Shows
TopMedTalkTopMedTalks to Manu Malbrain; the patient experienceThis piece follows on from the previous interview with Manu Malbrian, but works as a standalone podcast. It is presented from the annual conference of the Society of Critical Care Medicine (SCCM), the largest non-profit medical organization dedicated to promoting excellence and consistency in the practice of critical care. Here our guest very kindly shares his personal experience of critical care, before the conversation moves into the patient experience in general. Presented by Desiree Chappell and Monty Mythen with their guest Manu Malbrain, CMO of Medaman, an initiative that seeks to optimize the use of...
2025-05-1917 min
IFA TalksIFA Talks meet TopMedTalk with Tim Miller | Fluid Matters - The nil by mouth (NPO) debate Fluid Matters - The nil by mouth (NPO) debate | TopMedTalk Nov 28, 2018 This piece is taken from "The Great Fluid Debate", it's about changes in practice that have been implemented both in the UK and at various medical centres in the US. Hear how and why the old 'nil by mouth' or ‘NPO’ policy has changed in many instances. From water to carbohydrate drinks, to black coffee, the thinking has changed in many institutions but part of the battle is in educating patients and their well meaning friends and relatives. These...
2025-04-1212 minIFA TalksIFA Talks meet TopMedTalk with Mike Grocott | 'The Great American Fluid Debate'Fluid Matters - 'The Great American Fluid Debate' | TopMedTalks Nov 27, 2018 This is an excerpt from 'The Great American Fluid Debate' which was hosted at Duke University Medical Centre's "Controversies in Perioperative Medicine" conference of this year. These pieces have been released to coincide with IFAD, the 7th International Fluid Academy Day. Make sure you subscribe to TopMedTalk to ensure you hear some of the pieces we recorded there. The two pieces Monty mentions in the podcast, featuring Paul Myles, are found here: "THE RESULTS" https://ww...
2025-04-1231 minIFA TalksIFA Talks meet TopMedTalk with Manu Malbrain & Tom Woodcock | Fluid Matters - Total body water and electrolytes | POQI Fluid Matters - Total body water and electrolytes | POQI Nov 24, 2018 These pieces have been released to coincide with IFAD, the 7th International Fluid Academy Day. Make sure you subscribe to TopMedTalk to ensure you hear some of the pieces we recorded there. Coming from this summer's Peroperative Quality Initiative (POQI) hosted at Washington Duke University in Durham this podcast is presented by Monty Mythen and Henry Howe with their guests Tom Woodcock, an independent consultant in patient safety, medical law and ethics, and Manu Malbrain, Professor at Faculty of Medicine and Pha...
2025-04-1239 minIFA TalksIFA Talks meet TopMedTalk with Tim Miller | Fluid Matters - Definite definitions, fluid physiology | POQIFluid Matters - Definite definitions, fluid physiology | POQI Nov 23, 2018 This conversation was recorded on the morning of the second day of the Perioperative Quality Initiative (POQI) meeting hosted at Washington Duke University in Durham. These pieces have been released to coincide with IFAD, the 7th International Fluid Academy Day. Make sure you subscribe to TopMedTalk to ensure you hear some of the pieces we recorded there. Presented by Desiree Chappell with Professor Monty Mythen, Henry Howe and their guest Tim Miller, anaesthsiologist from Duke University Medical Centre and organiser of t...
2025-04-1238 minIFA TalksIFA Talks meet TopMedTalk 4The growing popularity of new media in medical education | IFAD Nov 23, 2018 This piece is a chance to reflect upon the importance of new media within the sphere of medical education. As the run away success of TopMedTalk and other podcasts in this area shows people are hungry to use the unique potential of this medium. Also - how has social media, video casting and live streaming altered the way conferences are both organised, executed and received? Finally, our team of experts tackle the eternal question; where to next? Presented by...
2025-04-1215 minIFA TalksIFA Talks meet TopMedTalk 3Discussing The Paradigm Shift in Fluid Therapy | IFAD Nov 23, 2018 This podcast is an exclusive discussion regarding the second session at The International Fluid Academy Day (IFAD) in Amsterdam. This in depth discussion is a reaction to the session at IFAD and contains insights into the following topics; 'Everything you need to know about fluid therapy', results from some of the most recent trials and 'How to set-up a fluid guideline'. The team also reflect a little more on the first session. Presented by Joff Lacey with Monty Mythen and H...
2025-04-1218 minIFA TalksIFA Talks meet TopMedTalk 2TopMedTalk at IFAD | Understanding Fluid Physiology Download this podcast for an exclusive discussion regarding the first session at The International Fluid Academy Day (IFAD) on Friday morning in Amsterdam. This in depth discussion is a reaction to the first session at IFAD and contains insights into the following topics; 'Everything you need to know about fluid physiology'; 'From Frank-Starling to Guyton-Hall'; 'Understanding edema formation' and 'Where does the albumin go?'. Presented by Joff Lacey with Monty Mythen and Henry Howe. -- Streamed live from the International Fluid Academy...
2025-04-1218 minIFA TalksIFA Talks meet TopMedTalk with Manu Malbrain IFAD2018 Have you joined the International Fluid Academy yet? Nov 23, 2018 Live from the International Fluid Academy Day (IFAD) in Amsterdam; the team explain how you can join in for free online https://www.fluidacademy.org/ and give us a bit of the history of the conference along with some of the discussion points you can expect to hear. Presented by Joff Lacey with Henry Howe, Monty Mythen and their guest Manu Malbrain, Professor at the Faculty of Medicine and Pharmacology Vrije University in Brussels and organiser of the conference.
2025-04-1208 minIFA TalksIFA Talks to SoMe Team 2 IFAD2018 Participants and Setting Jonny – Host/moderator, introducing the social media team at the International Fluid Academy (IFA) 2018 in Amsterdam. David – Social Media Chair for the conference. Catherine (Beni) – A new social media team member from Seattle, USA. Cian – Returning social media team member, participated in the previous year’s IFA event. They discuss their roles within the conference’s social media coverage, including how they prepare content (infographics, posts, and video segments), their personal journeys in social media, and the various platforms they use. Main Discussion Points 1. Newcomers to the Social Media...
2025-04-1218 minIFA TalksIFA Talks to SoMe Team IFAD2018Participants and Setting Speakers: Dr. Catherine (“Beni”) – A surgical resident posing detailed questions about fluid management. Dr. Johnny Wilkinson – An intensivist and physiology enthusiast, referencing research trials and discussing fluid strategies. Additional Colleagues (unnamed) – Intensivists, surgeons, or critical care professionals joining the discussion. They are at the International Fluid Academy 2018 in Amsterdam, where they discuss advanced fluid-management topics and reflect on conference sessions. Main Discussion Topics 1. The “Three-Day” Ebb and Flow Rule for Capillary Leak Traditional Teaching: Clinicians often cite a three-day period during which capillary permeability peaks (capillary leak), followe...
2025-04-1214 minIFA TalksIFA Talks to John Downham IFAD2018Context and Setting John Downham is hosting a live webcast or social media feed from the International Fluid Academy 2018 conference. They are updating virtual attendees about streaming quality, ongoing conference events, and future content plans. Main Discussion Points Technical Setup and Streaming Quality The speaker acknowledges that the video is “choppy” and they are adjusting recording settings on the fly to improve the streaming experience. They invite feedback from viewers via Facebook, Twitter, or Periscope regarding any ongoing technical issues. Conference Updates and Agenda The conference is currently on a coffee brea...
