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SPEAKERS
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SALZBURG WEILL CORNELL SEMINAR ANESTHESIOLOGY AND INTENSIVE CARE Sunday, October 18 – Saturday, October 24, 2020 Schloss Arenberg, Salzburg, Austria

Course Director:
Hugh C. Hemmings Jr., MD, PhD, FRCA

Co-Course Director: Klaus Markstaller, MD Co-Course Director: Kane O. Pryor, MD Co-Course Director: Peter Marhofer, MD

SPEAKERS AND TOPICS:

Meghann M. Fitzgerald, MD

Assistant Professor of Clinical Anesthesiology Weill Cornell Medical College Assistant Attending Anesthesiologist NewYork-Presbyterian Hospital Weill Cornell Medicine Anesthesiology New York, NY USA

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Robotic Cardiac Surgery Blood Management in Cardiac Surgery TAAA Repair

Lukas Kirchmair, MD, PD, DESA, EDRA

Department of Anesthesiology and Intensive Care District Hospital Schwaz Schwaz Austria

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Polytrauma Management

Rudolf Likar, MD, MSc

Professor Head, Department of Anesthesiology and Intensive Care General Hospital Klagenfurt Klagenfurt am Woerthersee Austria

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Invasive Methods in Cancer Pain Invasive Methods in Low Back Pain

SPEAKERS
AND TOPICS

Peter Marhofer, MD

Professor of Anesthesia and Intensive Care Medicine Department of Anesthesia and Intensive Care Medicine Medical University of Vienna Vienna Austria

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Principles of Regional Anaesthesia I Principles of Regional Anaesthesia II Ultrasound in Anaesthesia and Intensive Care Medicine I Ultrasound in Anaesthesia and Intensive Care Medicine II

Rohan Panchamia, MD

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Resuscitation Ultrasonography Fluid Management Lung Ultrasound

Birgit Stoegermueller, MD

Department of Anesthesiology and Intensive Care District Hospital Schwaz Schwaz Austria

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Principles of Paediatric Anaesthesia

Sheida Tabaie, MD

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Management of Sepsis Prothrombin Complex Concentrates Respiratory Critical Care

SPEAKERS
AND TOPICS

Guenter Weiss, MD

Department of Internal Medicine II Infectious Diseases, Immunology, Rheumatology, Pneumology Medical University of Innsbruck Innsbruck Austria

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COVID-19: Past-Present-Future (streamed)

Additional Webinar Session:

BJA Webinar: Pain

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Recommended publications

COVID-19 Pneumonia: Different Respiratory Treatment for Different Phenotypes? L

Intensive Care Medicine EDITORIAL Un-edited accepted proof COVID-19 pneumonia: different respiratory treatment for different phenotypes? L. Gattinoni1, D. Chiumello2, P. Caironi3, M. Busana1, F. Romitti1, L. Brazzi4, L. Camporota5 Affiliations: 1Department of Anesthesiology and Intensive Care, Medical University of GöttinGen 4Department of Anesthesia, Intensive Care and Emergency - 'Città della Salute e della Scienza’ Hospital - Turin 5Department of Adult Critical Care, Guy’s and St Thomas’ NHS Foundation Trust, Health Centre for Human and Applied Physiological Sciences - London Corresponding author: Luciano Gattinoni Department of Anesthesiology and Intensive Care, Medical University of Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany Conflict of interests: The authors have no conflict of interest to disclose NOTE: This article is the pre-proof author’s accepted version. The final edited version will appear soon on the website of the journal Intensive Care Medicine with the following DOI number: DOI 10.1007/s00134-020-06033-2 1 Gattinoni L. et al. COVID-19 pneumonia: different respiratory treatment for different phenotypes? (2020) Intensive Care Medicine; DOI: 10.1007/s00134-020-06033-2 Intensive Care Medicine EDITORIAL Un-edited accepted proof The Surviving Sepsis CampaiGn panel (ahead of print, DOI: 10.1007/s00134-020-06022-5) recently recommended that “mechanically ventilated patients with COVID-19 should be managed similarly to other patients with acute respiratory failure in the ICU.” Yet, COVID-19 pneumonia [1], despite falling in most of the circumstances under the Berlin definition of ARDS [2], is a specific disease, whose distinctive features are severe hypoxemia often associated with near normal respiratory system compliance (more than 50% of the 150 patients measured by the authors and further confirmed by several colleagues in Northern Italy).
Intensive Care Medicine in 10 Years

