Lars Lundell's guest appearances

Lars Lundell

Neuro Resus

Jellybean Podcast with Doug Lynch

Paul Young

Sarah Yong

Roger Harris

Claire Kerr

Michael Parr

Jon Gatward

Chris Hicks

David Anderson

Chris Nickson

Derek Angus

Sarah Webb

Michael O'Leary

Mark Wilson

Dan Davis

Michael Stanley

OwlTail

 Hepatic resections are complex surgical procedures harboring a significant risk for complications. In line with the continued development of liver surgery, hepatic resections tend to be more complex and extensive, with to this associated enhanced risk for post-hepatectomy liver failure (PHLF). Despite these improvements in outcome after major liver resection, PHLF remains one of the most serious and fatal complication of major liver resection occurring in up to 8 % of the cases. Multiple factors increase the risk of PHLF but in clinical practice the risk of PHLF is closely associated with the assessment of the pre-operative Future Liver Remnant (FLR). Accordingly the prevention of PHLF is alleged to be affected by the induction of hypertrophy of the liver remnant via portal vein embolization or ligation if the expected functional left remnant in cases where the FLR is judged too small. An alternative therapeutic strategy is to perform a two-stage procedure allowing the FLR to grow after the first non-curative resection. Irrespective of these surgical-technical advancements, early recognition and initiation of supportive care is crucial to improve patient outcomes in PHLF. Despite its fatal consequences, the complexity behind the pathogenesis of PHLF remains poorly understood and treatment options (except for preventive measures) are limited. The advent of extra corporeal, albumin-based liver-dialysis system (Molecular Adsorbent Recirculating System, MARS) seemed to offer a treatment modality for patients with liver failure being either acute or acute on chronic (ACLF). The information on the use of MARS in PHLF is meager and basically no experiences have been reported with the use of well-defined criteria for liver failure. For instance Van de Kerkhove et al. reported on five patients treated with MARS due to unspecified PHLF, of whom 3 improved but only one survived. We have recently compiled our experience with MARS treatment for well-defined PHLF and found that four out of 13 patients survived (31%) three months postoperatively. However, this survival figure rose to 44% (4/9) if the analysis was confined to patients with primary PHLF fulfilling the Balzan criteria alone. These results formed the basis of a prospective clinical trial with the objective of evaluating early and consistent MARS treatment in patients with primary PHLF. Results from this study will be presented and discussed References Balzan S, Belghiti J, Farges O, Ogata S, Sauvanet A, Delefosse D, et al. The "50-50 criteria" on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy. Annals of surgery. 2005;242(6):824-8 Stange J, Mitzner S, Ramlow W, Gliesche T, Hickstein H, Schmidt R. A new procedure for the removal of protein bound drugs and toxins. Asaio J. 1993;39(3):M621-5. Gilg S, Escorsell A, Fernandez J, Garcia-Valdecasas JC, Saraste L, Wahlin S Nowak G, Stromberg C, Lundell L, Isaksson B. Albumin dialysis with MARS in post-hepatectomy liver failure (PHLF): experiences from two HPB centers. Surgery Current Research, 2015, 6: 252.