2025-04-1201 minIFA TalksIFA Talks to John Mackenney IFAD2018Participants and Setting Host/Interviewer (introduced as David Lyness, Social Media Chair) Guest (introduced as Dr. John Mackenney) – An intensivist and self-described “physiology geek” They are at an event called “five 2018” (likely another fluid-focused conference or session in 2018), discussing topics such as physiology, fluid management, and research trials. The exchange also references prior sessions on these subjects. Main Discussion Themes 1. Previewing “the Next Session” and Conference Updates The transcript begins with a brief question: “What’s the next session on?” The answer mentions “things... basically like in the meantime… updates”—suggesting that multiple sessions are c...
2025-04-1208 minIFA TalksIFA Talks to Manu Malbrain IFAD2018Participants Dr. Catherine Benny – Surgery resident at the University of Washington in Seattle (USA). Dr. Johnny Wilkinson – Intensivist from Northampton, UK, and founder of Critical Care Northampton. Dr. Manu Malbrain – Intensivist from Brussels, Belgium, and founder of International Fluid Academy Days. They are at the 2018 International Fluid Academy Day in Amsterdam, discussing challenging topics in fluid management and perioperative care. Main Discussion Points 1. Interpreting Declining Hemoglobin Values Context After major surgery (or in an ICU setting), clinicians often track hemoglobin or hematocrit levels to detect potential bleeding. However, a drop in hemogl...
2025-04-1204 minIFA TalksIFA Talks to Xavier Monnet IFAD2017🎤 Live from IFAD 2017 – A Conversation with Dr. Xavier Monnet We caught up with Dr. Xavier Monnet, who delivered a compelling session today on fluid challenges in critically ill patients. 🗣️ Xavier, what was the key message of your talk? *“I spoke about the importance of testing for preload responsiveness—especially in complex patients like those with sepsis. Before administering fluids, we need to assess whether they will actually be effective. The traditional fluid challenge has a major flaw—it inherently induces fluid overload. So instead of fluid challenges, we should be performing preload challeng...
2025-04-1201 minIFA TalksIFA Talks to Tom Woodcock IFAD2017🎤 Live from IFAD 2017 – Talking Fluid Physiology with Dr. Tom Woodcock Hi again! We’re still going strong at IFAD, and I’m here with Dr. Tom Woodcock, who’s been diving deep into fluid dynamics and stirring some healthy debate. 🗣️ Tom, what did you talk about this morning? “I introduced the audience to the Steady-State Starling Principle, a new way of thinking about fluid therapy—especially why fluids sometimes don’t behave the way we expect them to. It’s a shift from traditional textbook physiology to something more consistent with what we actually see in practice...
2025-04-1201 minIFA TalksIFA Talks to Tamas Szakmany IFAD2017🎤 Live from IFAD 2017 – ECMO Insights with Tamas We caught up with Tamas, who made quite the journey to get here—from Wales, by motorbike, no less! 🏍️ “It was about 400 miles, but luckily it stayed dry the whole way,” he said with a smile. So what’s been the highlight so far? 🩺 “I attended the Beginners ECMO Course this morning. It’s designed for people either starting an ECMO service or wanting to understand the basics. I’ve referred many patients for ECMO in the past, so I wanted to better understand what actually happens on th...
2025-04-1202 minIFA TalksIFA Talks to Ruth Kleinpell IFAD2017🎤 Live from IFAD 2017 – Interview with Dr. Ruth Kleinpell, President of the Society of Critical Care Medicine (SCCM) We had the pleasure of catching up with Dr. Ruth Kleinpell, who just delivered a talk at IFAD 2017 on a topic that resonates across ICUs worldwide: appropriate lab testing in critical care. 🧪 Ruth, what was the focus of your presentation? “My talk was centered on the need to rethink routine practices in the ICU—particularly daily lab testing and daily chest X-rays, which are often ordered out of habit rather than necessity.” Dr. Kleinpell highlighted th...
2025-04-1201 minIFA TalksIFA Talks to Ross Fisher IFAD2017🎥 Live from the International Fluid Academy Days (IFAD) 2017! Welcome to the IFAD Live Stream, where we’ll be bringing you interviews, conversations, and behind-the-scenes moments with some of the incredible faculty and delegates joining us here in Antwerp. Joining me now is the always engaging Ross Fisher, who’s speaking later today. 🗣️ Ross, what will you be talking about? Ross Fisher: “As ever, I’ll be talking about presentation skills. There’s very little I can add to the core clinical science of the International Fluid Academy—except to say that salt water is f...
2025-04-1201 minIFA TalksIFA Talks to Matt Rowland IFAD2017🎤 Still going strong at IFAD 2017! I caught up with Matt Rowland to see what he’s most excited about today. 🗣️ Matt: “I’m really looking forward to Ross Fisher’s ‘Talk Like TED’ workshop this afternoon. I think it’s going to be absolutely brilliant.” 🎤 Are you speaking today? Matt: “Nope, not this time—I’m here purely as a delegate, just soaking up all the knowledge. And honestly, it’s been fantastic to finally put Twitter handles to real-life faces!” 🧠 That’s what IFAD is all about—learning, connecting, and sharin...
2025-04-1200 minIFA TalksIFA Talks to Manu Malbrain IFAD2017🎤 Live from IFAD 2017 – Interview with Conference Organizer Prof. Manu Malbrain 🎬 "Okay, ready? Three, two, one..." Hi everyone! We’re here live at the International Fluid Academy Day 2017, and I’m joined by the conference organizer himself, Prof. Manu Malbrain. 🗣️ So Manu, what’s the key message from the conference this year? Manu: “The core message is simple but powerful: Fluids should be treated as drugs. Just like antibiotics, we must think about fluids in terms of indication, type, dose, duration, and eventually, de-escalation.” 💉 He draws a parallel with the Four D’s of antib...
2025-04-1203 minIFA TalksIFA Talks to Karim Brohi IFAD2017🎥 Live from the International Fluid Academy Day 2017 Hi everyone, I’m Shagan Onasanya, and I’m here with Karen Browey, who just delivered a brilliant and succinct summary on the management of trauma-induced hyperglycemia and massive hemorrhage. 🩸 So, Karen, let’s distill it down. Someone is exsanguinating on the floor—what’s the one-word summary of what we should do? Karim: “Stop the bleeding. That’s the first, second, third, and fourth priority. Press on the wound, apply a tourniquet, do something—get them to surgery. In the meantime, do as little as possible...
2025-04-1201 minIFA TalksIFA Talks to Jonny Wilkinson IFAD2017🎤 Live from IFAD – Catching Up with Johnny Wilkinson We’re back again at IFAD, and I’ve got Johnny Wilkinson with me—who’s been very busy this week. 🗣️ “Essentially, I’m doing a hell of a lot of podcasting. I’ve been wandering around like a bit of a roving lunatic with a microphone, catching people in the halls, at sessions, in workshops—basically anyone I can grab—to have short, sharp conversations about what’s happening here at the meeting.” Johnny and his team are on a mission to give listeners a snapshot of the full IFAD expe...
2025-04-1201 minIFA TalksIFA TAlks to Jan De Waele IFAD2017🎙️ Live from IFAD – Friday Afternoon We caught up with Dr. Jan just after his session on a crucial—yet often overlooked—topic: the dangers of de-resuscitation. 🗣️ “Yes, I spoke about de-resuscitation, or what’s also called fluid de-escalation or fluid removal. The first thing we need to do is really understand what it is—and why it's important. It typically comes at the very end of resuscitation, which might be why it doesn’t always get the attention it deserves.” While many clinicians rely on cumulative fluid balance numbers, biomarkers, and hemodynamic indices, Jan emphasizes a critical...
