterinary professionals, such as Zenalpha.If you have questions about this episode or want to suggest topics for future episodes, reach out to the producers at education@mynavas.org.All opinions stated by the host and their guests are theirs alone and do not represent the thoughts or opinions of any corporation, university, or other business or governmental entity.

#connectivityThe innovation village, was inaugurated at Euroanaesthesia 2024, in Munich, as a space where ESAIC and Industry Partners connected, discussed and presented healthcare opportunities and challenges generated by innovation. This year, the focus was on three key areas of discussion: connectivity, sustainability, and neuroscience. Listen to the “Innovation Village Podcasts” and find out more.In this session, chaired by Prof. Bernd Saugel, Dr Marjolein Haveman, Mr. Pau Imaz Boada, and Mr. Sam Ajizian discuss on seamless integration in postoperative continuous vital sign monitoring.

In this JCO Precision Oncology Article Insights episode, Fergus Keane provides a summary on "Multi-Institutional Study Evaluating the Role of Circulating Tumor DNA in the Management of Appendiceal Cancers" by Belmont, et al published on May 9th, 2024. TRANSCRIPT  Fergus Keane: Hello and welcome to JCO Precision Oncology Article Insights. I'm your host, Fergus Keane, an ASCO editorial fellow. Today I will be providing a summary of the article entitled, "Multi-Institutional Study Evaluating the Role of Circulating Tumor DNA in the Management of Appendiceal Cancers" by Dr. Erika Belmont and colleagues.  While appendiceal cancers represent an uncommon diagnosis, the incidence has been rising, with now over 3000 new cases per year diagnosed in the United States. The management of appendiceal cancers includes surgical resection for localized tumors and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, also known as HIPEC, for select patients with peritoneal metastasis. For patients with higher grade appendiceal cancers, systemic therapy is often included in the treatment paradigm. However, little data pertaining to the optimal treatment regimens exists.  Despite best practice, disease recurrence within three years of surgery will be observed in about 70% of cases of appendiceal cancers. The current conventional methods for surveillance for both detection of recurrence as well as for assessment of response to systemic therapy are using cross sectional imaging and serum tumor markers. These methods are limited and there is a recognition that more accurate biomarkers are required. Circulating tumor DNA, also known as liquid biopsies, refer to shed tumor DNA identified in the plasma. Several ctDNA assays exist, including tumor agnostic assays and tumor informed assays, the latter of which assess presence of personalized tumor derived mutations. The utility of circulating tumor DNA has been studied across several different cancer types and in several different disease settings, for instance in lung cancer and colorectal cancer. However, it has not been well demonstrated to date in appendiceal cancers.  This study aimed to investigate the role of the Signatera ctDNA assay in patients with appendiceal cancer. Specifically, the authors aimed to evaluate factors associated with circulating tumor DNA detection and the association between ctDNA and recurrence free survival after surgery. Their hypothesis was twofold, firstly, that circulating tumor DNA detection would be reduced in patients who received recent systemic therapy, and secondly, that circulating tumor DNA detection after cytoreductive surgery and HIPEC would be associated with a shorter recurrence free survival across all appendiceal cancer grades. The study design was a retrospective review of patients with appendiceal cancers treated at MD Anderson Cancer Center in Texas and the University of Chicago who underwent circulating tumor DNA testing between January 2019 and December 2022. Clinical, pathologic and treatment related information was collected for all patients. Regarding patient treatment, all patients received treatment as per the consensus recommendations at both cancer centers. Diagnostic evaluation was with CT or MRI imaging and serum tumor markers. Diagnostic laparoscopy was performed to evaluate for the presence of peritoneal metastases. The patient treatment plans were determined via MDT tumor board discussions and cytoreductive surgery, and HIPEC was offered with curative intent to eligible patients.  