Critical Care physiology through history: Matt Morgan
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Critical Care physiology through history: Matt Morgan
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Matt Morgan describes critical care physiology through history. Matt’s story begins in Copenhagen, 1952, when an 11-year-old girl in developed acute and severe polio. The last iron lung had been used. So, a young anaesthetist, Bjørn Ibsen, organised a tracheostomy and positive pressure ventilation (PPV) and changed the world. From that point we have discovered and understood the physiology of traumatic brain injury, mechanics of PPV, HFOV, APRV and echo to name a few. However, Matt contends that this story was not the beginning of our understanding of physiology. Matt will take you back through time to show how giraffes, dogs, fish and even frogs can teach us about physiology. Giraffes can tell us about the delivery of CPP. They utilise massive mean arterial pressures and a complex system of venous valves. The MAP is achieved through massive left ventricular hypertrophy – a completely normal finding in giraffes. High frequency oscillatory ventilation was first used in the 1970s… however, dogs have been doing this for 100s of 1000s of years ago. Airway pressure release ventilation was described in the late 1980s… again this is not new. Frogs and lizards have been using this method for millennia. Finally, Matt tells us about ice fish – who live 1.5 kilometres under the Antarctic Ocean surface. The ice fish CAN transcribe haemoglobin; however, it does not bother. All its oxygen is provided by dissolved oxygen in its harsh environment. Matt will pin his tale of historical physiology on the events around one of his patients – Nathan – who suffered a TBI. During delivering Nathan’s treatment, Matt relies on all these animal lessons. Matt wants you to remember these animals when thinking about physiology. In doing so, he hopes you will educate, innovate, and connect with other medical professionals. For more like this, head to our podcast page. #CodaPodcast
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Critical Care physiology through history: Matt Morgan
- DR MATT PG MORGAN MBBCH BSC PHD FRCA FFICM INTENSIVE CARE CONSULTANT, CARDIFF, UK HOW KISSING A CAN SAVE YOUR LIFE
- 7 million 22 million300 million
- CPP = MAP – (ICP + CVP)
- #ONEMEDICINE @MATRIX_MANI A
Editor's Notes
- The Frog King
- Beautiful sunny August morning in Copenhagen as Vivi played in her local park. She was a happy, 11-year-old girl with sandy golden hair and apple red cheeks. As her mother pushed her higher on the chain-metal swing, life was good. Twenty four hours later Vivi was about to die. Her journey was the first step along a fifty year long road that now allows us to care for 2000 300 people 1952 Copenhagen epidemic, Blegdam hospital. No iron lung. Bjon Ibsen, 36 anaesthetist. Tracheotomy. 3 weeks later.
- Timeline 3.8 billion years of life 1953 20,000 modern human 100,000 dogs 7 million giraffes 22 million ice fish 65 million years ago dinosaur extinct 300 million years frogs Understand physiology + glimpse at unanswered questions
- Monroe Kelly in early 19th Lundberg 1965 7 million giraffes
- Misha, Perth, died May 2016 25 years.
- 2m neck 250 systolic Bend over to drink - faint - valves
- No cardiovascular disease, no subendocardial ischemia,
- Deadspace and carbon dioxide
- 1978 Died in 2000 83 Respiratory physician, explorer, Jamaica and Amazon. Blowpipes MRC Cardiff Marking papers Find out tidal volumes
- Temperature - goat 40C. Core enzymes, range temperatures, why selective advantage hot not clear. Fungal infections?
- 1970 Work out mechanics
- 5 Hz ideal, resonant frequency
- Spiny tailed lizard, Beduwin delicacy in Africa. 300 million years frogs
- Perth, less hours, more pay, better weather. Lucky I like bad coffee, warm beer and clouds. Flu epidemic Saturday night looking at journal of amphibian respiratory physiology Understand physiology + glimpse at unanswered quesitons
- Ice fish, 1.5 km deep, -2 PFC, hyperbaric chamber. 22 million ice fish
- Why look at this? Understand physiology, deadspace, dissolvedoxyegn New insights, LVH, flow patterns Interdisciplinary – oneMedicine/specaist, teaching vets
- 1971, 19 years after, readmitted, died.