TopMedTalk

Episodios

• 
  EBPOM London 2026: European Postoperative Care Pathways 17.08.2026 15m

  This presentation was recorded at the Evidence Based Perioperative Medicine (EBPOM) 2026 Annual Global Meeting. It features Nicolai Bang-Foss, Consultant, head of GI and orthopaedic anaesthesia, Hvidovre University Hospital, Denmark His main research field is the perioperative care of the elderly emergency patient. Specific areas of research have been regional analgesia, transfusion thresholds, outreach programs and perioperative logistics as well as perioperative haemodynamics. He describes wide European variation in postoperative pathways driven largely by ICU bed capacity, with Scandinavian countries running lean systems that push PACUs toward 24-hour, higher-acuity perioperative units and preoperative optimization for emergency laparotomy and hip fracture care. He outlines nonstandardized PACU/IMC structures, variable nursing education, and Danish strategies such as bypassing PACU for uncomplicated spinal anesthetic hip/knee replacements to free capacity for high-risk cases. He also reports research suggesting PACU nurses' clinical judgment outperforms discharge scores and highlights deteriorating surgical ward staffing and post-COVID pressures affecting triage and outcomes. If you'd like to hear presentations of this standard - before anyone else - we suggest you investigate our forthcoming EBPOM Ireland conference, being held in the beautiful location of Dingle. World leading experts in perioperative medicine presenting the latest cutting edge research in periperative medicine and enhanced recorvery after surgery. Find more information at EBPOM.org
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  Breaking Trials: The VITAL trial on TIVA, volatiles and outcome 13.08.2026 22m

  Recorded at the Evidence Based Perioperative Medicine (EBPOM) World Congress in London this episode of TopMedTalk sees Andy Cumpstey speaking with a panel of experts about the VITAL trial: a pragmatic randomised controlled trial about volatile vs total intravenous anaesthesia (TIVA) for major non-cardiac surgery in adult patients. The primary outcome was days alive and out of hospital at 30 days. Despite finding no significant differences in the primary outcome, the trial reveals that patients receiving TIVA anesthesia experience better recovery, with less postoperative nausea and other side effects. The conversation also touches on the trial mechanics, related ongoing studies, and implications for future research and clinical practice. Our guests include Professor Joyce Yeung, Director, Perioperative Medicine Clinical Trials Network, Associate Clinical Professor at University of Warwick and Honorary Consultant in critical care; Professor Shaji Sebastian, IBD Service Lead at Hull University Teaching Hospitals, and Chair of the BSG Research Committee and Professor Bernhard Riedel, Director, Department of Anaesthetics, Perioperative Medicine, and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia The paper is here: https://jamanetwork.com/journals/jama/fullarticle/2852741 For more about EBPOM check out www.ebpom.org
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  ANZCA ASM: Emerging Leaders 10.08.2026 17m

  At the ANZCA Annual Scientific Meeting in Auckland, Kate Leslie and Andy Cumpstey discuss ANZCA's Emerging Leaders Conference (ELC), a retreat-style program held immediately before the ASM for clinicians within five years of achieving FANZCA, with allowances for career disruptions. Their guests, Dr Saana Taylor FANZCA and Dr Vik Singh FANZCA, co-conveners of this year's ELC, describe shaping this year's New Zealand-hosted ELC with an Aotearoa focus, naming it Te Herenga Matua ("the pursuit of consciousness") and emphasizing collaboration, communication, wellbeing, compassion, and equity. The program included Māori and Pacific health sessions, leadership self-reflection, and an interactive session challenging fixed leadership "styles," alongside strong mentorship and networking with senior college leaders. Highlights included the openness of delegates, relationship-building, and a keynote on leadership "outside the box." Next year's ELC will be in the Adelaide Hills, with applications opening in September. More here: https://www.anzca.edu.au/fellowship/information-for-new-fellows/emerging-leaders-conference -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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  SOAP 2026: Ron George on community, partnerships, and expanding peripartum anaesthesia 06.08.2026 23m