2025-04-1202 minIFA TalksIFA Talks to Jamie Strachan IFAD2017🎉 Good morning from IFAD! We’re really excited as the first day of the conference kicks off—and the opening plenary session is starting in just one minute! We just wanted to say a quick hello 👋 🎤 Kean, what are you most excited about today? 🗣️ “I’m really looking forward to diving into the heart of the conference—meeting all the delegates and hearing the keynote presentations. I’m especially excited for the sepsis debate and the hot topics session this afternoon. There’ll be plenty of lively back-and-forth on some of the most controversial issues we face...
2025-04-1200 minIFA TalksIFA Talks to Delegates-2 IFAD2017🎙️ Welcome back to the iFAD Live Vodcasts! It’s Friday afternoon here at IFAD, and we’re joined by Jade and Eve, two fantastic research nurses from Cardiff ICU. 🩺 So, what brought you to IFAD? Jade: “One of our colleagues was presenting a poster, and we helped collect the data for it. But more than that, we really wanted to see how research is impacting clinical care across different centers.” Eve: “Yeah—it’s a great opportunity to collaborate, to share what we’re doing, and also learn what others are working on so we can...
2025-04-1201 minIFA TalksIFA Talks to Delegates-1 IFAD2017🎤 Live from IFAD 2017 in Antwerp, Belgium! We’re joined now by two local attendees, Sim and Tom, who’ve come to the conference from nearby. 👋 “We’re from Brussels,” they tell us. “I work in Bruges,” says Sim, “and Tom works at the University Hospital in Brussels.” 🗣️ So why did they come to IFAD? “We know about the conference because our new Head of the Intensive Care Department is Professor Malbrain,” Tom explains. “He invited us, and even though I’m a trainee in internal medicine and Sim’s more in nuclear medicine, it’s a great opportun...
2025-04-1202 minIFA TalksIFA Talks to David Lyness IFAD2017🎥 Live from IFAD! I’m here with the ever-energetic David Lyness from Propofology.com and @gas_craic on Twitter. So, David—what are you up to at IFAD? 🗣️ “I’m herding cattle and cats—basically trying to rally the social media troops! I’m helping to run the social media campaign, getting content online, pushing Twitter hard, and broadcasting as much of the conference to the #FOAMed community as humanly possible. Also, I’m being very militant about hashtags.” We appreciate the dedication! And just to be clear—what’s the official hashtag? 🟦 #IFAD2017 – for anyone...
2025-04-1201 minIFA TalksIFA Talks to Cian McDermott IFAD2017🎬 Lunchtime update from IFAD! We’ve just wrapped up a fantastic morning of the Critical and Acute Care Ultrasound (CACU) course, and it's been really popular! I'm here in my classic white IFAD t-shirt, soaking up the atmosphere—and now, we’re bringing you some top ultrasound tips straight from our amazing faculty. 🎉 🎤 Cian: “When I teach ultrasound, I always wear jeans—and here’s why. On your right-hand side, there's that little jeans pocket. If you're struggling with rib shadows, line up your probe and twist it like you’re sliding it into that pocket. Works every tim...
2025-04-1202 minIFA TalksIFA Talks to Brendan Riordan IFAD2017🎙️ Hello from the Fluid Academy! We're back again—and this time, I'm joined by Brendan Riardan, who might just be the furthest-traveled member of our faculty. Brendan, where have you come from? 🗺️ “I’ve come from Seattle in the US—but I did spend a bit of time traveling through the Netherlands before arriving here, so technically I’ve only just come from The Hague by train!” So maybe not quite in the last 24 hours—but still impressive! 🚨 Don’t forget—we’ve got an exciting Social Media Workshop happening this afternoon! 📍 Hope Room...
2025-04-1201 minIFA Talks6th IFAD 2017 - 036 - ZSOLT MOLNARWhen you walk into an ICU, you often see patients who look very much alike. Regardless of the original insult—be it trauma, infection, or another trigger—they’re all receiving mechanical ventilation, hemodynamic support, renal replacement therapy, artificial feeding, and more. That’s because any localized insult can trigger a systemic host response—transforming a regional issue into a body-wide disease. I had the opportunity to give two lectures at this congress. One focused on cytokine removal in septic shock patients, and the other addressed fluid therapy—specifically, crystalloids versus colloids—and their impact on hemodynamics. Let me...
2025-04-1102 minIFA Talks6th IFAD 2017 - 035 - BERNARD VAN DEN BERGOne of the more technical yet fascinating aspects I discussed was freeze substitution, a technique performed at -90°C, where water remains mobile, but larger molecules are immobilized. During this process, we introduce acridine orange and uranyl acetate, which results in a "fluffy" structural visualization—a revealing view into the delicate architecture we’re studying. What I want the audience to understand is the crucial role of the glycocalyx—not just as an isolated structure, but as a dynamic, functional layer of the cell surface. It plays a vital role in cell behavior, communication, and vascular integrity, and its...
2025-04-1101 minIFA Talks6th IFAD 2017 - 034 - DELEGATE INTERVIEWIn extracorporeal support systems like ECMO, understanding pressure dynamics is key. For example, internal pressure refers to the pressure after the pump head but before the oxygenator. By comparing this with the arterial pressure, we calculate the pressure gradient (delta P) across the oxygenator—a critical metric for assessing oxygenator function and circuit performance. Our mission today is to bring clinicians closer to advanced therapies like ECMO, including not only how to initiate them but also how to monitor the system and the patient holistically. ECMO remains a complex and high-risk therapy, and our goal is to de...
2025-04-1101 minIFA Talks6th IFAD 2017 - 033 - CHRISTIAAN BOERMAOver the years, the trend in fluid therapy has been clear: we're using fluids less and less. But if we project that trend too far into the future, we might imagine a time when we stop using fluids altogether—and I simply don’t see that happening. There has to be a balance point—a place where we can appreciate both the benefits and the risks of fluids, and use them wisely. That’s the real challenge: finding that middle ground. The importance of this conference is considerable, because many doctors are still confused about fluid th...
2025-04-1101 minIFA Talks6th IFAD 2017 - 032 - MATTHEW MORGANThis is the environment I feel most comfortable in. Put me in a general practice setting—sitting in a quiet room with a patient—and I get nervous. My hands sweat, my heart races. But in the complex, high-stakes environment of intensive care, I feel completely at home. I am Matthew Morgan and I just delivered a talk that partially explored the history of intensive care medicine, which dates back to the 1953 polio epidemic in Copenhagen. From those early days, I traced how the specialty has evolved over the decades, and how far we’ve come in our...
2025-04-1101 minIFA Talks6th IFAD 2017 - 031 - NIELS VAN REGENMORTELThe sodium conundrum. A conundrum is a riddle, a brain teaser, an enigma. So perhaps a better title for my talk would be: "The Riddle of Salts." I am Niels Van Regenmortel from Antwerp in Belgium and what I’m most passionate about in fluid management today is this: We should be doing much more to avoid excessive sodium administration in hospitalized patients. Why? Because sodium—not just fluid—is a major contributor to fluid overload in our patients. This issue goes beyond the volume of fluids we give—it's also about the sodium c...
2025-04-1101 minIFA Talks6th IFAD 2017 - 030 - MIKE SMETI am Mike Smet from Antwerp in Belgium. When I’m teaching echocardiography, I always remind my students that there are really just three basic probe movements: You either rotate the probe, Slide the probe along the body, Or tilt it to change your angle of view. These simple techniques form the foundation of ultrasound scanning—and once understood, they empower clinicians to begin exploring visual medicine. This is a beginner’s course, designed to spark interest in both basic and more advanced ultrasound applications. Point-of-care ultrasound is truly a revol...
