Programa version Español

English version program

International forum on the use of ultrasound (US) for hemodynamic and pulmonary monitoring in the critically ill patient

FICC international forum in critical care is proud the present the First International forum on the use of ultrasound (US) for hemodynamic and pulmonary monitoring applied to the critically ill patient, Bogotá, Colombia 2017.  International experts and hands-on experience with life models will guide the attendant into the new hemodynamic and pulmonary monitoring tools available with US. Some of this experts (Prof Daniel De Backer, Prof. Paul Mayo) have being in our blog previously (Echocardiography for Hemodynamic Monitoring 2015, Brussels, Belgium, November 2015 Comprehensive summary).

The differences between this course and other local courses is that it specifically applies to critically ill patients and that all the speakers are currently engaged with treating ICU patients. This makes a big difference for the intensivist as he/she can relate and thus increase attention and will to learn.

Another big objective of the course as that the attendant will be able to use the ultrasound machine the next day at work when he/she is confronted with a difficult case. The course is planned for 50 people only, in order the ensure that the attendee learns to proper skills to monitor the hemodynamic and pulmonary variables in his/her critically ill patient. These new techniques are not invasive, available at the bedside and cost-effectives as the intensivist can initiate the proper treatment fast. The course also includes hemodynamic and pulmonary monitoring in specific ICU populations not seen in the ED or in the operating room, such as patients with ARDS and post-cardiac surgery shock.
Lastly, the course also includes lunches and refreshments and the opportunity the share with others at the FICC lounge-party.

Join us for a three day course on ultrasound-based hemodynamic and pulmonary monitoring applied to critically ill patients.

Registrations starts in January 2017
Pre-registration: intforumcc@gmail. Request your pre-registration form and reserve your place.First come first served.

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English version

First international forum on the use of ultrasound (US) for hemodynamic and pulmonary monitoring applied to the critically ill patient

Bogota, Colombia 2017

Thursday, April 27th

8:30 am: Welcome message and presentation of the course.

Dr. Carlos A. Santacruz H. (Colombia)

Basic concepts

8:35 – 8:55 am: Physical principles of ultrasound.

Dr. Carlos A. Santacruz H. (Colombia)

9:00-9:45 am: Transthoracic and Transesophageal echocardiography: indications and planes.

Prof. Daniel De Backer (Belgium)

9:50-10:35 am: Lung and pleural ultrasound: Indications and planes.

Prof. Paul Mayo (USA)

10:35-10:55: Refreshment Break.

11:00-12:30 pm: Ultrasound workshop:

Group 1: Transthoracic echocardiography: parasternal short axis and long axis, apical 2-4-5 chamber and subcostal basic views.

Group 2: Assessment of inferior vena cava: B and M mode to measure inferior vena cava diameter and respiratory variations.

Group 3: Basic lung and pleural ultrasound: Lung sliding and A profile.

Group 4: Emergency abdominal ultrasound: Eco Fast.

Group 5: Lower Limbs ultrasound: B mode common and superficial femoral, saphenous and deep veins, femoral common superficial and deep arteries, popliteal vein and artery.

12:30-1:55 pm: Lunch.

2:00 – 2:40 pm: Echocardiographic assessment of a patient in hemodynamic shock.

Prof. Daniel De Backer (Belgium)

2:45- 3:30 pm: Lung and pleural ultrasound evaluation of ultrasound in patients with acute respiratory failure.

Prof. Paul Mayo (USA)

3:30 – 4:00 pm: Refreshment break.

4:00 – 6:pm: Free access to hands-on.

Friday, April 28th

8:30 – 9:15 am: Prediction and evaluation of fluid responsiveness

Prof. Paul Mayo (USA)

9:20 – 10:00 am: Echocardiographic evaluation of a patient with pulmonary embolism.

Dr. Carlos A. Santacruz H. (Colombia)

10:05 – 11:05 Pros/cons debate

- The left ventricle ejection fraction is useful [DDB1] in the ICU: cardiologist’s point of view.

            Dr. Patrick Zampaio (Brasil)

-  The left ventricle ejection fraction is not useful in the ICU: intensivists point of view.

           Prof. Daniel De Backer (Belgium)

11:10 – 11:55:  Diastolic evaluation of the left ventricle with emphasis on fluid responsiveness.

Dr. Antoine Herpain (Belgium)

12:00 – 1:25 pm: Lunch.

1:30 – 2:30 pm: Live case presentations.

Prof. Daniel De Backer (Belgium) – Prof. Paul Mayo (USA)

2:35 – 3:05 pm: Refreshment break.

3:10 – 6:00 pm: Ultrasound workshop:

Group 1: Measurement of cardiac output (LVOT diameter, LV VTI, stroke volume).

Group 2: Measurement of LVEF.

Group 3: Left ventricle diastolic function: A, E, E/A, E/É waves.

Group 4: Right ventricle: normal shapes, TAPSE.

Group 5: Tricuspid, mitral and aortic valves: basic views.