  From the 58th annual meeting of the Society for Obstetric Anesthesia and Perinatology (SOAP) in Montreal, Mike Grocott and new co-host Joe Larvin speak with SOAP president Ron George about SOAP's growth to over 1,000 attendees and its international, collaborative community. George outlines his career from Dalhousie to UCSF and back to Canada as director of obstetric anesthesia at Mount Sinai Hospital in Toronto, highlighting its high-risk referral practice and large, internationally diverse fellowship program. He reflects on his presidency's focus on mission alignment and partnerships, including work with the New York State Society of Anesthesia, discussions with the California Society of Anesthesia, and a planned memorandum of understanding with the World Federation of Societies of Anaesthesiologists (WFSA) to support evidence-based global education. He also discusses formative work in low- and middle-income settings, advocacy, peripartum anesthesiologist roles, and meeting highlights such as trainees, pain during cesarean delivery panels, and the Gerard W. Ostheimer Lecture. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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  TopMedTalk Classic: Should direct laryngoscopy be consigned to the history books? 03.08.2026 18m

  This classic TopMedTalk piece was originally cast in April 2020. The debate 'Direct laryngoscopes should be consigned to history', was hosted by The Royal College Of Anaesthetists and carried out by our two guests on this piece, where the debate is outlined in advance. We get into the advantages and challenges behind the two techniques; video laryngoscopy and direct laryngoscopy. The conversation explores the fact that these skills are a key part of the job of practitioners, are we "de-skilling" the profession in an overly enthusiastic race toward new technology or are some resisting it simply because it's not what they are used to? Presented by Joff Lacey and Monty Mythen with their two guests; Professor Tim Cook, Consultant in Anaesthesia and ICM, Royal United Hospitals, Bath and Dr William Harrop-Griffiths, St Mary's Hospital, Imperial College Healthcare NHS Trust.
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  Euroanaesthesia 2026: Hot Topics in General Anaesthesiology with Laszlo Vutskits and Hugh Hemmings 30.07.2026 29m

  Live from Euroanaesthesia 2026 in Rotterdam, Kate Leslie and Andy Cumpstey speak with Laszlo Vutskits and Hugh Hemmings ahead of the "Hot Topics in General Anaesthesiology" lecture. Vutskits discusses reports of devastating neurologic outcomes after minor procedures in previously healthy patients, linked in a Spanish series to a shared mitochondrial DNA haplotype traced to Venezuela, including a rare ND4 complex I mutation; cybrid and fibroblast experiments showed clinically relevant sevoflurane rapidly suppresses oxidative phosphorylation but reversibly on washout, while propofol (tested without lipid) did not. Hemmings highlights the DAS 2026 airway management guidance advocating video laryngoscopy as first-line for routine and difficult intubation and emphasizes continuous oxygen delivery during intubation, prompting debate about skill retention and global feasibility. We reference this classic episode of TopMedTalk: https://topmedtalk.libsyn.com/-sunday-special-should-direct-laryngoscopy-be-consigned-to-the-history-books -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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  Perioperative Profile: Alan Merry 27.07.2026 35m

  Recorded live at the ANZCA Annual Scientific Meeting in Auckland, Kate Leslie interviews Professor Alan Merry for a perioperative profile, covering his retirement from clinical practice, ongoing research supervision, and work on environmental sustainability. Merry recounts being raised by a single mother in Zimbabwe, studying medicine at the Godfrey Huggins School of Medicine in Harare, and moving to New Zealand amid the Rhodesian Bush War. He describes entering anaesthesia after initially planning psychiatry, then becoming involved in New Zealand medical manslaughter law reform following prosecutions of clinicians, helping achieve the Crimes Amendment Act 1997's higher "major departure" threshold. He also discusses co-authoring "Error, Medicine and the Law" with Alexander McCall Smith, establishing New Zealand's Health Quality & Safety Commission, and international quality work through WFSA, the Global Oximetry Project, and the WHO surgical safety initiative that produced the surgical safety checklist, including its Auckland implementation. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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  The Lancet Surgery and Anaesthesiology: A New Journal for Perioperative Medicine 23.07.2026 16m

  At the EBPOM World Congress in London; TopMedTalk's Andy Cumpsty sits down for an exclusive interview with Amy Slogrove, editor-in-chief of the new journal, The Lancet Surgery and Anaesthesiology, ahead of its public launch on 20 July and a planned first issue in early 2027. Dr Slogrove, a South Africa–based pediatrician and epidemiologist, explains the journal's aim - to bring surgery and anaesthesiology together across the perioperative space, emphasizing research integrity, rigor, and ethics, supported by clinical peer review. She outlines the editorial team, submission route via thelancet.com/surgery, expected decision timelines, and peer-review approach. The journal will be a monthly, small-format, hybrid subscription model, with priorities including equity, patient-centered care, sustainability, resilience of perioperative systems, and global inclusivity. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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  TopMedTalk AI: Identifying How AI Can Help in Intensive Care 20.07.2026 28m