2025-04-1101 minIFA Talks6th IFAD 2017 - 029 - MARTIN BALIKAtrial fibrillation (AF) is likely the most frequent supraventricular arrhythmia encountered in clinical practice—and in the ICU, it’s also a leading cause of diastolic heart failure. I am Martin Balik from Czech republic and in my lecture, I focused on the potential role of short-acting beta-blockers, particularly landiolol and esmolol, in the management of atrial fibrillation in critically ill patients. These agents offer unique advantages due to their short half-lives and rapid titratability, making them ideal for the dynamic environment of the ICU. In this setting, it’s crucial to optimize preload, taper catech...
2025-04-1101 minIFA Talks6th IFAD 2017 - 028 - HILDE DE GEUSWhat is the effect of renal replacement therapy (RRT) modality on renal recovery in critically ill patients? I am Hilde De Geus from The Netherlands and that was the focus of my lecture—looking specifically at whether the choice between hemofiltration and dialysis impacts renal outcomes. There’s a common myth in intensive care that hemofiltration is somehow superior for renal recovery. However, the literature I presented clearly shows that there is no significant difference between hemofiltration and hemodialysis in terms of their impact on renal recovery. While convective therapies like hemofiltration may provide more...
2025-04-1101 minIFA Talks6th IFAD 2017 - 027 - XAVIER MONNETWhy are we still giving fluids to test fluid responsiveness? Today, we have methods to predict fluid responsiveness without administering a single drop of fluid. I’m referring, of course, to the passive leg raising (PLR) test, which functions as a reversible fluid challenge. I am Xavier Monnet from Paris in France and in my lecture today, I focused on the concept of fluid challenges—or more precisely, preload challenges. What we really need is not a fluid challenge that risks overloading the patient, but rather a safe and reversible preload test to determine wheth...
2025-04-1102 minIFA Talks6th IFAD 2017 - 026 - JAN POELAERTI am Jan Poelaert from Brussels, Belgium and it’s undeniably difficult to distinguish between lung tissue and thrombus on ultrasound, especially in certain patient populations. During the CACU (Critical and Acute Care Ultrasound) workshops, I spoke about some of these challenges, particularly in our newer patient populations, such as those with obesity, where cardiovascular structures are harder to visualize. This issue becomes even more pronounced in cervical patients, where access and image quality can be significantly compromised. One of the most critical parameters to assess in ICU and perioperative care is left ventricular (LV) function. It pl...
2025-04-1101 minIFA Talks6th IFAD 2017 - 025 - ROBERT WISEI am Rob Wise and in South Africa, we normally maintain a supply of about two to three days' worth of emergency blood. But recently, we were down to just 0.7 days. That’s not a warning sign—it’s a national crisis. A severe shortage of blood products is placing enormous strain on healthcare services. My lecture focused on the use of fluids in resource-limited countries. One of the most important messages I wanted to convey is that the developing world faces challenges that many in high-income countries simply do not encounter. The reality on the ground can be...
2025-04-1101 minIFA Talks6th IFAD 2017 - 024 - ROBERT HAHNOne of the key advantages of colloid fluids in the operating room is their ability to provide a pronounced and stable plasma volume expansion. Unlike crystalloids—where most of the fluid tends to disappear from the vascular space within 30 minutes—colloids remain longer, offering more sustained intravascular support. I am Robert Hahn from Sweden and I’ve had a long-standing interest in fluid therapy, and at this meeting, I’m giving a lecture on the kinetic modeling of fluids—a powerful tool that helps us understand how different types of fluids behave in the body, and how we can use...
2025-04-1100 minIFA Talks6th IFAD 2017 - 023 - YAZINE MAHJOUBWe need technology to help us—not necessarily to work harder, but to work smarter. I am Yazine Mahjoub from France. Yesterday, I had the opportunity to give a lecture on the right ventricle and how to evaluate right ventricular function using Doppler echocardiography. I emphasized to attendees that while this technique is relatively easy to perform, it does require practice and training, especially in the intensive care setting, where such evaluations are often crucial. My main take-home message was this: In any ICU patient in shock, we must always consider acute cor pulmonale as...
2025-04-1101 minIFA Talks6th IFAD 2017 - 022 - DELEGATE INTERVIEWI am the Scientific Chairman of the Society of Cardiac Anesthesiologists of Thailand, and I’ve been traveling across Asia to promote fluid therapy and goal-directed therapy throughout the region. I must say, I found this meeting to be truly outstanding. It offers a global update on the latest data and practices in fluid management, all presented in an accessible and engaging format. While this may not be one of the largest meetings, it is certainly one of the most valuable. The quality of the content, the depth of discussion, and the opportunity to interact wi...
2025-04-1100 minIFA Talks6th IFAD 2017 - 021 - DELEGATE INTERVIEWAs we previously published, the Mortality Prediction Model version II appears to be the most accurate tool for predicting maternal mortality in obstetric populations, particularly in low- and middle-income countries such as Colombia and others in Latin America. Our presentation focused on the use of severity of illness scores in pregnant patients. We evaluated several general severity indices and assessed how effectively they measure the clinical condition of obstetric patients. After completing our analysis, we concluded that the Mortality Prediction Model II outperformed other models in predicting maternal mortality within our specific patient population in Colombia.
2025-04-1101 minIFA Talks6th IFAD 2017 - 020 - PATRICK HONORELet’s try not to swing the pendulum too far in the other direction—risking another form of high mortality. Instead, let’s aim to find the sweet spot. My lecture focused on de-resuscitation in the critically ill—and whether this could be the key to solving the problem of fluid overload. As we’ve seen, aggressive fluid administration may save lives in the early phases of shock, but excess fluids later on can be harmful, and managing this balance is critical to improving outcomes. One of the great strengths of the IFAD Congress is that, unli...
2025-04-1101 minIFA Talks5th IFAD 2015 - 028 - GEERT CREEMERSSimplicity is key. We need to keep things simple—because even experts often struggle to interpret complex data. That’s why it’s crucial to ensure that data are not only easy to access, but also easy to understand and act upon. My name is Geert Creemers, and I’m the CEO and founder of Argon Measuring Solutions. I’m probably one of the few, if not the only, non-medically trained professionals attending this conference. I come from the industrial sector, where we specialize in high-precision 3D measurement technologies. In a conversation with Prof. Manu Malbr...
2025-04-1101 minIFA Talks6th IFAD 2017 - 019 - ANNIKA REINTAM BLASERHi I am Annika Reintam Blaser from Estonia and when we talk about enteral nutrition, it's important to clarify that it can be administered via gastric, jejunal, or even transgastric routes—and each of these approaches matters. They are not interchangeable, and the route of administration can have a significant impact on tolerance and outcomes. In my lecture, I presented the European guidelines on early enteral nutrition in critically ill patients. These guidelines represent a substantial collaborative effort, and we developed them with a clear goal: to make them practical and applicable at the bedside, supporting clinicians in...
2025-04-1100 minIFA Talks6th IFAD 2017 - 018 - FABIO TACCONEI am Fabio Taccone from Brussels, Belgium. When you look at real patients—and not just models—undergoing CPH (continuous purification therapies) and measured for antibiotic concentrations, what you find is striking: there is huge variability in how these drugs behave. I was invited to speak about the association between fluids and fluid overload, specifically in relation to pharmacokinetics—the study of how drug concentrations change over time in the body. I shared two key messages with the audience: Pharmacokinetics in critically ill patients is highly unpredictable. In the ICU, we often adminis...