BOOKS,FILMS,TAPES &SOFTWARE are difficult to read, the editing is inconsis- tory for critical care medicine. The book is initiate a planning process for leaders who tent, and the content that was omitted indi- divided into sections entitled “Setting the recognize the imperative for change and ad- cates that “efforts to bring this work from Stage,” “Diagnostic, Therapeutic, and In- aptation in critical care. Accordingly, I rec- conception to fruition in less than one year” formation Technologies 10 Years From ommend this book to individuals and groups (as stated in the book’s acknowledgments Now,” “How Might Critical Care Medicine engaged in all aspects of critical care man- section) prevented this book from being a Be Organized and Regulated?” “Training,” agement, now and in the future. “gold standard” text. and “The Critical Care Agenda.” Each sec- J Christopher Farmer MD tion consists of a series of essays/chapters Marie E Steiner MD MSc Department of Medicine that discuss various aspects of the topic, and Department of Pediatrics Mayo Clinic all the sections have solid scientific support Divisions of Pulmonary/ Rochester, Minnesota and bibliographies. The individual topics Critical Care and Hematology/ span the entire range of critical-care clinical Oncology/Blood and Marrow The author reports no conflict of interest related practice, administration, quality and safety, Transplantation to the content of this book review. and so forth. The contributors are acknowl- University Children’s Hospital, Fairview edged senior clinical and scientific leaders University of Minnesota Mechanical Ventilation: Physiological in critical care medicine from around the Minneapolis, Minnesota and Clinical Applications, 4th edition.
Intravenous Immunoglobulin Fails to Improve ARDS in Patients

Prohaska et al. Journal of Intensive Care (2018) 6:11 DOI 10.1186/s40560-018-0278-8 RESEARCH Open Access Intravenous immunoglobulin fails to improve ARDS in patients undergoing ECMO therapy Stefanie Prohaska1, Andrea Schirner1, Albina Bashota1, Andreas Körner1, Gunnar Blumenstock2 and Helene A. Haeberle1* Abstract Background: Acute respiratory distress syndrome (ARDS) is associated with high mortality rates. ARDS patients suffer from severe hypoxemia, and extracorporeal membrane oxygenation (ECMO) therapy may be necessary to ensure oxygenation. ARDS has various etiologies, including trauma, ischemia-reperfusion injury or infections of various origins, and the associated immunological responses may vary. To support the immunological response in this patient collective, we used intravenous IgM immunoglobulin therapy to enhance the likelihood of pulmonary recovery. Methods: ARDS patients admitted to the intensive care unit (ICU) who were placed on ECMO and treated with (IVIG group; n = 29) or without (control group; n = 28) intravenous IgM-enriched immunoglobulins for 3 days in the initial stages of ARDS were analyzed retrospectively. Results: The baseline characteristics did not differ between the groups, although the IVIG group showed a significantly reduced oxygenation index compared to the control group. We found no differences in the length of ICU stay or ventilation parameters. We did not find a significant difference between the groups for the extent of inflammation or for overall survival. Conclusion: We conclude that administration
Characteristics and Risk Factors for Intensive Care Unit Cardiac Arrest in Critically Ill Patients with COVID-19—A Retrospective Study

Journal of Clinical Medicine Article Characteristics and Risk Factors for Intensive Care Unit Cardiac Arrest in Critically Ill Patients with COVID-19—A Retrospective Study Kevin Roedl 1,* , Gerold Söffker 1, Dominic Wichmann 1 , Olaf Boenisch 1, Geraldine de Heer 1 , Christoph Burdelski 1, Daniel Frings 1, Barbara Sensen 1, Axel Nierhaus 1 , Dirk Westermann 2, Stefan Kluge 1 and Dominik Jarczak 1 1 Department of Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; [email protected] (G.S.); [email protected] (D.W.); [email protected] (O.B.); [email protected] (G.d.H.); [email protected] (C.B.); [email protected] (D.F.); [email protected] (B.S.); [email protected] (A.N.); [email protected] (S.K.); [email protected] (D.J.) 2 Department of Interventional and General Cardiology, University Heart Centre Hamburg, 20246 Hamburg, Germany; [email protected] * Correspondence: [email protected]; Tel.: +49-40-7410-57020 Abstract: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causing the coron- avirus disease 2019 (COVID-19) led to an ongoing pandemic with a surge of critically ill patients. Very little is known about the occurrence and characteristic of cardiac arrest in critically ill patients Citation: Roedl, K.; Söffker, G.; with COVID-19 treated at the intensive care unit (ICU). The aim was to investigate the incidence Wichmann, D.; Boenisch, O.; de Heer, and outcome of intensive care unit cardiac arrest (ICU-CA) in critically ill patients with COVID-19. G.; Burdelski, C.; Frings, D.; Sensen, This was a retrospective analysis of prospectively recorded data of all consecutive adult patients B.; Nierhaus, A.; Westermann, D.; with COVID-19 admitted (27 February 2020–14 January 2021) at the University Medical Centre et al.
Rapid Evidence Review

