Volume 7 Number 2 July 2006 - JICS - The Intensive Care Society

Volume 7 Number 2
6
Meeting Report
Harrogate ICS Spring Meeting
2006 Report
T Jackson
Harrogate was once again chosen to host the
Spring ICS meeting this year. Having enjoyed the
successful SKINT meeting, delegates gathered amid
the decidedly changeable weather for the two day
conference. A packed programme boasted parallel
sessions with such diverse themes as trauma and
climate change (ironic in the context of the change
of weather from Monday to Tuesday!) and promised
an array of expert speakers.
The Harrogate International Centre has developed
since the last ICS meeting, with the addition a year
ago of the Queens Suite adding to the flexible
conference facilities. The first session here centred
on trauma, starting with Prof Monty Mythen’s
presentation of the pitfalls in evidence for volume
resuscitation strategies based on certain well-quoted
trials. The general consensus was carried into the
questions, namely that minimal resuscitation should
not be mistakenly interpreted as under-resuscitation.
Prof Pete Giannoudis developed a comprehensive
journey through the genetic basis of trauma
responses, from the history of trauma management
strategies to the future expectations of genetic
markers of inflammatory responses. The session
was concluded with a poignant reminder of the
recent London terrorist bombs from Dr Hugh
Montgomery, with the chilling message that many
of our colleagues in the capital knew a terrorist
attack was a certainty, and the place that drills and
preparation played in the response to those attacks.
Having watched the events unfold in the media that
day, as many of us will remember, it was fascinating
to hear first hand experience of the dynamics of
casualty flows and intensive care activity at such a
testing time.
The parallel session in the main auditorium
concerned outreach issues, with presentations on
the lack of evidence for efficacy of outreach in the
light of the antipodean MERIT study, the spectrum
of musculoskeletal dysfunction in the ICU setting
and some potential avenues for impacting on these
difficult conditions, and discussion of the commonly
applied ‘track and trigger’ scoring systems applied
to patients at risk of critical illness.
The refreshment break provided the first
opportunity to view the range of industry exhibitors,
although there was some debate as to who would
pluck up courage to visit the rectal tube vendors
with confidence!
The second session of the day fell to a choice of
matters nephrological or scanning the horizon for
areas of forthcoming impact on the critical care
world. The former, began with a talk from Dr
Andrew Davenport concerning the haemodynamic
instability associated with renal replacement therapy.
There were some useful insights into methods of
minimising this potentially serious complication.
Dr Andy Lewington from Leeds spoke on the
interplay between nephrologists and intensivists in
the management of the critically ill patient with renal
failure, although it was clear that not all shared his
experience of joint care. Following on from this was
Prof Didier Payen from Paris presenting his work on
whether early renal replacement has any impact on
the progression of organ dysfunction in sepsis.
On the background of various theories why
haemofiltration might be effective was clear
evidence to the contrary, however he ended by
suggesting that high-volume filtration may offer
some as yet unproven benefit.
Lunch was followed by an intriguing look at how
climate change may affect the spectrum of infectious
diseases presenting to UK ICUs. This was put into
context by a talk from Prof Ken Carslaw from Leeds
University’s school of Earth and Environment,
detailing how the evidence for global warming has
developed over the years, and predictions of how
our impact on the climate is likely to progress. With
increasing coverage of this field in the media, it was
interesting to hear expert opinion on a politically ‘hot’
topic. Following this, Dr Philip Stanley presented
illustrative cases of diseases associated with foreign
travel which may already necessitate ICU admission
in a small group of individuals, a theme which was
July 2006
The Journal of the Intensive Care Society