2025-04-1102 minIFA Talks6th IFAD 2017 - 017 - JAN DE WAELEHi, I am Jan De Waele from Ghent, Belgium. At this meeting, fluid therapy has rightly taken center stage—with many presentations and discussions focused on when and how to give fluids. But far fewer have tackled the other side of the coin: fluid removal. In my talk, I addressed a topic that’s gaining attention yet remains understudied: the dangers of fluid de-escalation. While it’s a common intervention, we still have limited understanding of the potential risks involved. These risks are closely tied to both the methods and the rate at which fluids are removed.
2025-04-1101 minIFA Talks6th IFAD 2017 - 016 - DIRK HIMPEI am Dirk Himpe from Antwerp Belgium. Gelatins are still considered the Cinderella of the colloids. Much like the fairytale character, they’re often overlooked or spoken about in hushed tones—but they continue to quietly do a great deal of work behind the scenes. And perhaps, like Cinderella, they too have a promising future. Gelatins are actually the oldest synthetic plasma substitutes, with their first use in humans dating back to 1915 during World War I. Their role expanded significantly during and after World War II, with ongoing modifications to improve their safety and applicability in c...
2025-04-1102 minIFA Talks6th IFAD 2017 - 015 - FILIP DE SOMERWhat is the importance of a meeting like this? I am Filip De Somer from Belgium and a meeting like this is incredibly valuable because it focuses on a relatively new technology—ECMO—that is increasingly being adopted outside of university hospitals. As its use expands into more general and community settings, it becomes essential for clinicians to have a clear understanding of both its indications and limitations. It’s not just about knowing how to initiate ECMO, but also about recognizing when it's appropriate to use, and critically, when a patient should be transferred to a more...
2025-04-1100 minIFA Talks6th IFAD 2017 - 014 - CIAN MACDERMOTTDo you know how long it typically takes for a piece of research to make its way into clinical practice? 16 years. Some say 17. That’s an entire generation of medical graduates before evidence becomes routine care. It’s far too long—and that's where tools like social media can help bridge the gap. I’m Cian McDermott, an emergency medicine doctor, and I’m passionate about the use of point-of-care ultrasound (POCUS). I’m also very active on social media, where I regularly promote the integration of POCUS into everyday clinical practice. Later today, in abo...
2025-04-1102 minIFA Talks6th IFAD 2017 - 001 - MANU MALBRAINWe need better classifications for ARDS. Definitions must always reflect underlying pathophysiology and, importantly, they should guide our treatment decisions. Unfortunately, the current definitions often fall short in this regard. However, incorporating parameters like extravascular lung water might help bridge that gap. It’s also essential to remember that fluids are drugs—they come with indications, contraindications, and potential adverse effects. It's not just about the type of fluid; we must also consider the dose. Giving too much or too little can be harmful. Next is the duration—if a patient is no longer fluid responsive, we must st...
2025-04-1103 minIFA Talks5th IFAD 2015 - 023 - PAUL ELBERSWe live in a time where we have so many tools and parameters to measure, and we must use this information to decide on the best therapy for our patients. As Professor Lichtenstein points out in his book, there are indeed a multitude of variables, but in the end, it often comes down to just three key choices. My name is Dr. Paul Elbers, and I’m an intensivist at VU University Medical Center in Amsterdam. My talk at IFAD focuses on how to consolidate ultrasound into your ICU practice. After completing a basic ultrasound co...
2025-04-0901 minIFA Talks5th IFAD 2015 - 021 - CAN INCEUntil now, I’ve noticed that the topic of anemia—and the oxygen-carrying capacity of the blood—has not been mentioned much. We’ve heard discussions on hypovolemia, fluid overload, and volume status, but anemia, which directly impacts oxygen delivery, seems to be underrepresented in the conversation. My name is Professor Can Ince, and I’m a physiologist, not a clinician. I have the pleasure of giving two lectures at this year’s congress. The first is on the glycocalyx—a crucial component of the endothelial surface layer that lines blood vessels. The glycocalyx plays a central role...
2025-04-0901 minIFA Talks5th IFAD 2015 - 015 - MANU MALBRAINI’m here to introduce our host and chairman, Dr. Manu Malbrain. Dr. Manu Malbrain: Thank you, Monty. Thank you, Dirk. And welcome, everyone. This meeting originally started in our hospital in collaboration with the ZiekenhuisNetwerk Antwerpen (ZNA) in Antwerp, Belgium. We’re proud to say that this is now the fifth edition of the International Fluid Academy Days (IFAD), and a lot has changed since our first event in 2011. Over the years, we’ve come to understand that fluids should be treated as drugs—just like any other medication we administer to patie...
2025-04-0901 minIFA Talks5th IFAD 2015 - 011 - AZRIEL PERELThat’s the challenge—we need to define and target specific hemodynamic goals. But the question remains: Can we truly find one hemodynamic target that fits everyone—you, her, him, and me? I’m Professor Azriel Perel from Tel Aviv, and I just participated in a pro/con debate on goal-directed therapy (GDT). While GDT is gaining popularity, it’s important to recognize that it often means different things to different people. The term is frequently used, but not always clearly defined. In my presentation, I addressed the pathophysiological rationale behind this approach, and I also chall...
2025-04-0901 minIFA Talks5th IFAD 2015 - 003 - MICHEL SLAMAYou may observe very good contractility of the left ventricle, but if the afterload is significantly elevated, the ejection fraction may still appear reduced. This distinction is essential in understanding left ventricular performance. My name is Michel Slama, and I am a Full Professor of Intensive Care Medicine at Amiens University Hospital in France. My lecture focused on left ventricular function, specifically on how to use echocardiography—a simple yet powerful ultrasound technique—to assess cardiac function, particularly that of the left ventricle, which plays a critical role in systemic circulation. This congress, organized by Prof...
2025-04-0901 minIFA Talks5th IFAD 2015 - 002 - DANIEL LICHTENSTEINThis is what I refer to as the correct terminology. We begin with the peri-heart, focusing on the heart itself—specifically, the volume status of the right ventricle. My lecture today is about lung ultrasound, and from my perspective, the lung is just as vital as the heart. Traditionally, the lung was considered off-limits for ultrasound—it wasn’t thought to belong in the domain of sonography. But I had a different experience. When I began my training in intensive care medicine, I often found myself with free time during night shifts. With nothing else to do...
2025-04-0901 min
IFA Talks4th IFAD 2014 - TAKE HOME MESSAGES1. Rainer Gatz (Copenhagen, Denmark) My name is Rainer Gatz. I work in one of the hospitals in Copenhagen. There are quite a lot of easy-to-learn applications in ultrasound which are fitting for beginners—this is essentially the essence of the FAST examination. These applications must be fast and easy to learn. Abdominal ultrasound is probably a bit more complicated, but even there, some applications are accessible to novices. I want to encourage people to take up ultrasound and get familiar with using the probe. Another important message is to always use the ultrasound probe before placing invasive devices, whether ce...
2025-04-0811 min
IFA Talks2nd IFAD 2012 - 016 - XAVIER MONNETI am Xavier Monnet from Paris in France. Today, there is strong evidence that excessive fluid loading is harmful to ICU patients. The good news is that we now have reliable tools to help guide our decisions: tools that indicate when to give fluids—and just as importantly, tools that help us determine when to withhold them. This allows us to tailor fluid therapy more precisely and safely than ever before.