Saturday, April 29th

8:30 – 9:00 am: Echocardiographic evaluation of patients with Mechanical complications of Acute Myocardial Infarction.

Dr. Patrick Zampaio (Brasil)

9:05 – 9:35 am: Focused echocardiographic evaluation of a patient during  cardiopulmonary resuscitation

Dr. Antoine Herpain (Belgium)

9:40 – 10:10 am: Echocardiographic evaluation of a patient in shock post cardiac surgery.

Dr. Patrick Zampaio (Brasil)

10:15 – 10:45 am: Heart-Lung interactions.

Prof. Paul Mayo (USA)

10:50 – 11:20 am: Management of a patient with septic shock

Prof. Daniel De Backer (Belgium)

11:25 – 11:55 am: Echocardiographic evaluation of a patient with ARDS.

Prof. Paul Mayo (USA)

12:00 – 12:30 am: The role of echocardiography in a patient under Extra-Corporeal Membrane Oxygenation (ECMO).

Prof. Daniel De Backer (Belgium)

12:35 – 1:05: Utility of recent echocardiographic tools in the ICU: introduction to 2D strain and speckle tracking imaging.

Dr. Antoine Herpain (Belgium)

1:10 – 1:30 Key messages and conclusions.

Dr. Carlos A. Santacruz H. (Colombia)

Versión Español

Primer foro Internacional

Uso de ultrasonografía para la monitorización hemodinámica y pulmonar aplicada al paciente crítico

Día 1: 27 de abril 2017

8:30 am: Bienvenida al curso.

Dr. Carlos A. Santacruz H. (Colombia)

Conceptos básicos

8:35 – 8:55 am: Principios físicos de la ultrasonografía.

Dr. Carlos A. Santacruz H. (Colombia)

9:00-9:45 am: Indicaciones y planos básicos de ecocardiografía tras-torácica y tras-esofágica.

Prof. Daniel De Backer (Bélgica)

9:50-10:35 am: Indicaciones y planos básicos de ultrasonografía pulmonar y pleural.

Prof. Paul Mayo (USA)

10:35-10:55: Descanso

11:00-12: pm: Taller de ultrasonografía básica (Todos)

Grupo 1: Ecocardiografía trastorácica, ventanas básicas: paraesternal eje corto y largo, apical 2-4 cámaras y sub-xifoideo.

Grupo 2: Valoración de la vena cava inferior: medición del diámetro en modo B, variación del diámetro en modo M.

Grupo 3: Ultrasonografía pulmonar y pleural:  Lung sliding, Perfil A,B y C, lung point

Grupo 4: Ultrasonografía abdominal en urgencias: Eco Fast.

Grupo 5: Ultrasonografía de miembros inferiores: Venas femoral común, superficial, safena y venas profundas, Arteria femoral común, superficial y profundas, arteria y vena poplítea.

12:30-1:55 pm: Almuerzo

2:00 – 2:40 pm: Valoración ecocardiográfica del paciente en choque.

Prof. Daniel De Backer (Bélgica)

2:45- 3:30 pm: Valoración ultrasonográfica pulmonar y pleural del paciente en insuficiencia respiratoria aguda.

Prof. Paul Mayo (USA)

3:30 – 4:00 pm: Descanso.

4:00 – 6:pm: Acceso libre a hands-on.

Día 2: abril 28 2017

8:30 – 9:15 am: Valoración ecocardiográfica de la predicción y evaluación de respuesta a fluidos.

Prof. Paul Mayo (USA)

9:20 – 10:00 am: Uso de la ecocardiografía para valoración del paciente con trombo-embolismo pulmonar masivo.

Dr. Carlos A. Santacruz H

10:05 – 11:05 Debate pro/con

-       La FEVI si sirve en cuidados intensivos: la visión del cardiólogo.

-       Dr. Patrick Zampaio (Brasil)

-       La FEVI no sirve en cuidados intensivos: la visión del intensivista.

Prof. Daniel De Backer (Bélgica)

11:10 – 11:55:  Valoración ecocardiográfica de la función diastólica con énfasis en la predicción a respuesta a fluidos.

Dr. Antoine Herpain (Bélgica)

12:00 – 1:25 pm: Almuerzo

1:30 – 2:30 pm: presentación de casos en vivo.

Prof. Daniel De Backer (Bélgica) – Prof. Paul Mayo (USA)

2:35 – 3:05 pm: Descanso.

3:10 – 6:00 pm: Taller de ultrasonografía (Todos)

Grupo 1: Estimación del gasto cardiaco (LVOT, LV VTI, volumen sistólico).

Grupo 2: Estimación de la FEVI: Método Simpson.

Grupo 3: Valoración ecocardiográfica de la función diastólica: onda E, A, E/A, E/É.

Grupo 4: Valoración ecocardiográfica del VD: vista normal, TAPSE.

Grupo 5: Valoración ecocardiográfica básica del aparato valvular: Doppler color VM, VT, VA.