  Recorded live at the EBPOM World Congress in London, this episode of TopMedTalk AI features host James Bowness and co-host Amy Gomes speaking with Joe Harris, anaesthesia resident and Innovation Fellow in Anaesthesia at University College London Hospitals (UCLH) NHS Foundation Trust and Sanjay Wijayatilake, Consultant in Anaesthesia and Neuro Intensive Care MedicineBarking, Havering and Redbridge University Hospitals NHS Trust about "AI demand signaling" in intensive care. Harris explains the demand-signaling method—surveying clinicians on key problems, translating these into candidate AI use cases, prioritizing them via a Delphi panel, then exploring them in multidisciplinary workshops—to ensure AI development starts from frontline clinical needs rather than industry assumptions. Following completion of the anesthesia project, the intensive care survey is open to UK ICM clinicians across professions until July 31, with Delphi work planned for August–September and workshops in November–December. Follow this link for more: https://demandsignal.uk/ The discussion highlights governance, regulation, liability, and "black box" concerns, alongside potential ICU applications such as reducing alarm fatigue, documentation and transcription support, ventilator and workflow assistance, medication interaction checks, and evidence synthesis to support diagnosis and treatment, emphasizing AI as a partner with a human in the loop. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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  IARS 2026: WFSA Programs and Paediatric Anaesthesia Training in Africa 16.07.2026 24m

  At the International Anesthesia Research Society (IARS) and Society of Critical Care Anesthesiologists (SOCCA) meeting in Montreal, TopMedTalk hosts Mike Grocott and Desiree Chappell speak with Dr Faye Evans, Senior Associate in Perioperative Anesthesia at Boston Children's Hospital and Associate Professor of Anaesthesia at Harvard Medical School and Director of Partnerships on the Board of Directors for the World Federation of Societies of Anaesthesiologists (WFSA). The conversation covers efforts to improve access to safe surgery and anesthesia for children globally. Evans explains the WFSA as a society of over 150 member societies focused on advocacy, safety, quality, publications, short courses (including SAFE), and a fellowship program that has trained over 400 fellows from 62 countries. She highlights growing emphasis on leadership, teaching, and evaluation within fellowships and describes Pediatric Anesthesia Training in Africa (PATA), formed to expand fellowship training, which has developed a shared curriculum and launched four programs with support from ELMA Philanthropies and Smile Train. Evans outlines ways to get involved through teaching, virtual support, and donations via the WFSA website. If you would like to support the WFSA Scholars Program we mention this link in the show: https://wfsahq.org/get-involved/donate/ -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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  ANZCA ASM: Opioid sparing strategies for ambulatory anesthesia 13.07.2026 19m

  At the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine (FPM) held in Auckland, New Zealand, Kate Leslie and Andy Cumpstey interview Neel Desai about non-opioid multi-modal analgesia, especially the use of paracetamol/NSAID combinations for minor surgery. Dr Neel Desai is a Consultant Anaesthetist at Guys and St Thomas's Hospital, London, UK. He is supported by AFT Pharmaceuticals. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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  EBPOM 2026: Research oral abstract finalists 09.07.2026 27m

  Joff Lacey and Imogen Fecher-Jones interview six oral abstract finalists at this years' EBPOM. Nora Cruz Rodriguez; Association Between Participation in Remote Prehabilitation and High-Dependency Unit Length of Stay After Oesophagectomy and Radical Cystectomy: A Retrospective Cohort. Alexios Dosis; Remote wearable monitoring as a preoperative risk assessment tool. Ned Douglas; The Fluids, Atomoxetine or Midodrine (FAME) pilot trial. Tom Scodellaro; The new normal: CPET findings in patients aged 80 years and older. Gerry O'Callaghan; Preventing and Reducing Re-Presentations and Admissions following surgery, new thinking required. Sandy (Alexander) Jackson; Cost of Radial Arterial Line Placement in UK Operating Theatres. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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  TopMedTalk Classic: Dan Martin and the Ebola Epidemic of 2018 06.07.2026 13m

