Medicine and Science from The BMJ

Prehabilitation before surgery, alcohol's impact on clinical care, and life after a cardiac arrest

Jan 29, 2025

Daniel McIsaac, a Professor of Anesthesiology at the University of Ottawa, discusses how prehabilitation—exercise and nutrition before surgery—can significantly improve patient outcomes. Julia Sinclair, a Professor of Addiction Psychiatry, highlights the urgent need for a national strategy to address alcohol's impact on health that the NHS has overlooked. Lastly, Matt Morgan, a Consultant in intensive care, shares compelling insights from his book 'A Second Act,' reflecting on the transformative experiences and renewed perspectives of those who survive cardiac arrest.

40:40

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Episode guests

Daniel I. McIsaac

Julia Sinclair

Matt Morgan

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Episode notes

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Quick takeaways

Implementing prehabilitation through exercise and nutrition can drastically improve surgical outcomes and reduce complications for patients.

A national strategy to address alcohol-related health issues is essential to improve screening and management within the NHS.

Deep dives

The Impact of Prehabilitation on Surgical Outcomes

New research highlights the benefits of prehabilitation interventions, such as exercise and nutritional improvements, on patient recovery after surgery. These interventions have demonstrated a significant impact on lowering complication rates and enhancing overall recovery, suggesting patients can benefit from engaging in such programs before undergoing surgical procedures. A systematic review and meta-analysis of existing trials indicated that combining exercise and nutrition can lead to a 40 to 50% reduction in surgical complications and faster recovery times. However, the success of these programs depends on patient adherence and on addressing healthcare disparities to ensure equitable access to prehabilitation resources.

Intro

2min

Enhancing Surgical Outcomes through Prehabilitation

6min

Understanding Network Meta-Analysis in Clinical Trials

1min

The Power of Prehabilitation

7min

Addressing Alcohol-Related Harms

11min

Transformative Reflections on Life and Death

11min

Reflecting on Life Through Living Funerals

2min

Exercise and a better diet, prior to surgery, can improve outcomes. Daniel McIsaac, a professor of anaesthesiology from the University of Ottowa and lead author of that research, joins us to talk about getting those results into practice.

Julia Sinclair, professor of addiction psychiatry at the University of Southampton, explains how the NHS has lost sight of the impact alcohol consumption has on clinical care, and why we need a strategy to tackle it.

Finally, Matt Morgan, consultant in intensive care and BMJ columnist, has written another book - this time about patients who are revived after cardiac arrest, and the profound effect it can have on their outlook in life.

Reading list:

Relative efficacy of prehabilitation interventions and their components

UK needs national strategy to tackle alcohol related harms

A Second Act