Día 3: abril 29 2017

8:30 – 9:00 am: Evaluación ecocardiográfica del infarto agudo de miocardio.

Dr. Patrick Zampaio (Brasil)

9:05 – 9:35 am: Valoración ecocardiográfica del paciente en paro cardiaco.

Dr. Antoine Herpain (Bélgica)

9:40 – 10:10 am: Valoración ecocardiográfica del paciente en choque post cirugía cardiaca.

Dr. Patrick Zampaio (Brasil)

10:15 – 10:45 am: Interacciones corazón-pulmón.

Prof. Paul Mayo (USA)

10:50 – 11:20 am: Manejo del paciente en choque séptico.

Prof. Daniel De Backer (Bélgica)

11:25 – 11:55 am: Valoración ecocardiográfica del paciente con SDRA.

Prof. Paul Mayo (USA)

12:00 – 12:30 am: Uso de la ecocardiografía para el paciente en circulación extra-corpórea (ECMO).

Prof. Daniel De Backer (Bélgica)

12:35 – 1:05: Utilidad de nuevas herramientas eco cardiográficas para pacientes en cuidados intensivos: introducción al 2D-strain  y speckle tracking imaging.

Dr. Antoine Herpain (Bélgica)

1:10 – 1:30 Conclusiones y mensajes claves.

Dr. Carlos A. Santacruz H

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Echocardiography for Hemodynamic Monitoring 2015

Brussels, Belgium, November 2015

Comprehensive summary

An International group of experts came together in Brussels for the hemodynamic monitoring using Echocardiography in the intensive care unit (ICU) course. Echocardiographic evaluation of patients in shock states constitutes a new field of research for both intensivists and critical care cardiologists. Here, a comprehensive review and photos of key lectures.

Prof. Paul May(New York, USA), Fluid responsiveness. "In New York, we keep it simple"

Many techniques exists to evaluate fluid responsiveness ( RVEDV less than 90 ml/m2 ; LVEDA of less than 10cm² or a LVEDA index (LVEDA / BSA)) of less than 5.5cm²/m² ; LVOT VTI variation (peak systolic velocity  > 13%), variations of IVC ( 1 cm caudal from its junction with the hepatic vein)) >12%, variations of SVC (>36%), kissing papillar muscle sign, Passive leg elevation to 45° induced increase in LVOT VTI by > 12.5% (500ml over 15minutes) that may indicate significant hypovolaemia. However, many of these or bound to intrinsic problems (passive MV) and thus a combination or trends of individual values is preferred to evaluate fluid responsiveness. The "mini" (100 ml of crystalloid) fluid challenge and changes in LVOT VTI could be an interesting option.

Prof Daniel DeBacker (Brussels, Belgium), septic cardiomyopathy. "The use of ECMO for cardiac failure after septic shock is very rare"

Septic cardiomyopathy is a complication of patients with severe sepsis that has no definitive diagnostic criteria or pathophysiological hallmarks. We may say that it is a cardiac complication that, if the patients survives, is normally completely reversible.  Also, it is present in up to 2/3 of patients and comprises a systolic and diastolic dysfunction of the right and left ventricle. The measurement of an EF < 45% (with no prior cardiac dysfunction) along with clinical and biomarkers are proposed as diagnostic criteria. However, patients with normal EF can have low cardiac index, and, inversely, patients with low EF may have normal CI. Echocardiographic evaluation may also help to distinguish other complications such as endocarditis, cardiac valve destruction with secondary mitral or aortic regurgitation.

Prof. Antoine Vieillard-Baron, Paris, France: Right ventricular failure ."Right ventricular breathing"

It is clear now that the higher the tidal volume (Vt), the higher the risk of acute for pulmonate (ACP). Individualized mechanical ventilation thresholds should target low driving pressures (DP 17 cmH20) and avoid hypercapnia (recruitment?). Open lung strategies reduce pulmonary vascular resistance (PVR) and aid the right ventricle. Echocardiographic anomalies related to right ventricular failure include dilation as a first phenomenon ( RVEDV/LVEDV > 0.6, lost of triangular shape, RV apex higher than LV apex), then doppler abnormalities (RV S´ wave < 10 cm/s, TAPSE < 12 mm) and finally septal bowing to the LV). Evaluation of the RV echocardiographic characteristics may help to set up the mechanical ventilation parameters in patients with ARDS or RV failure due to RV myocardial infarction. 

Prof. Anthony McLean.  The intensivist’s point of view. "We should take ICU-Echo to the next level"

On a personal note, i think that consolidation of ICU-echocardiography as a speciality is necessary. Many societies world-wide have validated Intensivist-operated echocardiographic evaluation of cardiac parameters that may aid in the hemodynamic management. For the to be possible, a echo machine is required in every ICU. Second, proper training and evaluation of skills is necessary to maintain competence. Lastly, a fast field of research is open thanks to the introduction of echo-labs and newer technology able to reduce inter-operator variability (thanks to automatization) and improve imagine (e.g.contrasts).

 

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