The IX t h Makassed Medical Congress - American University of Beirut

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T h e I X t h M a k a s e d M e d i c a l C o n g r e s s Central lines > 8 mmHg > 65 mmHg NO > 70% CVP MAP ScvO2 YES Goals < 8 mmHg < 65 mmHg > 90 mmHg < 70% Hospital admission Crystalloid or colloid Vasoactive agent(s) Packed red blood cells to Hct > 30% < 70% Inotrope(s) > 70% AN UPDATE ON PEDIATRIC ARDS Marianne Majdalani MD ARDS is a devastating disorder leading to hypoxemia and respiratory failure. It remains an important challenge for the pediatric intensive care physician. In this review, I will discuss the definition of ARDS and the available intensive care treatment modalities including newer lung-protective mechanical ventilation strategies, fluid management and nutritional needs. 70 Central catheter insertion is a barrier in EDs CVP measurement is an important barrier in EDs Echocardiography-Doppler and dynamic indices of fluid responsiveness are more accurate What is the ideal end-point for MAP? Can non-invasive blood pressure measurement replace arterial cannulation? What is the optimal ScvO2 value? What is the prevalence of low ScvO2 after fluid resuscitation? Packed red blood cells may compromise tissue oxygenation Echocardiography-Doppler might be a good surrogate for ScvO2 to guide inotropic support.
EARLY CHILDHOOD DEVELOPMENT WORKSHOP Durriyah Sinno, MD AND Lama Charaffeddine, MD More than 200 million children worldwide fail to reach their potential in cognitive development due to poverty, poor health and nutrition, and deficient care. Early experiences during development form the basis for enhancing the physical, mental, and psychological well being of children through an entire life time. This workshop is an introduction to the Care for Child Development. The goal is to provide pediatricians with additional skills to allow them to better screen for developmental delays and intervene to enhance early childhood development. It is intended to help physicians recognize the importance of Early Childhood Development (ECD), describe the scientific basis and implications of ECD, identify available developmental screening tools and discuss their culture specificity. The workshop will be interactive where the audience will practice using the WHO/UNICEF Care for Child Development tool kit, in addition to recognizing the four domains of child development and analyzing mother-child interaction PERINATAL MANAGEMENT OF DISORDERS OF SEXUAL DEVELOPMENT (DSD) Alaa EL GHONEIMI, MD, PhD, FEBPS, FEAPU Fetal sex détermination is now a current and accurate ultrasound finding during the routine prenatal ultrasound. Any discrepancy of the typical aspect of the fetal external genitalia should alert the gynecologist and a multidisciplinary prénatal counseling be arranged. Th Prenatal thérapeutique measures are now available for the congénital adrenal hyperplasia, otherwise for the oser anomalies; the main advantage of the prénatal diagnosis is to expand the work up and to prépare an optimal néonatal management in a specialized center witloof an extensive delay in sex détermination or in worse cases a mistake in the sex determination. The aim of neonatal management is mainly to identify the anomaly and to determine the optimal choice for sex determination. The urgent medical management of congenital adrenal hyperplasia (CAH) cases should start immediately. The initial workup (hormonal, karyotype, imaging, molecular biology) and the clinical assessment by experienced pediatric endocrinologist and surgeon, can clarify in most of the cases the exact diagnosis and the determination of sex breading. This decision should be made in a multidisciplinary way including all the participants in the future management of the child, and the parent’s opinion should be taken seriously in consideration. The role of a specialized psychologist is mandatory in the process of evaluation of the family environment and in establishing a strong trusting relationship with the parents for the future management of the child. The decision is a major step and will depend on many factors: external genitalia, internal genitalia, hormonal synthesis, fertility, social environment (especially in delayed diagnosis). The reconstruction surgery will be planned according to the final diagnosis and the choice of sex breading. The feminizing genitoplasty is usually done when the child is 3 to 6 months of age. Currently there is still a controversy regarding the age and the type of surgery to be done. The virilizing genitoplasty is planned around the age of one, hormonal stimulation of external genitalia is sometimes needed, but again there is still controversy on its benefits and indications. In conclusion, the DSD should be considered as a major anomaly and that even with the most sophisticated techniques of investigations or reconstruction, it is still a challenging anomaly to manage. For one more this entity needs an optimal multidisciplinary management to be able to give children and their families the optimal therapy. 71
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The IX th Makassed Medical Congress
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CONGRESS PRESIDENT Said Sayegh, MD,
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GENERAL INFORMATION
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• Target Audience: Physicians, Pr
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Durriya Sinno, MD Pediatrics Americ
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Moderators
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PEDIATRICS Bassem Abou Merhi, MD Pe
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Maroun Sokhn, MD Pediatrics Saint G
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Scientific Program
Page 19 and 20: Session 3: Intensive Care Neonatolo
Page 21 and 22: Session 1: Pediatric Intensive Care
Page 23 and 24: 8:00 - 8:05 08:05 - 08:10 Welcome r
Page 25 and 26: Cardiology Session III: Interventio
Page 27 and 28: Cardiology Session VI: Intervention
Page 29: Cardiology Symposia (NON-CME) Frida
Page 32 and 33: T h e I X t h M a k a s e d M e d i
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