Rapid Evidence Review Clinical evidence for the use of intravenous immunoglobulin in the treatment of COVID- 19 Version 2, 14th May 2020 1 Prepared by the COVID-19 Evidence Review Group with clinical contribution from Dr. Niall Conlon, Consultant Immunologist, St. James Hospital, Dr. Mary Keogan, Clinical Lead National Clinical Programme for Pathology & Consultant Immunologist, Beaumont Hospital. Key changes between version 1 and version 2 (14th May 2020) A number of case reports describing the use of IVIG are included in this version and 2 additional studies which focused specifically on the use of IVIG in patients with COVID-19 – one case series and one retrospective cohort study (available as a pre-print). A number of guidelines have included a reference to IVIG, but the general consensus is not to use IVIG. The recent reports of Kawasaki Disease in children with COVID-19 highlight the role of IVIG and aspirin to treat this condition and supporting evidence of its benefit are available from 2 case reports and one case series. The COVID-19 Evidence Review Group for Medicines was established to support the HSE in managing the significant amount of information on treatments for COVID-19. This COVID-19 Evidence Review Group is comprised of evidence synthesis practitioners from across the National Centre for Pharmacoeconomics (NCPE), Medicines Management Programme (MMP) and the National Medicines Information Centre (NMIC). The group respond to queries raised via the Office of the CCO, National Clinical Programmes and the Department of Health and respond in a timely way with the evidence review supporting the query.
Surviving Sepsis Campaign Guidelines for COVID-19

DISCLAIMER. The information contained herein is subject to change. The final version of the article will be published as soon as approved on ccmjournal.org. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19) Waleed Alhazzani1,2, Morten Hylander Møller3,4, Yaseen M. Arabi5, Mark Loeb1,2, Michelle Ng Gong6, Eddy Fan7, Simon Oczkowski1,2, Mitchell M. Levy8,9, Lennie Derde10,11, Amy Dzierba12, Bin Du13, Michael Aboodi6, Hannah Wunsch14,15, Maurizio Cecconi16,17, Younsuck Koh18, Daniel S. Chertow19, Kathryn Maitland20, Fayez Alshamsi21, Emilie Belley-Cote1,22, Massimiliano Greco16,17, Matthew Laundy23, Jill S. Morgan24, Jozef Kesecioglu10, Allison McGeer25, Leonard Mermel8, Manoj J. Mammen26, Paul E. Alexander2,27, Amy Arrington28, John Centofanti29, Giuseppe Citerio30,31, Bandar Baw1,32, Ziad A. Memish33, Naomi Hammond34,35, Frederick G. Hayden36, Laura Evans37, Andrew Rhodes38 Affiliations 1 Department of Medicine, McMaster University, Hamilton, Canada 2 Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada 3 Copenhagen University Hospital Rigshospitalet, Department of Intensive Care, Copenhagen, Denmark 4 Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) 5 Intensive Care Department, Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia 6 Department of Medicine, Montefiore Healthcare
Best-Practice Igm- and Iga-Enriched Immunoglobulin Use in Patients with Sepsis

Nierhaus et al. Ann. Intensive Care (2020) 10:132 https://doi.org/10.1186/s13613-020-00740-1 REVIEW Open Access Best-practice IgM- and IgA-enriched immunoglobulin use in patients with sepsis Axel Nierhaus1,2* , Giorgio Berlot3, Detlef Kindgen‑Milles4, Eckhard Müller5 and Massimo Girardis6 Abstract Background: Sepsis is a life‑threatening organ dysfunction caused by a dysregulated host response to infection. Despite treatment being in line with current guidelines, mortality remains high in those with septic shock. Intrave‑ nous immunoglobulins represent a promising therapy to modulate both the pro‑ and anti‑infammatory processes and can contribute to the elimination of pathogens. In this context, there is evidence of the benefts of immuno‑ globulin M (IgM)‑ and immunoglobulin A (IgA)‑enriched immunoglobulin therapy for sepsis. This manuscript aims to summarize current relevant data to provide expert opinions on best practice for the use of an IgM‑ and IgA‑enriched immunoglobulin (Pentaglobin) in adult patients with sepsis. Main text: Sepsis patients with hyperinfammation and patients with immunosuppression may beneft most from treatment with IgM‑ and IgA‑enriched immunoglobulin (Pentaglobin). Patients with hyperinfammation present with phenotypes that manifest throughout the body, whilst the clinical characteristics of immunosuppression are less clear. Potential biomarkers for hyperinfammation include elevated procalcitonin, interleukin‑6, endotoxin activity and C‑reactive protein, although thresholds for these are not well‑defned. Convenient biomarkers for identifying patients in a stage of immune‑paralysis are still matter of debate, though human leukocyte antigen–antigen D related expression on monocytes, lymphocyte count and viral reactivation have been proposed. The timing of treatment is potentially more critical for treatment efcacy in patients with hyperinfammation compared with patients who are in an immunosuppressed stage.
Recommendations for End-Of-Life Care in the Intensive Care Unit: a Consensus Statement by the American College of Critical Care Medicine