Hepatic resections are complex surgical procedures harboring a significant risk for complications. In line with the continued development of liver surgery, hepatic resections tend to be more complex and extensive, with to this associated enhanced risk for post-hepatectomy liver failure (PHLF). Despite these improvements in outcome after major liver resection, PHLF remains one of the most serious and fatal complication of major liver resection occurring in up to 8 % of the cases. Multiple factors increase the risk of PHLF but in clinical practice the risk of PHLF is closely associated with the assessment of the pre-operative Future Liver Remnant (FLR). Accordingly the prevention of PHLF is alleged to be affected by the induction of hypertrophy of the liver remnant via portal vein embolization or ligation if the expected functional left remnant in cases where the FLR is judged too small. An alternative therapeutic strategy is to perform a two-stage procedure allowing the FLR to grow after the first non-curative resection. Irrespective of these surgical-technical advancements, early recognition and initiation of supportive care is crucial to improve patient outcomes in PHLF. Despite its fatal consequences, the complexity behind the pathogenesis of PHLF remains poorly understood and treatment options (except for preventive measures) are limited. The advent of extra corporeal, albumin-based liver-dialysis system (Molecular Adsorbent Recirculating System, MARS) seemed to offer a treatment modality for patients with liver failure being either acute or acute on chronic (ACLF). The information on the use of MARS in PHLF is meager and basically no experiences have been reported with the use of well-defined criteria for liver failure. For instance Van de Kerkhove et al. reported on five patients treated with MARS due to unspecified PHLF, of whom 3 improved but only one survived. We have recently compiled our experience with MARS treatment for well-defined PHLF and found that four out of 13 patients survived (31%) three months postoperatively. However, this survival figure rose to 44% (4/9) if the analysis was confined to patients with primary PHLF fulfilling the Balzan criteria alone. These results formed the basis of a prospective clinical trial with the objective of evaluating early and consistent MARS treatment in patients with primary PHLF. Results from this study will be presented and discussed References Balzan S, Belghiti J, Farges O, Ogata S, Sauvanet A, Delefosse D, et al. The "50-50 criteria" on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy. Annals of surgery. 2005;242(6):824-8 Stange J, Mitzner S, Ramlow W, Gliesche T, Hickstein H, Schmidt R. A new procedure for the removal of protein bound drugs and toxins. Asaio J. 1993;39(3):M621-5. Gilg S, Escorsell A, Fernandez J, Garcia-Valdecasas JC, Saraste L, Wahlin S Nowak G, Stromberg C, Lundell L, Isaksson B. Albumin dialysis with MARS in post-hepatectomy liver failure (PHLF): experiences from two HPB centers. Surgery Current Research, 2015, 6: 252.

Is there a life in MARS after hepatectomy? by Professor Lars Lundell

Doug Lynch

Professor Lars Lundell. Professor of Surgery Karolinska University Hospital Stockholm. What this man doesn’t know about the oesophagus is probably not worth knowing. What he knows about so many other things is worth knowing. Professor Lundell's visit to Australia will not soon be forgotten. His distinct style and his willingness to grasp controversial issues made his multiple lectures at the ASM memorable. From his first talk about critical care aspects of GI surgery to his last asking “Is obesity a surgical disease?” Lars repeatedly surprised the audience. During this recording he again surprises with his commentary upon obesity, bariatric surgery and its future. The talk turns to the real public health problem we have to face and thus to global politics. Lars’ talks are worth seeking out via the CICM website. Indeed Lars had so much interesting stuff to say that this podcast, at 30 minutes, is twice the usual length. Sit back and listen.   Each year the CICM holds its Annual Scientific Meeting. The Meeting has always been focused upon a single issue or organ system. This year the theme was Gastroenterology entitled “A Gut Reaction; ICU Gastroenterology from beginning to end.”   The lectures presented at the meeting have been recorded and will all be shared among the delegates and some will also be shared with all comers via the Intensive Care Network (www.IntensiveCareNetwork.com), the celebrated “#FOAMed” website. (Free Open Access Medical Education.)   The organisers of the ASM invited #FOAMed podcaster/interviewer Dr Doug Lynch to come along to engage some of the leading lights of the meeting in conversation and record them. These recordings are the latest in a series of podcasts/blogcasts playfully called “Jellybeans”. They are entirely spontaneous chats with interesting people; short, completely unscripted, 100% unedited and recorded in one take. It is essentially an uninterrupted live recording. The focus is unapologetically on the quality of the conversation rather than the quality of the audio recording.   The host of the interview is a fast talking Irish doctor, a jack of all trades but a master of none, a perpetual student and a trainee of the CICM. The “Jellybean” is an itinerant podcast that regularly appears on www.LifeinTheFastLane.com, www.IntensiveCareNetwork.com and many other websites. Over 100 conversations have been recorded with persons of interest. They are on iTunes and Stitcher Radio.   The CICM ASM Jellybean series each start with a biographical component and then the conversation follows its own path. The subject matter is usually that which dwells upon the fringes of intensive care medicine; human factors, education, ethics, equality, gender, personal histories, possible futures and all the other challenges that we so often face. Being so they compliment the lectures but do not attempt to repeat them.    We hope you enjoy finding out a little more about the people behind the CICM Annual Scientific Meeting. The four CICM x Jellybean co-branded recordings are part of a larger collection. It is only these four that are formally associated with the College. Doug Lynch is not a representative of the college and any views expressed are his own.

