Penn Medicine's TTM Academy Podcasts

About Penn Medicine's TTM Academy Podcasts

Welcome to Penn Medicine's TTM Academy Podcast! Send ideas for new topics to TTMtraining@pennmedicine.upenn.edu Learn more about TTM Academy: www.med.upenn.edu/resuscitation/ttm-academy.html ** TTM Academy podcasts are intended for medical education only and should not be used for clinical decision making.

Publisher

Penn Medicine TTM Academy

Category

health & fitness

Language

en

Explicit

No

First episode

7 Mar 2019

Latest episode

17 Jun 2021

Latest episodes

25 episodes in the feed.

1. 

   17 Jun 2021

   Episode 25 – Interpreting the TTM2 Trial – 33C versus Controlled Normothermia

   A new multicenter trial published in NEJM, commonly known as the “TTM2” trial, evaluated treating patients resuscitated from out-of-hospital cardiac arrest with targeted temperature management to 33C versus controlled normothermia, and found that outcomes were equivalent.  Does this mean the end of TTM as we know it? In this podcast, Dr. Benjamin Abella presents a comprehensive argument why he believes that such pronouncements are premature and not consistent with the larger body of laboratory and clinical science over the past 20 years. He discusses TTM2 in context of recent work from France (the Hyperion study), as well as work from the US and Japan, suggesting that patient selection is key.  TTM may not be needed for patients with favorable characteristics (witnessed arrest, bystander CPR, no evidence of shock) but still may be required for patients with less favorable characteristics (non-shockable arrest rhythms, no bystander CPR, evidence of shock). Also join us for a free live Zoom webinar on June 24 at 4 PM EDT US time to discuss the TTM2 trial. Registration at: https://pennmedicine.zoom.us/webinar/register/WN_JrHlS0lFRreZ6Otzr4LcnA Key references: Dankiewicz J, Cronberg T, Lilja G,  et al. Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest. N Engl J Med. 2021 Jun 17;384(24):2283-2294. https://pubmed.ncbi.nlm.nih.gov/34133859/ Lascarrou JB, Merdji H, Le Gouge A, et al. Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm. N Engl J Med. 2019 Dec 12;381(24):2327-2337.  https://pubmed.ncbi.nlm.nih.gov/31577396/ Callaway CW, Coppler PJ, Faro J, et al. Association of Initial Illness Severity and Outcomes After Cardiac Arrest With Targeted Temperature Management at 36 °C or 33 °C. JAMA Netw Open. 2020 Jul 1;3(7):e208215. https://pubmed.ncbi.nlm.nih.gov/32701158/ Nishikimi M, Ogura T, Nishida K, et al. Outcome Related to Level of Targeted Temperature Management in Postcardiac Arrest Syndrome of Low, Moderate, and High Severities: A Nationwide Multicenter Prospective Registry. Crit Care Med. 2021 Apr 8. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/33826582/

2. 

   19 Apr 2021

   Episode 24 - ECG Timing and Post-Cardiac Arrest Cath Findings

   Electrocardiography (ECG) represents a central diagnostic tool in the post-arrest evaluation of patients resuscitated from out-of-hospital cardiac arrest (OHCA), and it should be acquired immediately after achievement of ROSC to identify the need for an urgent coronary angiography, which is indicated only in the case of ST-segment elevation myocardial infarction (STEMI). While resuscitation guidelines are clear in the recommendation and importance of obtaining an ECG during the post-ROSC phase, they don’t provide specific instructions about the best time for ECG acquisition after ROSC. In this context some have proposed that the timing of ECG post-ROSC may have an impact in the early post-ROSC phase, and that the ECG could reflect ischemia secondary to cardiac arrest more than or in addition to ischemia due to coronary artery pathology, possibly leading to overdiagnosis of STEMI. In episode 24 of the TTM Academy Podcast we review a recent study published in JAMA Network Open, by authors Enrico Baldi, Simone Savatano and colleagues, who performed a retrospective, multicenter cohort study evaluating whether the time from ROSC to ECG acquisition is associated with the percentage of false-positive ECG findings for STEMI in patients resuscitated from OHCA. Citation of the study and accompanying Editorial commentary: Baldi E, Schnaubelt S, Caputo ML, et al. Association of Timing of Electrocardiogram Acquisition After Return of Spontaneous Circulation With Coronary Angiography Findings in Patients With Out-of-Hospital Cardiac Arrest JAMA Netw Open. 2021; 4(1):e2032875-. DOI: 10.1001/jamanetworkopen.2020.32875 Kalra R, Yannopoulos D. Delaying Electrocardiography in Cardiac Arrest: A Pause for the Cause JAMA Netw Open. 2021; 4(1):e2033360-. DOI: 10.1001/jamanetworkopen.2020.33360

3. 

   12 Mar 2021

   Episode 23 - Cardiac arrest, up close and personal: A discussion with @Lglaucomflecken

   While we have focused on the science of targeted temperature management and other care strategies for critically ill survivors, it is important for us to remember that real people experience cardiac arrest and the consequences. In this unique episode, Dr. Benjamin Abella interviews Kristin Flanary, who jumped into action to provide 10 minutes of bystander CPR to her husband, Dr. Will Flanary, who has thankfully made a full recovery. You may know Kristin and Will as @lglaucomflecken and @dglaucomflecken , well-known on twitter – we are grateful that Kristin has chosen to go public with her story and support advocacy for cardiac arrest and post-arrest care. Suggested readings on bystander CPR and survivorship: Brian Anderson. The Conversation That Can Change the Course of a Cardiac Arrest. The Atlantic, 2021.   https://www.theatlantic.com/health/archive/2021/02/tcpr-telephone-cpr-can-save-lives/618145/ Riva G, et al. Survival after dispatcher-assisted cardiopulmonary resuscitation in out-of-hospital cardiac arrest.  Resuscitation, 2020 Dec;157:195-201. doi: 10.1016/j.resuscitation.2020.08.125.  https://pubmed.ncbi.nlm.nih.gov/32918983/ Sawyer et al, Sudden Cardiac Arrest Survivorship: A Scientific Statement From the American Heart Association. Circulation. 2020 Mar 24;141(12):e654-e685. https://pubmed.ncbi.nlm.nih.gov/32078390/

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Apple Podcasts (US)

5.0 / 5

44 ratings

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