Today - in part 1 of our 2 part series - we talk through the case of an 82 year old man with a ruptured abdominal aortic aneurysm who is scheduled for urgent open repair with special guest, Dr Lahiru Amaratunge.Resources for today's episode:BJAED: Anaesthesia for endovascular repair of ruptured abdominal aortic aneurysms by K. Berry et al.LITFL: AAA by C. NicksonLancet: Endovascular versus open repair of abdominal aortic aneurysm in 15-years' follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial by Patel, R. et al.Annals of Surgery: Endovascular Repair of Abdominal Aortic Aneurysm in Patients Physically Ineligible for Open Repair: Very Long-term Follow-up in the EVAR-2 Randomized Controlled Trial by Sweeting, M. et al.Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

In today's episode, we cover the recently released consensus clinical practice recommendation regarding the peri-procedural use of the GLP-1 and GIP receptor antagonists. Enjoy this topical episode - this is sure to be an evolving area.  Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

This week we're under the pump with work and life, but we'll be with you soon and it's a cracker of an episode covering an extremely topical subject. Keep an eye out for our next episode dropping something in the next couple of weeks. As an apology, we'll have a bonus ep coming sometime towards the end of the season! Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Today's episode is the final in our series on inotropic and vasopressor medications. Today, we're going to tackle some of the more obscure inotropes and vasopressors - these medications typically aren't encountered terribly often within anaesthesia. During this episode, we discuss milrinone, levosimendan, methylene blue and hydroxocobalamin (Vitamin B12).  Resources for today's episode:StatPearls:Inotropes and vasopressors by D. VanValkinburgh et al.Adrenergic Drugs by K. Farzam et al.LITFL:Inotropes, vasopressors and other vasoactive agents by C. NicksonMilrinone by C. NicksonLevosimendan by C. NicksonMethylene blue by C. NicksonHydroxocobalamin by N. LongDeranged Physiology:Classification of inotropes and vasopressorsMilrinoneLevosimendanDRUGBANK Online:MilrinoneLevosimendanFeel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Today's episode - the second in our three episode series focusing on inotropic and vasopressor medications - sees us covering some more medications commonly (or uncommonly, depending on your scope of practice) encountered within anaesthesia. During this episode, we discuss vasopressin, dopamine and dobutamine.  Resources for today's episode:StatPearls:Inotropes and vasopressors by D. VanValkinburgh et al.Adrenergic Drugs by K. Farzam et al.LITFL:Inotropes, vasopressors and other vasoactive agents by C. NicksonVasopressin by C. NicksonDopamine by C. NicksonDobutamine by C. NicksonDeranged Physiology:Classification of inotropes and vasopressorsVasopressinDobutamineDRUGBANK Online:VasopressinDopamineDobutamineBJAED:Vasopressin and its role in critical care by A. Sharman & J. Low.Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Today's episode is the first in a series of three that focus on inotropic and vasopressor medications used within anaesthetic practice. During this episode, we discuss metaraminol, ephedrine, phenylephrine, noradrenaline and adrenaline.  There's one section of our episode where we thought it important to clarify what we're saying, as to out ears it sounds a little confusing. During our discussion about adrenaline, we state that both noradrenaline and adrenaline have the same affinity for beta-1 adrenoceptors. We then advise that the reason for the inotropic and chronotropic effects of adrenaline - not seen with noradrenaline - are because adrenaline has much greater affinity for beta-2 adrenaceptors than noradrenaline.Resources for today's episode:StatPearls:Inotropes and vasopressors by D. VanValkinburgh et al.Adrenergic Drugs by K. Farzam et al.LITFL:Inotropes, vasopressors and other vasoactive agents by C. NicksonMetaraminol by R. ButtnerPhenylephrine by C. NicksonNoradrenaline by C. NicksonAdrenaline by C. NicksonDeranged Physiology:Classification of inotropes and vasopressorsMetaraminolNoradrenalineAdrenalineDRUGBANK Online:MetaraminolEphedrinePhenylephrineNoradrenalineAdrenalineFeel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Today, we discuss a 2023 BJA Education article titled 'Perioperative care for transgender and gender diverse adults'.  