ABSTRACTS from 16th International COnference on ... - CRRT Online

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Management of Severe Heart Failure: A Role for Ultrafiltration? Eric Adler MD 5:15-5:30 Thursday, February 16 Educational Objectives: 1. Develop tools for identifying patients with stage D heart failure 2. Learn management strategies for the severely congested patient with heart failure. 3. Learn about the newest options for providing mechanical circulatory support for such patients. Content Description: Heart Failure remains the number one reason for hospitalization among patients over 65 years of age. The majority of patients are admitted for congestion and, suprisingly remain congested at the time of discharge. We will discuss options for the patients with advanced heart failure, including aquaphoresis and mechanical circulatory support. Suggested Reading: 1. Treatment of congestion in heart failure with diuretics and extracorporeal therapies: effects on symptoms, renal function, and prognosis. Costanzo MR, Jessup M. Heart Fail Rev. 2011 May 11. 2. Adler ED, Goldfinger JZ, Kalman J, Park ME, Meier DE. Palliative care in the treatment of advanced heart failure. Circulation. 2009 Dec 22;120(25):2597-606. Review. PMID 20026792 53
Telemedicine in the ICU: The Future is Here Jeffrey Lipman MD 5:30-5:45 Thursday, February 16 Educational Objectives: 1. Understanding what telemedicine for remote Intensive Care Units can provide 2. Review of current data on telemedicine services 3. Demonstrate how care via a targeted individual consultative service can improve outcomes Content Description: Telemedicine (audiovisual technologies) is increasingly being used to assist ICUs unable to be staffed by intensivists. Here I discuss recent data evaluating these services and their potential role in managing ICU patients. Finally I provide some data on a targeted individual consultative service we have set up with a regional ICU. Models of care range <strong>from</strong> complete remote 24-hour surveillance requiring direct video observation to a consultation liaison service only requiring conventional telephone links. Early work suggests savings in terms of cost and length of stay with an improvement in compliance with care protocols. However, later work is not as supportive, possibly related to differing care infrastructures and the organisation of individual units. The key task is to ascertain the most appropriate service requirements that would assist in care for a given patient circumstance. Bundaberg Base is a regional 200-bed hospital serving a population near 45,000 with the closest tertiary centre 400 kilometres. They have no intensive care specialist. In 2009 daily ward rounds were undertaken by an intensive care specialist Monday-Friday via a mobile wireless web-camera as part of a computer videoconferencing system. The telemedicine program reviewed near 220 patients per year in around 500 consultations. While the total number of annual admissions (522-590) increased during the study period, illness severity (APACHE II 15.2-15.9) and the proportions of deaths (8-9%) and transfers (11-13%) remained unchanged. ICU length of stay increased by 30 hours and SMRs fell (57% APACHE III-J, 20% APACHE II and 14% SAPS II). Increased local nursing resources were needed for the increased LOS. There is conflicting evidence as to the benefit of an objective improvement in care and even less that formally reviews the impact and contribution of ICU telemedicine to processes of care, the effects on unit staffing, hospital organisation and the health care region. However, the technology is available and being embraced by some, especially to deal with the tyranny of distance. Suggested Reading: 1. Boots R, Singh S, Tereblanche M, Widdecombe N, Lipman J. Remote Care for an ICU - many models of care can be effective Curr Opin Crit Care 2011;17:634-640 2. Morrison JL Cai Q, Davis N, Yan Y, Berbaum ML, Ries M, Solomon G. Clinical and economic outcomes of the electronic intensive care unit: results <strong>from</strong> two community hospitals. Crit Care Med 2010;38:2-8. 