2025-04-0800 min
IFA Talks2nd IFAD 2012 - 015 - WILFRIED MULLENSHello, I’m Wilfried Mullens from Genk, Belgium. I just gave a talk on cardiorenal syndrome, a highly prevalent condition in which renal function deteriorates in patients hospitalized with heart failure. Historically, we believed that this decline in kidney function was primarily due to poor forward flow—reduced cardiac output. However, recent insights have shifted our understanding. It’s now clear that congestion—not low flow—is the key driver. Specifically, elevated filling pressures, and in particular right-sided filling pressures, contribute significantly to worsening renal function. Another important factor is elevated intra-abdominal pressure, which further compromise...
2025-04-0800 min
IFA Talks2nd IFAD 2012 - 014 - THOMAS JACKI am Thomas Jack from germany. The focus of my talk is an often underestimated side effect of infusion therapy: particulate contamination. In my opinion, this issue does not receive the attention it deserves in clinical practice. All infusion solutions we administer to patients carry a significant burden of particulate matter. These particles can originate from drug incompatibilities, formulation excipients, or may already be inherent in the drug preparations provided by pharmaceutical manufacturers. While older experimental studies have long suggested that these particulates may be harmful, until now there has been no solid clinical evidence t...
2025-04-0800 min
IFA Talks2nd IFAD 2012 - 013 - SYBILLE KOZEKI am Sybille Kozek from Vienna in Austria. In hemorrhagic shock, we are dealing with absolute hypovolemia, meaning there is a true loss of circulating blood volume. Therefore, the primary target of our fluid resuscitation is the intravascular compartment. In this context, colloids can play a role as part of a multimodal resuscitation strategy, alongside crystalloids and blood products. However, their use must be carefully balanced with an awareness of potential complications. We must consider the coagulopathic side effects of colloids, especially in patients already at risk of bleeding, as well as the potential for f...
2025-04-0800 min
IFA Talks2nd IFAD 2012 - 012 - RAINER GATZI am Rainer Gatz, from Copenhagen in Denmark. Well, based on the findings from last year’s studies and the current body of evidence, my main takeaway is that we should exercise caution when using colloids—particularly in septic patients. The potential risks may outweigh the benefits, and until we have more definitive data, it's wise to take a conservative approach. There are ongoing trials, especially those evaluating the role of albumin in critical care, and their results will be crucial in guiding future practice. So for now, it’s best to hold off on routine...
2025-04-0800 min
IFA Talks2nd IFAD 2012 - 011 - NIELS VAN REGENMORTELI’m Niels Van Regenmortel drom ANtwerp, Belgium, and one of the co-organizers of this wonderful second International Fluid Academy Day together with Manu Malbrain. My talk focused on crystalloids, and I had some good news to share: we're now clearly favoring balanced crystalloids over saline. In recent months, strong clinical data have emerged supporting this shift, which is a significant step forward in fluid therapy. I’m excited to see what the next year brings, but for now, we’re very pleased with this progress and the growing support for balanced solutions.
2025-04-0800 min
IFA Talks2nd IFAD 2012 - 010 - MONTY MYTHENHi, my name is Monty Mythen. I'm from University College London in England. I just gave a talk on the engineering of next-generation resuscitation fluids—what we might call "superfluids"—and what the future holds in fluid development. My key conclusions are that, over the next decade, most advances in resuscitation fluids will likely come from semi-synthetic products. These will be improved, modified, and reformulated to better match physiological pH and electrolyte compositions, making them safer and more effective. Looking further ahead, we must continue to pursue the development of so-called "shelf blood"—a synthetic or eng...
2025-04-0800 min
IFA Talks2nd IFAD 2012 - 009 - MANU MALBRAINHello, I’m Manu Malbrain, intensivist from Antwerp, Belgium. Today, I spoke about therapeutic conflicts in the ICU. Many critically ill patients develop therapeutic dilemmas—these are not static, but dynamic challenges that evolve over time. In addressing them, we must always prioritize support for the organ most at risk of causing a fatal outcome. To navigate these conflicts, we need clear answers to four essential questions: When should I start giving fluids? Not all patients require fluids. In some cases, the best fluid is the one never given. This phase is about understanding the...
2025-04-0802 min
IFA Talks2nd IFAD 2012 - 008 - JULIA WENDONI'm Jules Wendon, and my talk was about fluid therapy in patients with liver disease. When managing a patient with cirrhosis, getting the volume status just right is critical—not too little, and not too much. An underfilled patient is at significant risk, as inadequate perfusion can worsen organ function. But overfilling is equally harmful. It can exacerbate edema, increase liver stiffness, and aggravate portal hypertension. Both extremes are dangerous. In addition to careful fluid management, vasoconstrictors—particularly splanchnic vasoconstrictors—play a vital role. They help redistribute blood centrally, improve effective circulating volume, and counteract the ce...
2025-04-0800 min
IFA Talks2nd IFAD 2012 - 007 - JEAN-LOUIS VINCENTI am Jean-Louis Vincent from ULB Erasme in Brussels, Belgium. My talk focused on the types of fluids we can administer to our patients. While it's true that patients often need fluids, it's important to remember that not all fluids are inherently good—especially when given in excessive amounts. Intravenous fluids can help, but they can also harm. Take albumin, for example. It's expensive, and there's no clear evidence of benefit in most situations. Hydroxyethyl starches (HES) have been linked to potential harm, especially in critically ill or septic patients. Gelatins are not well studied and might ca...
2025-04-0801 min
IFA Talks2nd IFAD 2012 - 006 - FREDERIC MICHARDMy name is Frédéric Michard, and I am responsible for the global medical strategy at MiCo Critical Care division. In addition to this role, I serve as a visiting doctor at the University Hospital of Lausanne. I’m truly pleased to be here today to discuss a topic that is both clinically relevant and impactful—fluid optimization in high-risk surgical patients. We know from both clinical experience and growing scientific evidence that optimizing fluid therapy is one of the simplest and most effective strategies to enhance postoperative outcomes. When carefully tailored to a patient’s individu...
2025-04-0800 min
IFA Talks2nd IFAD 2012 - 005 - ERIC HOSTEI am Eric Hoste from University Hospital Ghent in Belgium. Fluids and acute kidney injury (AKI) present a complex relationship—one that can be described as the good, the bad, and the ugly. Fluids are undoubtedly beneficial in cases of hypovolemia. When administered appropriately, they help restore intravascular volume, improve renal perfusion, and can effectively prevent the onset of AKI. This is the "good" part of the story. However, fluids can also be harmful when given in excess. Overzealous fluid administration increases venous congestion and raises renal afterload, which in turn compromises kidney perfusion and promotes the de...
2025-04-0800 min
IFA Talks2nd IFAD 2012 - 004 - DIRK HIMPEMy name is Dirk Himpe, and I am an anesthesiologist at Middelheim General Hospital in Antwerp, Belgium and I am primarily involved in cardiac anesthesia for patients undergoing cardiac surgery. We know that long-term outcomes after cardiac surgery are significantly influenced by the administration of blood, blood products, and the occurrence of anemia—often caused by hemodilution during the procedure. The focus of my talk was on fluid management during cardiac surgery, particularly during cardiopulmonary bypass, a phase where large volumes of fluid are administered. I explored whether the type of fluid given during this period can im...
