Podcast 2: Live from Boston ASA 2017 - The big challenge of big trials

The challenges facing the anaesthesia community as the need for big trials looms large. Why does it take so long for the anaesthesia community to adopt new techniques? Goal directed fluid therapy, as an example, seems to work but involves a cultural change and huge trials before it can be adopted. The Optimisation of Peri-operative Cardiovascular Management to Improve Surgical Outcome II (OPTIMISE II) trial is discussed in detail, as is the FLO-ELA (FLuid Optimisation in Emergency LAparotomy) trial. Could it be that because fluid therapy involves a cultural change within the anaesthesia community there is a difficulty for some to accept the evidence as it is? Finally Monty asks, as regards big trials, "blood pressure, shouldn't there be more of a focus on that?". Presenting live from Boston ASA; Professor Monty Mythen, Professor Mike Grocott and Dr Joff Lacey. Join the debate: [email protected]