Professor Lars Lundell. Professor of Surgery Karolinska University Hospital Stockholm. What this man doesn’t know about the oesophagus is probably not worth knowing. What he knows about so many other things is worth knowing. Professor Lundell's visit to Australia will not soon be forgotten. His distinct style and his willingness to grasp controversial issues made his multiple lectures at the ASM memorable. From his first talk about critical care aspects of GI surgery to his last asking “Is obesity a surgical disease?” Lars repeatedly surprised the audience. During this recording he again surprises with his commentary upon obesity, bariatric surgery and its future. The talk turns to the real public health problem we have to face and thus to global politics. Lars’ talks are worth seeking out via the CICM website. Indeed Lars had so much interesting stuff to say that this podcast, at 30 minutes, is twice the usual length. Sit back and listen.   Each year the CICM holds its Annual Scientific Meeting. The Meeting has always been focused upon a single issue or organ system. This year the theme was Gastroenterology entitled “A Gut Reaction; ICU Gastroenterology from beginning to end.”   The lectures presented at the meeting have been recorded and will all be shared among the delegates and some will also be shared with all comers via the Intensive Care Network (<a href="http://www.intensivecarenetwork.com/" rel="noopener nofollow" target="_blank">www.IntensiveCareNetwork.com</a>), the celebrated “#FOAMed” website. (Free Open Access Medical Education.)   The organisers of the ASM invited #FOAMed podcaster/interviewer Dr Doug Lynch to come along to engage some of the leading lights of the meeting in conversation and record them. These recordings are the latest in a series of podcasts/blogcasts playfully called “Jellybeans”. They are entirely spontaneous chats with interesting people; short, completely unscripted, 100% unedited and recorded in one take. It is essentially an uninterrupted live recording. The focus is unapologetically on the quality of the conversation rather than the quality of the audio recording.   The host of the interview is a fast talking Irish doctor, a jack of all trades but a master of none, a perpetual student and a trainee of the CICM. The “Jellybean” is an itinerant podcast that regularly appears on <a href="http://www.lifeinthefastlane.com/" rel="noopener nofollow" target="_blank">www.LifeinTheFastLane.com</a>, <a href="http://www.intensivecarenetwork.com/" rel="noopener nofollow" target="_blank">www.IntensiveCareNetwork.com</a> and many other websites. Over 100 conversations have been recorded with persons of interest. They are on iTunes and Stitcher Radio.   The CICM ASM Jellybean series each start with a biographical component and then the conversation follows its own path. The subject matter is usually that which dwells upon the fringes of intensive care medicine; human factors, education, ethics, equality, gender, personal histories, possible futures and all the other challenges that we so often face. Being so they compliment the lectures but do not attempt to repeat them.    We hope you enjoy finding out a little more about the people behind the CICM Annual Scientific Meeting. The four CICM x Jellybean co-branded recordings are part of a larger collection. It is only these four that are formally associated with the College. Doug Lynch is not a representative of the college and any views expressed are his own.

Prof Lars Lundell talks to Doug Lynch. CICM x Jellybean No. 4 (Jellybean 74)

Professor Lars LundellCollege of Intensive Care Medicine x Jellybean Number 4 in a special series of 4 Co-Branded PodcastsProfessor Lars Lundell. Professor of Surgery Karolinska University Hospital Stockholm. What this man doesn’t know about the oesophagus is probably not worth knowing. What he knows about so many other things is worth knowing. Professor Lundell's visit to Australia will not soon be forgotten. His distinct style and his willingness to grasp controversial issues made his multiple lectures at the ASM memorable. From his first talk about critical care aspects of GI surgery to his last asking “Is obesity a surgical disease?” Lars repeatedly surprised the audience. During this recording he again surprises with his commentary upon obesity, bariatric surgery and its future. The talk turns to the real public health problem we have to face and thus to global politics. Lars’ talks are worth seeking out via the CICM website. Indeed Lars had so much interesting stuff to say that this podcast, at 30 minutes, is twice the usual length. Sit back and listen.Each year the CICM holds its Annual Scientific Meeting. The Meeting has always been focused upon a single issue or organ system. This year the theme was Gastroenterology entitled “A Gut Reaction; ICU Gastroenterology from beginning to end.”The lectures presented at the meeting have been recorded and will all be shared among the delegates and some will also be shared with all comers via the Intensive Care Network (www.IntensiveCareNetwork.com), the celebrated “#FOAMed” website. (Free Open Access Medical Education.)The organisers of the ASM invited #FOAMed podcaster/interviewer Dr Doug Lynch to come along to engage some of the leading lights of the meeting in conversation and record them. These recordings are the latest in a series of podcasts/blogcasts playfully called “Jellybeans”. They are entirely spontaneous chats with interesting people; short, completely unscripted, 100% unedited and recorded in one take. It is essentially an uninterrupted live recording. The focus is unapologetically on the quality of the conversation rather than the quality of the audio recording.The host of the interview is a fast talking Irish doctor, a jack of all trades but a master of none, a perpetual student and a trainee of the CICM. The “Jellybean” is an itinerant podcast that regularly appears on www.LifeinTheFastLane.com, www.IntensiveCareNetwork.com and many other websites. Over 100 conversations have been recorded with persons of interest. They will appear on iTunes and Google play once the 100th episode is published later this year.The CICM ASM Jellybean series each start with a biographical component and then the conversation follows its own path. The subject matter is usually that which dwells upon the fringes of intensive care medicine; human factors, education, ethics, equality, gender, personal histories, possible futures and all the other challenges that we so often face. Being so they compliment the lectures but do not attempt to repeat them. We hope you enjoy finding out a little more about the people behind the CICM Annual Scientific Meeting. The four CICM x Jellybean co-branded recordings are part of a larger collection. It is only these four that are formally associated with the College. Doug Lynch is not a representative of the college and any views expressed are his own.