3. Young L, Chan PS, Lu X, Nallamothu BK, Sasson C, Cram PM. Impact of telemedicine intenisve care unit coverage on patient outcomes. Arch Intern Med 2011;171:498-506. 4. Lilly C, Cody S, Zhao H et al. Hospital mortality, length of stay, and preventable complications among criticallu ill patients before and after Tele-ICU re-engineering of critical care processes. JAMA, 2011. 305. 5. Thomas E, Lucke JF, Wueste L, Weavind L, Patel B. Association of telemedicine for remote monitoring of intensive care patients with mortality, complications, and length of stay. JAMA 2009;302:2671-2678. 6. Kahn J. Intensive care unit telemedicine: promises and pitfalls. Arch Intern Med 2011 54
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CRRT 2012 SEVENTEENTH INTERNATIONAL
Page 4 and 5: FACULTY DISCLOSURES CRRT 2012 Facul
Page 6 and 7: CRRT 2012 ORGANIZING COMMITTEE USA
Page 8 and 9: CRRT 2012 FACULTY Patrick Honoré,
Page 10 and 11: ACKNOWLEDGEMENTS CRRT 2012 ACKNOWLE
Page 12 and 13: PLENARY SESSIONS CRRT 2012 PROGRAM/
Page 18 and 19: WORKSHOPS CRRT 2012 PROGRAM/INDEX T
Page 20 and 21: WORKSHOPS CRRT 2012 PROGRAM/INDEX W
Page 22 and 23: POSTER ABSTRACTS C
Page 24 and 25: POSTER ABSTRACTS C
Page 26 and 27: NURSING FORUM LUNCHEON Communicatio
Page 28 and 29: Nutritional Support in ICU Patients
Page 30 and 31: Educational Objectives: The Endothe
Page 32 and 33: SPECIAL LECTURE Engineering Critica
Page 34 and 35: Nishimura R, Ornato JP, Page RL, Ri
Page 36 and 37: Do Vasoactive Drugs and Fluids Impr
Page 38 and 39: Blood Transfusions are Important fo
Page 40 and 41: Thinking Outside of the Box: A Nove
Page 42 and 43: Nursing Forum 2 Luncheon Benchmarki
Page 44 and 45: 4. Mori K, Lee HT, Rapoport D, Drex
Page 46 and 47: Differential Diagnosis of AKI: Can
Page 48 and 49: Myocardial Stunning and Brain Edema
Page 50 and 51: 4. Udy A, Roberts JA, Lipman J. Wha
Page 52 and 53: CRRT and ECMO: Techniques and Outco
Page 56 and 57: Avoiding Anticoagulation for CRRT:
Page 58 and 59: Improving Outcomes from</st
Page 60 and 61: The Changing Face of AKI: Snapshots
Page 62 and 63: Alkaline Phosphatase Peter Pickkers
Page 64 and 65: creatinine (Cr) was measured using
Page 66 and 67: Surveillance and Early Recognition
Page 68 and 69: therapy admitted to general intensi
Page 70 and 71: A01 Assessing the Microcirculation
Page 72 and 73: A01 Assessing the Microcirculation
Page 74 and 75: C03 Critical Care Pharmacology: Vas
Page 76 and 77: D04 Biomarkers 1: Principles and Ap
Page 78 and 79: 6. Ferguson JW, Dover AR, Chia S, C
Page 80 and 81: G07 Fluids and Solutions in the Cri
Page 82 and 83: A09 Vascular Access /Membrane and C
Page 84 and 85: A09 Vascular Access /Membrane and C
Page 86 and 87: C11 Critical Care Management: Nutri
Page 88 and 89: D12 Biomarkers 2: Application in AK
Page 90 and 91: Educational Objectives: E13 Liver a
Page 92 and 93: G15 Fluids and Solutions in the Cri
Page 94 and 95: Educational Objectives: 1) Discuss
Page 96 and 97: B18 Fluid Management Ravindra L. Me
Page 98 and 99: C19 Acid Base and Electrolyte Probl
Page 100 and 101: D20 Extracorporeal Techniques for S
Page 102 and 103: the mediatordelivery hypothesis. In
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F22 Ensuring Patient Safety and Qua
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H24 Patient Centered Care in the IC
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B26 Starting and Stopping RRT for A
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C27 Acid Base and Electrolyte Probl
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D28 Extracorporeal Techniques for S
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E29 Heart Failure and Cardio-Renal
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F30 Ensuring Patient Safety and Qua
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H32 Withdrawing & Withholding Suppo
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Patel SS, Holley JL. Withholding an
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