Special Articles Recommendations for end-of-life care in the intensive care unit: A consensus statement by the American College of Critical Care Medicine Robert D. Truog, MD, MA; Margaret L. Campbell, PhD, RN, FAAN; J. Randall Curtis, MD, MPH; Curtis E. Haas, PharmD, FCCP; John M. Luce, MD; Gordon D. Rubenfeld, MD, MSc; Cynda Hylton Rushton, PhD, RN, FAAN; David C. Kaufman, MD Background: These recommendations have been developed to to die, and between consequences that are intended vs. those that improve the care of intensive care unit (ICU) patients during the are merely foreseen (the doctrine of double effect). Improved dying process. The recommendations build on those published in communication with the family has been shown to improve pa- 2003 and highlight recent developments in the ﬁeld from a U.S. tient care and family outcomes. Other knowledge unique to end- perspective. They do not use an evidence grading system because of-life care includes principles for notifying families of a patient’s most of the recommendations are based on ethical and legal death and compassionate approaches to discussing options for principles that are not derived from empirically based evidence. organ donation. End-of-life care continues even after the death of Principal Findings: Family-centered care, which emphasizes the patient, and ICUs should consider developing comprehensive the importance of the social structure within which patients are bereavement programs to support both families and the needs of embedded, has emerged as a comprehensive ideal for managing the clinical staff. Finally, a comprehensive agenda for improving end-of-life care in the ICU.
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This article has been retracted: please see INNOVATIONS in pharmacy retraction policy (https://pubs.lib.umn.edu/index.php/innovations/policies). This article has been retracted by the Editor and Publisher due to the inappropriate use of previously published work. Commentary PHARMACY PRACTICE Pharmacists in Critical Care AK Mohiuddin, Assistant Professor Department of Pharmacy, World University of Bangladesh, Bangladesh Abstract The beginnings of caring for critically ill patients date back to Florence Nightingale’s work during the Crimean War in 1854, but the subspecialty of critical care medicine is relatively young. The first US multidisciplinary intensive care unit (ICU) was established in 1958, and the American Board of Medical Subspecialties first recognized the subspecialty of critical care medicine in 1986. Critical care pharmacy services began around the 1970s, growing in the intervening 40 years to become one of the largest practice areas for clinical pharmacists, with its own section in the SCCM, the largest international professional organization in the field. During the next decade, pharmacy services expanded to various ICU settings (both adult and pediatric), the operating room, and the emergency department. In these settings, pharmacists established clinical practices consisting of therapeutic drug monitoring, nutrition support, and participation in patient care rounds. Pharmacists also developed efficient and safe drug delivery systems with the evolution of critical care pharmacy satellites and other innovative programs. In the 1980s, critical care pharmacists designed specialized training programs and increased participation in critical care organizations. The number of critical care residencies and fellowships doubled between the early 1980s and the late 1990s. Standards for critical care residency were developed, and directories of residencies and fellowships were published.
Chronic Critical Illness: Are We Saving Patients Or Creating Victims?