2025-04-0801 min
IFA Talks2nd IFAD 2012 - 003 - CHRISTIAN PUTENSENHello, my name is Christian Putensen from the University of Bonn. I recently gave a talk on respiratory monitoring in patients with ARDS. For many years, we’ve recognized that ARDS is not a uniform condition—it is a highly heterogeneous disorder. Traditional respiratory monitoring techniques, such as airway pressure measurements, do not provide sufficient information about the actual stress applied to the lungs. This is why measuring esophageal pressure and intra-abdominal pressure has become increasingly important. These methods help us better understand transpulmonary pressure, which is a key factor in the development of ventilator-induced lung injury. Additionally, emerging tech...
2025-04-0801 min
IFA Talks2nd IFAD 2012 - 002 - CAN INCEMy name is Can Ince, and I’m based in Amsterdam at the University of Amsterdam’s Academic Medical Centre, where I serve as Head of the Department of Translational Physiology. In addition, I work two days a week as a physiologist in the Department of Intensive Care Medicine at Erasmus Medical Centre. My area of expertise focuses on the behavior of fluids, oxygen transport, and blood flow at the cellular level within the microcirculation—because that’s truly where the critical processes take place. I’ve developed technologies to observe and better understand these mechanisms. In my lecture, I will exp...
2025-04-0800 min
IFA Talks2nd IFAD 2012 - 001 - AZRIEL PERELThe subject of my talk was the perioperative management of patients undergoing high-risk surgery. This remains a significant challenge in clinical practice, as a large number of patients require such complex surgical interventions, and the associated complication rates are still considerable. One promising strategy to improve outcomes is the implementation of goal-directed therapy. By closely monitoring and optimizing fluid administration during the perioperative period, we can potentially reduce complications and enhance recovery. However, despite encouraging evidence, several unresolved questions and areas of uncertainty remain regarding this approach. In my talk, I aimed to shed light on these controversies and...
2025-04-0800 minIFA Talks1st IFAD 2011 - 012 - MICHAEL BAUERMy name is Michael Bauer, and I’m from Jena, Germany. My area of interest is dye dilution techniques. Traditionally, our approach in critical care has focused on maximizing blood flow to tissues, often without fully considering the potential side effects of such aggressive strategies. However, I believe it's time for a paradigm shift. Instead of simply increasing perfusion, we should aim to match blood flow to the actual metabolic demand of the tissues. Dye dilution techniques offer a valuable tool to help us achieve this more individualized and precise approach to hemodynamic management.
2025-04-0800 minIFA Talks1st IFAD 2011 - 011 - PAUL ELBERSMy name is Paul Elbers, and I’m from Amsterdam, the Netherlands. I’m proud to be part of the first telemedicine unit established in Europe. In my presentation, I focused on saline-induced metabolic acidosis—a real and clinically significant phenomenon. Using the Stewart approach, I explained how this framework helps us better understand the underlying mechanisms and why this condition can be harmful to many patients. When managing critically ill individuals, every detail matters, including fluid composition. That’s why my key message was simple but important: think twice before choosing saline.
2025-04-0800 minIFA Talks1st IFAD 2011 - 010 - DIRK HIMPEI am Dirk Himpe, a cardiac anesthesiologist at Middelheim General Hospital in Antwerp, Belgium. In my presentation, I discussed the use of hypertonic solutions in clinical practice. Sometimes, it is beneficial to administer highly concentrated saline solutions to draw water from areas in the body where it has accumulated abnormally. By doing so, we can shift fluid back to where it is needed most. These hypertonic, or very salty, solutions can effectively help manage fluid distribution, especially in cases of fluid overload or compartmental imbalances. This principle formed the core of my talk.
2025-04-0800 minIFA Talks1st IFAD 2011 - 009 - ERIC HOSTEMy name is Eric Hoste, and I work at Ghent University Hospital in Belgium. In my talk, I addressed the ongoing debate around whether colloids or crystalloids are superior for volume replacement in critically ill patients. Overall, the evidence shows that colloids are not superior to crystalloids in the general ICU population—they tend to be more expensive and are associated with a higher risk of side effects. However, there are certain subgroups of patients, such as those with severe sepsis, undergoing cardiac surgery, or suffering from cirrhosis, where colloids—particularly albumin—may offer specific benefits. In patients with cirrho...
2025-04-0800 minIFA Talks1st IFAD 2011 - 008 - SYBILLE KOZEK LANGENECKERMy name is Sybille Kozek, and I’m an anesthetist from Vienna, Austria. One of my main areas of interest is the potential side effects of colloids and crystalloids, particularly in relation to dilutional coagulopathy and their impact on clinical outcomes such as blood loss and transfusion requirements. In my lecture, I focused on why fluid choice truly matters—not just in terms of the type of colloid, but also the timing and dosing of its administration. I presented evidence highlighting the clear clinical advantages of using 6% iso-oncotic tetrastarch compared to gelatin, emphasizing its superiority based on the data curr...
2025-04-0800 minIFA Talks1st IFAD 2011 - 007 - XAVIER MONNETMy name is Xavier Monnet, and I work at Bicêtre Hospital in Paris. In my talk, I discussed the various monitoring devices currently available for use in the ICU and operating room. The key message was that recent technological advances have led to the development of several innovative tools that enable us to assess cardiovascular function more accurately and in real time. These advancements provide clinicians with a valuable opportunity to tailor hemodynamic monitoring to each patient's condition, selecting the most appropriate device based on the severity of illness and specific clinical needs.
2025-04-0800 minIFA Talks1st IFAD 2011 - 006 - AZRIEL PERELMy name is Professor Azriel Perel, and I’m from Tel Aviv in Israel. In my presentation, I addressed the challenge of accurately interpreting the numerous parameters displayed on our monitors. While modern monitoring systems provide a wealth of data, not all of these parameters are equally reliable—some can be quite inaccurate. My aim was to bring clarity to this issue by highlighting the limitations of certain measurements and proposing practical strategies for navigating these inaccuracies. Ultimately, I focused on how to make sound clinical decisions despite the presence of potentially misleading information.
2025-04-0800 minIFA Talks1st IFAD 2011 - 005 - NIELS VAN REGENMORTELI am Niels Van Regenmortel, Internist-Intensivist at ZAS in Antwerp, Belgium. In my lecture, I emphasized that not all intravenous fluids are the same, and understanding their composition is crucial for effective fluid management. Specifically, the lower the strong ion difference of a solution, the lower the pH will be, which can lead to increased acidosis in the patient. This highlights the importance of selecting the right fluid based on the clinical context. Crystalloids, for example, vary significantly in their electrolyte composition and buffering capacity, and need to be carefully balanced to achieve optimal outcomes. Similarly, not all colloids...
2025-04-0800 minIFA Talks1st IFAD 2011 - 004 - JEAN-LOUIS VINCENTI am Jean-Louis Vincent, a professor of Intensive Care Medicine at the University of Brussels. My talk was on fluid responsiveness — how we can predict a patient's response to fluid administration using indices like pulse pressure variation or stroke volume variation. There are limitations to this approach: the patient must be sedated, and there shouldn't be major arrhythmias. In many cases, we still have to administer fluids, but we can use a fluid challenge approach, considering the type of fluid, rate of infusion, and specific objectives and limits. Ultimately, we often ha...
2025-04-0201 minIFA Talks1st IFAD 2011 - 003 - JAN BAKKERI am Jan Bakker from the Erasmus Medical Center in Rotterdam, and I'm talking about lactate and fluid resuscitation in my presentation. It's clear that fluid resuscitation is associated with significant decreases in lactate levels, especially in the early phase in critically ill and surgical patients. Preventing increases in lactate within the normal range is important to reduce the risk of multiple organ failure and death in these patients.