Systemic therapy with 5-FU based doublet or triplet therapy with or without VEGF inhibitors was offered to patients with grade two or three tumors and with a good performance status. HIPEC protocols involved the use of mitomycin C. Postoperative surveillance involved cross sectional imaging and tumor marker evaluation every three months for two years and thereafter every six months if the patients remain disease-free. Circulating tumor DNA testing was offered at the discretion of the treating physician, typically every three months after surgery. The Signatera assay is a personalized, multiplexed, PCR based next generation sequencing platform. Three major analyses were performed. Number one, the frequency of any time ctDNA detection was evaluated in patients with ctDNA assays drawn at the time of radiographic or laparoscopically identifiable disease. Number two, the correlation between preoperative ctDNA levels and intraoperative peritoneal cancer index was evaluated in patients with peritoneal metastases. The third analysis involves the association between circulating tumor DNA presence drawn within one year of optimal resection.  A total of 402 plasma samples were obtained from 94 patients from the two centers. Most patients had grade 2 or 3 appendiceal cancers and 85% underwent surgery. Most patients had peritoneal metastases. 50 patients had circulating tumor DNA assessment in the presence of stage 4 disease, included in this, 13 patients were tested preoperatively, 26 patients who developed recurrence after surgery were included, and 11 patients who did not undergo surgery. In total, circulating tumor DNA was detected in 66% of these patients. The detection frequency was 57.1% in patients with grade 1, 62.5% in patients with grade 2, and 70.4% in patients with grade 3 disease, but this variability did not meet statistical significance. Lower circulating tumor DNA detection was observed in patients who received systemic therapy within six weeks before ctDNA assessment at 43.8% versus 76.5%, and multivariate analysis confirmed this association, demonstrating that recent systemic therapy was associated with an odds ratio of 0.22 versus less recent systemic therapy.  17 patients underwent circulating tumor DNA testing before cytoreductive surgery, and HIPEC and circulating tumor DNA was detected in 23.5% of these cases. No correlation was observed between ctDNA detection and intraoperative PCI index in these patients. Among the 50 patients with ctDNA testing within one year of optimal resection, survival estimates were generated for 36 patients who underwent cytoreductive surgery and HIPEC for grade 2 and 3 appendiceal cancers. The median follow up was 19.6 months. Circulating tumor DNA detection after cytoreductive surgery was associated with a shorter median recurrence free survival of 11.3 months versus not detected in those without ctDNA detection. On multivariate analysis, this was confirmed. The median time interval between surgery and ctDNA detection was 31 weeks. In this cohort of 36 patients, 44.4% or 16 patients developed disease recurrence. During the surveillance period, ctDNA was elevated in 93.8% of these patients, demonstrating a higher sensitivity than CEA, CA 19-9 or CA 125 tumor markers. Only one patient with disease recurrence had negative ctDNA at that time. Among these 16 patients with disease recurrence, one patient with a positive ctDNA test had their first sample drawn after diagnosis of disease recurrence, and one patient who had extensive adjuvant systemic therapy developed ctDNA negative recurrence. In the remaining 14 patients, circulating tumor DNA detection preceded the diagnosis of recurrence on imaging by a median of 11 weeks.   In summary, this study is a large, retrospective report of tumor-informed circulating tumor DNA testing in patients with appendiceal cancers. This study is one of the first to elucidate the factors associated with circulating tumor DNA detection in this disease and a potential role for circulating tumor DNA as an adjunct tool in the surveillance of patients with this malignancy.  Again, I'm Fergus Keane, a JCO Precision Oncology Editorial Fellow. Thank you for listening to the JCO Precision Oncology Article Insight. Please tune in for the next topic. Don't forget to give us a rating or review, and be sure to subscribe so that you never miss an episode. You can find all ASCO shows at www.asco.org/podcasts.    The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.  Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.      

Interview with Adrian Diaz, MD, MPH, and Andrew M. Ibrahim, MD, MSc, authors of Variation in Postoperative Outcomes Across Federally Designated Hospital Star Ratings. Hosted by Amalia Cochran, MD. Related Content: Variation in Postoperative Outcomes Across Federally Designated Hospital Star Ratings

Interview with Adrian Diaz, MD, MPH, and Andrew M. Ibrahim, MD, MSc, authors of Variation in Postoperative Outcomes Across Federally Designated Hospital Star Ratings. Hosted by Amalia Cochran, MD. Related Content: Variation in Postoperative Outcomes Across Federally Designated Hospital Star Ratings