We start with a discussion of words and terms that are useful to understand, before diving in to discussions about a trauma-informed care approach to minimise and hopefully eradicate negative preoperative experiences, physical, chemical and surgical options for gender affirmation, and lastly how this can inform the provision of safe anaesthesia for transgender patients.Resources for this episode:BJA Education: Perioperative considerations for transgender and gender diverse adults by Harding, D. et al.Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Today, in part 2 of our 2 part series on anaesthesia for previous heart transplant recipients, we discuss the care of these patients for non-cardiac surgery with special guest, Dr Ivan Rapchuk.We begin by covering the electrophysiology of a transplanted heart and what you may see on the ECG, and then proceed to the management of our theoretical patient for general anaesthesia for non-cardiac surgery. Resources for this episode:Oxford Handbook of Transplant Anaesthesia and Critical CareBJAED: Anaesthesia for a patient with a cardiac transplant (2002) by Morgan-Hughes, N. & Hood, G.Circulation (2004): Drug therapy in the heart transplant recipient by Lindenfeld, J. et al.Indian Journal of Anaesthesia: Post cardiac transplant recipient: Implications for anaesthesia by M. ChoudhuryRCEM India Learning - The ECG after cardiac transplantationFeel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Today, in part 1 of our 2 part series on anaesthesia for previous heart transplant recipients, we discuss the care of these patients for non-cardiac surgery with special guest, Dr Ivan Rapchuk. We start our discussion with a review of how to assess whether these patients are suitable for elective surgery, and follow this with a deep-dive on the typical immunosuppressant medications that these patients may be taking,  as well as their mechanism of action and side effects.Resources for this episode:Oxford Handbook of Transplant Anaesthesia and Critical CareBJAED: Anaesthesia for a patient with a cardiac transplant (2002) by Morgan-Hughes, N. & Hood, G. Circulation (2004): Drug therapy in the heart transplant recipient by Lindenfeld, J. et al.Indian Journal of Anaesthesia: Post cardiac transplant recipient: Implications for anaesthesia by M. ChoudhuryRCEM India Learning - The ECG after cardiac transplantationFeel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Today, we discuss the rise of GLP-1 receptor agonists - what they are, how they work, and how they affect fasting during the perioperative period.  Resources for today's episode: StatPearls: Physiology, Gastrointestinal Hormonal Control by Parikh, A. & Thevenin, C. https://www.ncbi.nlm.nih.gov/books/NBK537284/StatPearls: Glucagon-like Peptide-1 Receptor Agonists by Collins, L. & Costello, R. https://www.ncbi.nlm.nih.gov/books/NBK551568/ ANZCA PG07(A) Appendixhttps://www.anzca.edu.au/getattachment/897f5bf5-b665-4c99-a56f-e72678f19f7e/PG07(A)-Appendix-1-%E2%80%93-Fasting-guideline  ADS-ANZCA Perioperative and Hyperglycaemia Guidelines (Adults) https://www.diabetessociety.com.au/wp-content/uploads/2023/03/ADS-ANZCA-Perioperative-Diabetes-and-Hyperglycaemia-Guidelines-Adults-November-2022-v2-Final.pdf Up To Date: Glucagon-like peptide 1-based therapies for the treatment of type 2 diabetes mellitus by Dungan, K. & DeSantis, A. https://www.uptodate.com/contents/glucagon-like-peptide-1-based-therapies-for-the-treatment-of-type-2-diabetes-mellitus#:~:text=Like%20native%20GLP%2D1%2C%20all,%27Glycemic%20efficacy%27%20below.) American Society of Anesthesiologists Consensus-Based Guidance on Preoperative Management of Patients (Adults and Children) on Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists by Joshi, G. et al. https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/american-society-of-anesthesiologists-consensus-based-guidance-on-preoperativeFeel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.Thanks for listening, and happy studying!Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