2025-04-0200 minIFA Talks1st IFAD 2011 - 002 - JULIA WENDON I am Jules Wendon from King's College Hospital in London. I was talking today about the role of albumin. Albumin seems to have a significant benefit in the management of patients with liver disease. Essentially, there are different roles for albumin. It has a role in liver disease, without question, particularly in the prevention of hepatorenal failure. More interestingly, it also has marked inflammatory and anti-inflammatory capacity, and I think increasingly we will see a role for albumin in sepsis, where it seems to have a beneficial effect in terms of outcomes...
2025-04-0200 minIFA Talks1st IFAD 2011 - 001 - MANU MALBRAINI am Manu Malbrain, co-founder and President of the International Fluid Academy and I gave a talk about fluid management and avoiding fluid overload. If you give too much fluids and the patient gets peripheral edema, that is not a cosmetic issue, but it's bad medicine. We must avoid it.
2025-04-0100 min
TopMedTalkTopMedTalks to Manu MalbrainThe Society of Critical Care Medicine (SCCM) is the largest non-profit medical organization dedicated to promoting excellence and consistency in the practice of critical care. This piece is presented from their annual conference this year. Presented by Desiree Chappell and Monty Mythen with their guest Manu Malbrain, CMO of Medaman, an initiative that seeks to optimize the use of data in hospitals, combined with a position as professor of Critical Care Research at the First Department of Anesthesiology and Intensive Therapy of the Medical University of Lublin in Poland. He is a co-founder and president of the...
2025-03-2430 min
5th World Sepsis Congress: Sepsis Research and Innovations99: 2024 WSC Spotlight – How Does Hypervolemia Increase the Mortality Risk in Sepsis?Session 4 ‘How Does Hypervolemia Increase the Mortality Risk in Sepsis?’ from the 2024 WSC Spotlight. Featuring Manu Malbrain, Sheila Myatra, Jean-Louis Teboul, Ludhmila Hajjar, Marlies Ostermann, and Naomi Hammond as your moderator.
2024-05-281h 25
dVO, de Vlaamse OndernemerbUZZ: Datamanagement in de medische sector (2/2)In deze tweedelige reeks bespreken dr. Manu Malbrain, Medaman, en Jan Vekemans, Intersystems, de uitdagingen van datamanagement in de medische sector.Wat komt in deze podcast aan bod:Kwaliteit van data en hoe verbeteren?"Patiënt heeft geen inzicht in zijn eigen agenda"Gestructureerde data en foute input?Invloed van NLP en kwaliteitscontroles, menselijke controles...Problematiek van negaties.Diagnose of een hypothese of...Eigenaar van data en data-privacy...Gebrek aan regelgeving? De welke zijn er? Welke problematiek?D...
2023-11-1316 min
dVO, de Vlaamse OndernemerbUZZ: Datamanagement in de medische sector (1/2)In deze tweedelige reeks bespreken dr. Manu Malbrain, Medaman, en Jan Vekemans, Intersystems de uitdagingen van datamanagement in de medische sector.Wat komt in deze podcast aan bod:Probleemstelling: Heel veel data, maar heel moeilijk juist te exporteren... Wat nu?Wie is Medaman?Wie is Intersystems?Hoe gaan we met patiëntendata om?Big data...Wat is Unified care record?Wat is one patient, one record?Support the show© 2023 dVO www.dvo.be
2023-11-1314 min
Ligne de MIRLigne de MIR n°107 - Le Pr Manu Malbrain nous parle de l'hypertension intra abdominale en réanimationLe Pr Malbrain, qui est chef du Département de Réanimation Médicale et de Médecine Hyperbare de l'Hôpital d'Anvers, nous parle de l'hypertension intra abdominale en réanimation.
Aucun conflit n'est déclaré.
Sommaire :
Quelles sont les différentes définitions de l’hypertension intra abdominale et quel est l’impact sur les autres organes de cette hypertension ?
Quelles sont les méthodes de mesure de la pression intra abdominale ?
Enfin, quelles sont les implications cliniques de cette hypertension intra abdominale
2023-02-0125 min
Asia Ventilation ForumHow I ventilate patients with intra-abdominal hypertension – Professor Manu MalbrainIn this AVF Podcast: ICU Tips & Tricks episode, Professor Manu Malbrain discusses the implications of increased intra-abdominal pressure on mechanical ventilation. Professor Malbrain is Professor of critical care research at the First Department of Anaesthesiology and Intensive Therapy at the Medical University of Lublin in Poland. He is the current President and co-founder of the International Fluid Academy, and the inaugural President, co-founder, and Treasurer of the Abdominal Compartment Society.Issues discussed in this interview:General effects of intra-abdominal hypertensionPhysiologic effects of increased intra-abdominal pressure on intra-thoracic pressureGuidance for adjusting ventilation in the presence of increased...
2022-02-2845 min
European Journal of Anaesthesiology | EJA - The EJA Podcast collectionThe EJA Podcast collection…Q&A with Aarne Feldheiser, author of “Vasopressor effects on venous return in septic patients: a review”.Listen to the Q&A between Prof. Manu Malbrain and author Prof Aarne Feldheiser on his article “Vasopressor effects on venous return in septic patients: a review” and discover further insights in this recent EJA article. You can find the two publications mentioned Here:
1) Simon Gelman: A physiological story of venous return (https://pubmed.ncbi.nlm.nih.gov/18362606/)
2) Aarne Feldheiser: Oesophageal Doppler and calibrated pulse contour analysis are not interchangeable within a goal-directed haemodynamic algorithm in major gynaecological surgery (https://pubmed.ncbi.nlm.nih.gov/25107544/)
2021-06-2422 min
The EJA Podcast collectionThe EJA Podcast collection…Q&A with Aarne Feldheiser, author of “Vasopressor effects on venous return in septic patients: a review”.Listen to the Q&A between Prof. Manu Malbrain and author Prof Aarne Feldheiser on his article “Vasopressor effects on venous return in septic patients: a review” and discover further insights in this recent EJA article. You can find the two publications mentioned Here: 1) Simon Gelman: A physiological story of venous return (https://pubmed.ncbi.nlm.nih.gov/18362606/) 2) Aarne Feldheiser: Oesophageal Doppler and calibrated pulse contour analysis are not interchangeable within a goal-directed haemodynamic algorithm in major gynaecological surgery (https://pubmed.ncbi.nlm.nih.gov/25107544/)
2021-06-2422 min
TopMedTalkFluid Matters | Series Highlight: Total body water and electrolytesThis piece has been released to coincide with the first virtual International Fluid Academy Day (IFAD). TopMedTalk listeners have enjoyed following the meeting annually for some time now; we're equally as excited about their online proposition. This piece is a chance to hear a now famous discussion which TopMedTalk recorded at the Peroperative Quality Initiative (POQI) at Washington Duke University in Durham. The discussion is predominately about total body water, electrolytes and the movement of fluid around the body; the idea of circulation of interstitial fluid; the Starling Curve and lymphatics; sodium balance and, at the end...
2020-11-2538 min
Coda ChangeThe four phases of intravenous fluid therapyManu Malbrain presents the four phases of intravenous fluid therapy. He takes you through the big questions of fluids - What, when, why and how? To Manu, there are four Ds of fluid therapy: Drug, dose, duration, and de-escalation Drug Fluids are drugs. This means, like any drugs, consideration must be taken about the type, indication, contraindication, and adverse effects of fluids whenever prescribing them. The evidence suggests that we should stop using starches in sepsis, albumin in TBI and stop using more than 2L of saline in resuscitation. For maintenance – eliminate the use of unbalanced isotonic fluids, and do...
2019-02-1020 min