In this episode, Emily Hellstrom, DVM, joined us to talk about her research on postoperative ileus and improving outcomes for colic surgery patients. She provided insight into a publication she co-authored titled “Postoperative Ileus: Comparative Pathophysiology and Future Therapies” and discussed some of the risk factors and treatment options for this condition in horses.The Disease Du Jour podcast is brought to you by Merck Animal Health.Disease Du Jour Podcast Hosts, Guests, and Links Episode 136:Host: Carly Sisson (Digital Content Manager) of EquiManagement | Email Carly (CSisson@equinenetwork.com) Guest: Dr.Emily Hellstrom, DVMPodcast Website: Disease Du JourThe Disease Du Jour podcast is brought to you in 2024 by Merck Animal Health.

In this episode, Emily Hellstrom, DVM, PhD, joined us to talk about her research on postoperative ileus and improving outcomes for colic surgery patients. She provided insight into a publication she co-authored titled “Postoperative Ileus: Comparative Pathophysiology and Future Therapies” and discussed some of the risk factors and treatment options for this condition in horses.The Disease Du Jour podcast is brought to you by Merck Animal Health.Disease Du Jour Podcast Hosts, Guests, and Links Episode 136:Host: Carly Sisson (Digital Content Manager) of EquiManagement | Email Carly (CSisson@equinenetwork.com) Guest: Dr.Emily Hellstrom, DVMPodcast Website: Disease Du JourThe Disease Du Jour podcast is brought to you in 2024 by Merck Animal Health.

Benzodiazepine-free Cardiac Anesthesia for Reduction of Postoperative Delirium (B-Free): A Multi-Centre Randomized Cluster Crossover Trial

Host Michael Blankstein, MD interviews paper authors Justin Haller, MD, and Lucas Marchand, MD. This paper was presented at the 2023 OTA Annual Meeting. For additional educational resources visit https://ota.org/ 

Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Philip Fleshner as they discuss the management of small bowel strictures in Crohn's disease.  Learning Objectives 1.    Discuss the role for J-pouch in a patient with inflammatory bowel disease 2.    Identify the key steps in creation of the J-pouch and technical considerations. 3.    Describe post operative complications and management in patients with a J-pouch Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Wind, water, walking, wound, & wonder drugs. The infamous 5 W's of your surgery rotation. Although this podcast is a bit more geared towards third-year shelf exams and Step 2/Level 2, its content is still super high-yield. In this episode, third-year medical student Maya Amy will discuss different etiologies and presentations of postoperative fever. Be sure to tune in and check it out!

Although intraoperative ankle motion serves as a foundational reference for anticipated motion after surgery and guides the addition of procedures to enhance ankle motion in total ankle arthroplasty (TAA), the relationship between intraoperative and postoperative ankle motion remains unclear. This study aimed to investigate the discrepancy between intraoperative and postoperative ankle range of motion (ROM) following TAAs using the anterior-approach, fixed-bearing systems.   In conclusion, this study revealed a significant difference between intraoperative ankle ROM and ankle ROM approximately 1 year after anterior-approach, fixed-bearing TAA, mainly due to plantarflexion motion restriction. Minimal difference in dorsiflexion suggests the importance of achieving the desired postoperative dorsiflexion motion during the surgery using the best possible adjunct procedures.   Click here to read the article.

In this episode, Dr. Neel Vaidya, a cataract, cornea, and refractive surgeon at Chicago Cornea Consultants and Rush University Medical Center shares what you need to know about lens-based refractive surgery - what it is, what makes it unique, and what post-op examinations look like for lens exchange procedures. There are many great pearls for medical students who have an upcoming ophthalmology rotation or want to learn more about these procedures.  0:54 - What is lens-based refractive surgery? 2:25 - Who are the right candidates? 6:35 - Risks & Benefits 11:20 - EVO-ICL 13:00 - Postoperative exam findings 16:40 - Pearls for your rotation