  This month's TopMedTalk Classic is particularly topical: first broadcast back in 2018 but relevant once again after the recent news of an Ebola outbreak in the Democratic Republic of the Congo. Originally recorded at the Intensive Care Society State of the Art Meeting in London, Desiree Chappell and Monty Mythen speak with Dan Martin, OBE, now Professor at the University of Plymouth and Consultant in Intensive Care Medicine at University Hospitals Plymouth NHS Trust, about the critical care management of Ebola and other viral haemorrhagic fevers. Dan Martin describes the Royal Free Hospital's role as the UK designated centre, using a Trexler isolator system to protect staff (rather than full PPE) and rehearsed RAF-supported repatriation and hospital drills, including simulations for intubation, lines and CPR. He explains that Ebola is not inevitably fatal and that outcomes improve with safe, good basic intensive care—fluids, electrolytes and preventing secondary infection—while evidence for expensive experimental therapies is limited. The discussion also covers screening based on travel history, UK planning for "high consequence infectious diseases," and international training visits. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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  NEJM and BMJ Editors: Joys and Challenges of Medical Publishing 02.07.2026 31m

  This piece is essential listening for anyone interested in modern academic publishing. Recorded at the Collaborative Clinical Trials Meeting in Prato, Italy, TopMedTalk hosts Kate Leslie and Mike Grocott speak with Eric Rubin (Editor-in-Chief, New England Journal of Medicine) and Jocalyn Clark (International Editor, BMJ) about medical publishing. The conversation covers, engaging with clinical researchers and seeing impactful work. How AI can help authors—especially non-native English speakers—while raising concerns about confidentiality, inaccurate or fabricated content, reviewer misuse, governance policies that struggle to keep pace, and AI-generated correspondence overwhelming journals. They explore how AI affects originality and idea generation, note an NEJM AI experiment using AI reviews, and consider how journals should communicate beyond clinicians to address misinformation and declining attention, while maintaining trust and collaborating more across publishing and science. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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  Perioperative Profile: Bruce Biccard 29.06.2026 30m

  Live from the World Congress of Anesthesiologists in Marrakesh, Kate Leslie speaks with Bruce Biccard, Nuffield Professor of Anaesthetic Science at the University of Oxford, Director of the African Perioperative Research Group, and board member of IARS and Safe Surgery South Africa. Bruce reflects on growing up in apartheid-era Cape Town, training in anaesthesia amid high-acuity care including trauma and HIV, and developing an interest in research through perioperative beta-blocker studies and mentorship in Oxford. He describes building South African and pan-African research collaborations that led to the African Surgical Outcomes Study (ASOS), which found mortality and failure-to-rescue rates about twice global averages despite relatively fit patients. He discusses a subsequent 30,000-patient cluster trial that showed no outcome improvement, highlighting implementation challenges, and outlines how Oxford's expertise can strengthen global health research in Africa and advance work on perioperative cognitive dysfunction. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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  Euroanaesthesia 2026: ESAIC Leadership Program for Experienced Anaesthesiologists 25.06.2026 15m

  At Euroanaesthesia in Rotterdam, TopMedTalk hosts Andy Cumpstey and Kate Leslie speak with Joana Berger-Estilita, ESAIC chair of education and training, about ESAIC's new leadership program. Developed over two years with a multidisciplinary team including ESAIC leadership and headquarters staff, the pilot addresses a gap for seasoned anaesthesiologists seeking further career progression. The retreat-style, experiential course includes two extended weekends (December and March), selects 25 ESAIC members with at least five years post-training leadership experience, and pairs participants with mentors. Content covers core leadership skills plus anaesthesia-specific challenges such as second victim, suicide, and drug abuse, alongside self-care. Funding is shared by industry and ESAIC, with applications via the ESAIC website. -- Join us at Evidence Based Perioperative Medicine (EBPOM) World Congress 2026 in London. Be part of a global conversation as clinicians from around the world gather between 7-9th July at the British Library in London. Three days of evidence-based perioperative medicine, global insights, and expert debate—featuring speakers including Michael Marmot and Ken Rockwood. Register here - https://ebpom.org/product/ebpom-world-congress-2026/
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  TopMedTalk AI: Generative AI Basics, Biases and the Future 22.06.2026 29m