It's taken almost a year, but we're finally giving you part 2 of our series on complex and uncommon cardiac conditions for non-cardiac surgery with special guest, Dr Shaun Roberts. Hold on to your earphones - this episode is a long one! If you haven't listened to part one, you can find it within season 6 - be sure to check it out before you listen to part 2.Today, we discuss anaesthesia for patient's with ventricular assist devices (or VADs), and we talk about providing anaesthetic care for a patient with a hypertrophic obstructive cardiomyopathy (or HOCM).Resources for today's episode:ANZCA Blue Book 2021Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Today, we take a close look at the SNACC guidelines for the diagnosis and treatment of neuroanaesthetic emergencies, and take a little time to discuss each of these emergencies in turn.Resources for the episode:Cognitive aids for the diagnosis and treatment of neuroanaesthetic emergencies: Consensus guidelines on behalf of the Society for Neuroscience in Anaesthesiology and Critical Care (SNACC) education committee by Hoefnagel, A.L. et al. (full journal article)SNACC cognitive aids for neurosurgical emergencies (cognitive aids only)Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Today, in part two of our two part series looking at perioperative hypotension and acute kidney injury (AKI), we take a closer look at the methods we can adopt - as anaesthetists - to try to prevent perioperative AKI and the evidence of their effectiveness in preventing this complication.Resources for today's episode:BJA: Role of perioperative hypotension in postoperative acute kidney injury: a narrative review (sciencedirectassets.com) by Lankadeva, Y. et al.KDIGO 2012 Acute Kidney Injury GuidelinesLITFL: RIFLE criteria and AKIN classificationFeel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Today, in part one of our two part series looking at perioperative hypotension and acute kidney injury (AKI), we take a close look at the diagnostic criteria for acute kidney injury. We then briefly revise aspects of renal physiology that make the kidney particularly susceptible to hypoxic injury, as well as looking at risk factors and other facets of anaesthesia that additionally predispose the kidney to perioperative injury.In part two - which will be released in a fortnight - we will take a closer look at the methods we can adopt as anaesthetists to try to prevent perioperative AKI and the evidence of their effectiveness in preventing this complication.Resources for today's episode:BJA: Role of perioperative hypotension in postoperative acute kidney injury: a narrative review (sciencedirectassets.com) by Lankadeva, Y. et al.KDIGO 2012 Acute Kidney Injury GuidelinesLITFL: RIFLE criteria and AKIN classificationFeel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Today we continue our discussion regarding preoperative functional capacity assessment. We'll cover the M-DASI, the 6-minute walk test, and put it all together to figure out how this applies to our practice as anaesthetists. Resources for today's episode include: BJAED: Subjective methods for preoperative assessment of functional capacity by Silvapulle & DarvallBJA: A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study by Riedel, B. et al.BJAED: Preoperative cardiopulmonary exercise testing by Agnew. N.BJA: Using the six-minute walk test to predict disability free survival after major surgery by Shulman, M. et al.STAT Pearls: 6 minute walk test by Matos Casano, M. & Anjum, F.Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Today, in part one of our two part series, we're taking a close look at the methods for performing pre-operative functional capacity assessments and their utility in predicting patient outcomes. In part 1, we focus our discussion on METS, activities of daily living (ADLs) and the DASI score.In part two - which will be released in a fortnight - we'll cover the M-DASI, the 6-minute walk test.Resources for today's episode:BJAED: Subjective methods for preoperative assessment of functional capacity by Silvapulle & DarvallBJA: A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study by Riedel, B. et al.BJAED: Preoperative cardiopulmonary exercise testing by Agnew. N.BJA: Using the six-minute walk test to predict disability free survival after major surgery by Shulman, M. et al.STAT Pearls: 6 minute walk test by Matos Casano, M. & Anjum, F.Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Deep Breaths returns next Monday February 5th with all new episode topics that we're sure will help with exam prep, and will keep your practice up to date. We'll also be joined by more wonderful guests this season and we can't wait to share their expertise with you all, so be sure to tune in and experience the learning revolution!Links for Lahiru Amaratunge's ANZCA Part 2 exam programs:Viva Boot Camp Courses (via Anaesthesia Collective)Online Part 2 Preparation Courses and ABCs of Anaesthesia Foundation Course (via Thinkific) - don't forget to use the code DB20 for 20% off when you purchase any of the two Anaesthetic part 2 exam preparation courses or the Anaesthesia Foundation course.If you'd like more information about any of these programs, you can email Lahiru at vivabootcamp@gmail.com. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Part 2 of our two-part series looking at common problems encountered in the post-anaesthetic care unit. We hope you enjoy another of our favourite topics. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

This two part series looks at some common problems we encounter in the post-anaesthetic care unit (PACU). It's another of our favourite topics and well worth the review. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

The final episode on our two-part series on cases in paediatric anaesthesia with special guest, Dr Paul Lee-Archer. Another of our favourites, we hope you enjoy it as much as we did. Resources for today's episode:Emergence delirium after paediatric anaesthesia: new strategies in avoidance and treatmentby Nair, S. & Wolf, A. Paediatric massive transfusion by Blain, S. & Paterson, N. Dilemmas in the preoperative assessment of children by Bhatia, N. & Barber, N. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!