REVIEW ARTICLE Sergio Henrique Loss1,2, Diego Silva Leite Nunes1, Oellen Stuani Franzosi1,3, Gabriela Soranço Chronic critical illness: are we saving patients or Salazar4, Cassiano Teixeira5, Silvia Regina Rios Vieira1,2,6 creating victims? Doença crítica crônica: estamos salvando ou criando vítimas? 1. Postgraduate Program in Medical Sciences, ABSTRACT metabolism, show immunodeficiency, Faculdade de Medicina, Universidade Federal do consume substantial health resources, Rio Grande do Sul - Porto Alegre (RS), Brazil. The technological advancements have reduced functional and cognitive 2. Intensive Care Unit, Hospital de Clínicas de that allow support for organ dysfunction Porto Alegre - Porto Alegre (RS), Brazil. capacity after discharge, create a sizable 3. Department of Nutrition, Hospital de Clínicas have led to an increase in survival rates workload for caregivers, and present high de Porto Alegre - Porto Alegre (RS), Brazil. for the most critically ill patients. Some long-term mortality rates. The aim of this 4. Department of Nutrition, Hospital Mãe de of these patients survive the initial acute review is to report on the most current Deus - Porto Alegre (RS), Brazil. critical condition but continue to suffer evidence in terms of the definition, 5. Faculdade de Medicina, Universidade Federal from organ dysfunction and remain in de Ciências da Saúde de Porto Alegre - Porto pathophysiology, clinical manifestations, Alegre (RS), Brazil. an inflammatory state for long periods of treatment, and prognosis of persistent 6. Department of Internal Medicine, Universidade time. This group of critically ill patients critical illness. Federal do Rio Grande do Sul - Porto Alegre (RS), has been described since the 1980s and Brazil. has had different diagnostic criteria over Keywords: Critical illness; the years.
Preoperative Anaesthesiologic

Psychiatria Danubina, 2019; Vol. 31, Suppl. 5, pp S745-S749 Medicina Academica Mostariensia, 2019; Vol. 7, No. 1-2, pp 23-27 Review © Medicinska naklada - Zagreb, Croatia PREOPERATIVE ANAESTHESIOLOGIC EVALUATION OF PATIENT WITH KNOWN ALLERGY Željko ýolak1, Mario Pavlek1, Mirabel Mažar1, Sanja Konosiü1, Višnja Ivanþan & Milenko Bevanda2 1University of Zagreb, School of Medicine, Department of Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Zagreb, Zagreb, Croatia 2University of Mostar, School of Medicine, Mostar, Bosnia and Herzegovina received: 13.9.2019; revised: 23.10.2019; accepted: 28.11.2019 SUMMARY Anaphylaxis is an unanticipated systemic hypersensitivity reaction which can produce deleterious effects, even death, if not treated promptly. Preventive approach implies taking a thorough anamnesis with the emphasis on previously diagnosed allergies. If an allergic reaction occurred during previous surgery, a detailed documentation of administered anaesthetic agents and drugs would be crucial for the following anaesthesiologic management. Preoperative planning and avoiding cross-reactivity with drugs commonly used during anaesthesia are the key points to prevent an anaphylaxis. In case of emergency surgery when the exact identification of allergens is not possible, premedication prophylaxis should be considered. General measures for prevention of anaphylaxis could be undertaken as well, such as the choice of anaesthesiologic drugs and techniques in the operating theatre adequately equipped for the management
Cardiothoracic Critical Care

Cardiothoracic Critical Care a, b c Kevin W. Lobdell, MD *, Douglas W. Haden, MD , Kshitij P. Mistry, MD KEYWORDS Critical care Cardiothoracic surgery Quality Safety Value KEY POINTS High-value cardiothoracic critical care (CCC) is rapidly evolving to meet the demands of increased patient acuity and to incorporate advances in technology. The high-performing CCC system and culture should aim to learn quickly and continu- ously improve. CCC demands a proactive, interactive, precise, and expert team, as well as continuity. CARDIOTHORACIC DISEASE AND THERAPY Incidence and Prevalence Acquired heart disease is the leading cause of death in the United States, with 611,106 deaths forecasted for 2016; it affects 11.5% of the population and is estimated to result in 3.7 million hospitalizations annually with an average stay of 4.6 days.1 Approx- imately 152,000 coronary artery bypass (CAB) operations were recorded in the Society of Thoracic Surgeons-Adult Cardiac Database (STS-ACSD) in 2015, while approxi- mately 600,000 cardiac surgical procedures were expected to be performed in 2016.2 Congenital heart disease affects approximately 40,000 children annually in the United States, and 25% of those require surgery in their first year of life.3 8.5% of adults will have a diagnosis of cancer in their lifetime, and cancer was fore- casted to claim 584,881 lives in 2016 (the second most common cause of death in the United States).4 Furthermore, the American Cancer Society estimated 224,390 new cases of lung cancer in the United States for 2016 and 158,080 deaths (which ac- counts for approximately 25% of cancer deaths).5,6 The American Cancer Society also forecasted 16,910 new cases and 15,690 deaths from esophageal cancer in the United States for 2016 (approximately 20% of patients survive 5 years or more after diagnosis, a four-fold improvement over the last 40 years).7,8 The authors have nothing to disclose.