  At the World Congress of Anaesthesiologists (WCA) in Marrakech, Morocco, TopMedTalk co-editors In chief, Kate Leslie and Mike Grocott speak with Sydney anaesthesiologist Alwin Chuan, a member of the joint ESRA-ASRA working group on AI, about strengths and limitations of AI for regional anaesthesia and medicine. Chuan explains how generative AI is trained on vast datasets using transformer architectures, why outputs are probabilistic, and how context affects meaning. They discuss privacy and the possibility of personal or creative work being used as a commodity in training, internet "scraping," and the inevitability of hallucinations, including false facts and fabricated citations. The conversation covers bias in training corpora, the need for human curation and reinforcement learning, and mitigation via prompt engineering such as retrieval-augmented generation (RAG), citation/page verification, and confidence estimates. Chuan predicts future advances and the fusion of imaging AI with generative AI for ultrasound guidance, previewing a follow-up episode. -- Join us at Evidence Based Perioperative Medicine (EBPOM) World Congress 2026 in London. Be part of a global conversation as clinicians from around the world gather between 7-9th July at the British Library in London. Three days of evidence-based perioperative medicine, global insights, and expert debate—featuring speakers including Michael Marmot and Ken Rockwood. Register here - EBPOM World Congress 2026
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  Euroanaesthesia 2026: Breaking Trials about Perioperative Blood Pressure Targets 18.06.2026 23m

  At Euroanaesthesia in Rotterdam, TopMedTalk hosts Andy Cumpsty and Kate Leslie speak with Denise Veelo Professor of Anesthesiology at the Amsterdam University Medical Center and Bernd Saugel Professor of Anesthesiology and Vice Chair of the Department of Anesthesiology in the Center of Anesthesiology and Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf, about two JAMA blood-pressure trials published on the same day. Veelo describes a 3,500-patient, two-center randomized trial comparing usual care (MAP 65) with more intensive, risk-stratified higher MAP thresholds (70/80/90) using a functional recovery primary outcome, stopped early for futility. Saugel outlines the 1,300-patient IMPROVE trial in 15 German centers, individualizing the lower intervention threshold to each patient's preoperative nighttime MAP versus routine MAP 65, with a 7-day composite outcome; no significant difference was found and event rates were ~30%. They conclude routine targeting substantially above MAP 65 is not supported for broad populations, note special circumstances may differ, and they discuss limitations, vasopressor-heavy practice, and future research including the ASPIRE 85 delirium-focused trial and work on autoregulation and physiology. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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  Euroanaesthesia 2026: ESAIC's White Paper on the Future of Anaesthesia and Intensive Care 15.06.2026 15m

  At this year's Euroanaesthesia meeting in Rotterdam, TopMedTalk host Andy Cumpsty interviews Wolfgang Buhre, Professor of Anesthesia and Perioperative Medicine at Utrecht University Medical Center and past president of the European Society of Anaesthesiology and Intensive Care (ESAIC). The discussion starts with a focus upon the annual ESAIC congress and its international reach, with next year's meeting planned for Copenhagen. Buhre explains ESAIC's White Paper, developed over two years using interviews and desk research with clinicians, stakeholders, and patient perspectives, to clarify the role of anesthesiologists and communicate core values and strategic goals for 2026. Key priorities include addressing workforce shortages and Europe-wide variation in training and working conditions, protecting patient safety, ensuring availability of critical medicines and supplies, and expanding standardized education tools such as the European Diploma. He outlines next steps focused on advocacy with European institutions and support for national societies. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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  Breaking Trials: SNaPP Trial of Sugammadex, Neostigmine and Postoperative Pulmonary Complications 11.06.2026 28m

  Andy Cumpstey and Mike Grocott interview Kate Leslie about the SNaPP study (Sugammadex, Neostigmine, and Postoperative Pulmonary Complications). SNaPP is a pragmatic randomized study run from the University of Melbourne with the ANZCA Clinical Trials Network across 45 sites in Australia, New Zealand, and Hong Kong. Patients aged 40+ having major abdominal or thoracic surgery (≥2 hours, overnight stay) were randomized after induction to reversal with sugammadex or neostigmine, with anesthetists unblinded and encouraged to use quantitative neuromuscular monitoring. In this podcast Andy, Mike and Kate discuss the results and their implications for anaesthetists and healthcare systems. Find the paper here: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00158-X/fulltext -- Join us at Evidence Based Perioperative Medicine (EBPOM) World Congress 2026 in London. Be part of a global conversation as clinicians from around the world gather between 7-9th July at the British Library in London. Three days of evidence-based perioperative medicine, global insights, and expert debate—featuring speakers including Michael Marmot and Ken Rockwood. Register here - https://ebpom.org/product/ebpom-world-congress-2026/