In this podcast, we will focus on same day discharge as part of Enhanced Recovery after Surgery (ERAS).Over the past two decades, and especially after the publication of the GOG LAP2 trial, minimally invasive surgery has been widely adopted in gynecologic oncology, as it is associated with lower rates of complications, and improved postoperative recovery and return to normal activity. Postoperative hospitalization is typically shorter after minimally invasive (MIS) hysterectomy, and many patients may even be candidates for discharge on the day of surgery, so-called same-day discharge (SDD).2023-2024 SGO ERAS Subcommittee Members and Speakers:Lee-may Chen, MD; Subcommittee Lead and ModeratorNawar Latif, MD, MPH, MSCEClarissa Polen-De, MDMichael Shu, MDCollin Sitler, DOBrenna Swift, MD, MASc, MSc, FRCSCDiogo Torres, MD

Host Dr. Joseph Patterson interviews paper author Dr. Patrick Kellam. This paper was presented at the 2023 OTA Annual Meeting. To see the abstract while listening download the free ConveyMED app: Apple Store or Google Play For additional educational resources visit https://ota.org/ 

Listen in as co-hosts Drs. Nicholas Strasser and Ben Jackson speak with paper author Dr. Joaquin Palma. This paper was presented live at the 2023 AOFAS Annual Meeting. For additional educational resources, visit: https://aofas.org 

Ever wonder what goes on behind the operating room doors? In this episode, we pull back the curtain on the fascinating world of anesthesia and surgery. Certified Registered Nurse Anesthetists Tanner and Cole from the Core Anesthesia podcast provide an insider's look at the perioperative process, from pre-op preparation to the orchestrated induction of anesthesia to navigating complications post-op. With vivid detail and expert insights, they break down the physiology behind general anesthesia, reveal secrets of the OR, and equip nurses with knowledge to better support surgical patients. Whether you're an ICU, ER, or floor nurse, you'll gain invaluable perspective on the surgical experience.Check out Nicole Kupchik's exam reviews and practice questions at nicolekupchikconsulting.com. Use the promo code UPMYGAME20 to get 20% off all products.Do you need help with your resume, interviewing, or need career coaching? Check out Sarah at New Thing Nurse:Get 15% off of her resume and cover letter templates using the promo code UPMYGAMENursing students and new grad career services Experienced RN career servicesNP career servicesSee the show notes at upmynursinggame.com.Time Stamps[06:16] - Pre-operative process, pre-anesthesia clinic visits, elective versus emergent preparation[18:02] - Overview of the induction process to put a patient under general anesthesia.[27:24] - Anesthesia: gases versus IV[42:47] - Postoperative nausea and vomiting (PONV)[44:08] - Postoperative urinary retention (PO-UR)

Host Mike Moore interviews Ralal Ali Ahmad, Founder/CEO of Predictive Care.  Predictive Care's technology connects clinicians to postoperative patients through MyHealthPal™: an AI-based postoperative surgical site infection monitoring technology that assesses wound health status, patient inputs, and patient vital signs to predict surgical site infection risk.Resources & LinksLinkedIn: Mike MooreLinkedIn: The Bleeding Edge of Digital Health

This week we review a recent work on postoperative ectopic atrial tachycardia (EAT) following congenital heart surgery in children. Are there risk factors for this arrhythmia and are any modifiable? What is the 'go to' therapy used by the electrophysiologists at Children's LA for the acute and chronic treatment of this arrhythmia in the postoperative period? Is the presence of EAT in a postoperative congenital heart patient a marker for a worse outcome? These are amongst the questions posed to Children's of Los Angeles pediatric electrophysiologist, Dr. Jonathan Uniat. DOI: 10.1007/s00246-022-03068-8

This week we delve into the worlds of cardiac critical care and congenital heart surgery when we review a recent report of a randomized controlled trial assessing the impact of nasal intubation on rates of NG or G tube feeds at discharge following neonatal congenital heart surgery. Do nasally intubated patients eat by mouth faster and have shorter lengths of stay? What would be the theoretical reasons that this might be useful? What is an 'ICU Liberation bundle' and how did its application to all postop newborns improve outcomes? Can the route of tracheal intubation truly be viewed as a possible 'modifiable risk factor'? These are amongst the questions posed to cardiology fellow at the Cleveland Clinic, Dr. Melissa Yildirim who conducted this study at the University of Virginia during pediatric critical care fellowship. doi: 10.1007/s00246-023-03322-7