Professor Lars Lundell College of Intensive Care Medicine x Jellybean Number 4 in a special series of 4 Co-Branded Podcasts Professor Lars Lundell. Professor of Surgery Karolinska University Hospital Stockholm. What this man doesn’t know about the oesophagus is probably not worth knowing. What he knows about so many other things is worth knowing. Professor Lundell's visit to Australia will not soon be forgotten. His distinct style and his willingness to grasp controversial issues made his multiple lectures at the ASM memorable. From his first talk about critical care aspects of GI surgery to his last asking “Is obesity a surgical disease?” Lars repeatedly surprised the audience. During this recording he again surprises with his commentary upon obesity, bariatric surgery and its future. The talk turns to the real public health problem we have to face and thus to global politics. Lars’ talks are worth seeking out via the CICM website. Indeed Lars had so much interesting stuff to say that this podcast, at 30 minutes, is twice the usual length. Sit back and listen. Each year the CICM holds its Annual Scientific Meeting. The Meeting has always been focused upon a single issue or organ system. This year the theme was Gastroenterology entitled “A Gut Reaction; ICU Gastroenterology from beginning to end.” The lectures presented at the meeting have been recorded and will all be shared among the delegates and some will also be shared with all comers via the Intensive Care Network (<a href="http://www.IntensiveCareNetwork.com" rel="nofollow" target="_blank">www.IntensiveCareNetwork.com</a>), the celebrated “#FOAMed” website. (Free Open Access Medical Education.) The organisers of the ASM invited #FOAMed podcaster/interviewer Dr Doug Lynch to come along to engage some of the leading lights of the meeting in conversation and record them. These recordings are the latest in a series of podcasts/blogcasts playfully called “Jellybeans”. They are entirely spontaneous chats with interesting people; short, completely unscripted, 100% unedited and recorded in one take. It is essentially an uninterrupted live recording. The focus is unapologetically on the quality of the conversation rather than the quality of the audio recording. The host of the interview is a fast talking Irish doctor, a jack of all trades but a master of none, a perpetual student and a trainee of the CICM. The “Jellybean” is an itinerant podcast that regularly appears on <a href="http://www.LifeinTheFastLane.com" rel="nofollow" target="_blank">www.LifeinTheFastLane.com</a>, <a href="http://www.IntensiveCareNetwork.com" rel="nofollow" target="_blank">www.IntensiveCareNetwork.com</a> and many other websites. Over 100 conversations have been recorded with persons of interest. They will appear on iTunes and Google play once the 100th episode is published later this year. The CICM ASM Jellybean series each start with a biographical component and then the conversation follows its own path. The subject matter is usually that which dwells upon the fringes of intensive care medicine; human factors, education, ethics, equality, gender, personal histories, possible futures and all the other challenges that we so often face. Being so they compliment the lectures but do not attempt to repeat them. We hope you enjoy finding out a little more about the people behind the CICM Annual Scientific Meeting. The four CICM x Jellybean co-branded recordings are part of a larger collection. It is only these four that are formally associated with the College. Doug Lynch is not a representative of the college and any views expressed are his own.

Jellybean 74 with Prof Lars Lundell (CICMxJellybean 4)