Colours of Sepsis is one of the most favourite events, which are organized in the Czech republic for wide group of specialists in anaesthesiology and intensive care medicine. This congress is focused on problems with infection and sepsis in ICU and how to deal with it. Here are some news which you might be interested in.
One of the foreign speakers on tuesday morning was Sándor Molnár, MD. from Szeged, Hungary. The audience was completely charmed, because he is respected specialist and grateful speaker. His presentanion was focused on sepsis, its new definition, early recognition and treatment. Like he said :
This means that the most important thing is to treat organ dysfunction and infection, not the "sepsis". You should always pay attention to the clinical state and not focus only on laboratory or other measured numbers. If you want to know more about this problem, you should visit SepsEast conference which will be hold in Budapest, in November 2018.
Hot topics in intensive care section begun again with Dr. Molnár and his lecture on Sepsis and Love. He explained, that love and sepsis have a lot in common as love resembles a system inflammatory response. He continued with patophysiological background of sepsis, introduced the topic of damage associated mollecular pattern and pathogen associated mollecular pattern and their similarities. He suggested, that we should define health as a balance of antagonistic forces such as coagulation and anticoagulation, acid and base, oxidants and antioxidants. At the end, he mentioned the difficulty of determination whether a patient with severe inflammatory response has an infection focus, or not and emphasised the role of biomarkers, mainly procalcitonine that can help us realize a patient is getting septic. Second lecture was on ECMO: a breakthrough in care for respirátory failure by Dr. Müller from Germany. In the introduction he emphasised that ARDS has still a very high mortality rate and we need to create effective guidelines for it´s treatment. He used a case report from his clinic to ilustrate ECMO´s effects and indications. He informed us about the potential risks of ECMO and listed what an ECMO center should have in order to work efficiently and safely. Last lecture “Intense nutrition for the critical times - can we afford not to get it right?“ was presented by Dr. Wallace from Netherlands. He explained the basics of health economics, it´s ways to determine effectivenes of treatment. Later Dr. Wallace introduced benefits of nutritional products, which are expensive but can prevent patient from infection which can shorten the hostpitalisation time and in a long run save money.
Dr. Gattinoni from Goettingen (one of the most known specialist on ARDS) made for us a lecture on topic ,,How ARDS should be treated in 2017.” At the beginning of the lecture he supported relaxed atmosphere, when he said:
He got on with dividing ARDS in three ranks - mild, moderate and severe. His sentence, “More force leads to bigger demage.”, reflects the essence of proper treatment of ARDS. He showed us visually how the breath frequency, PEEP and breath volume affect the force on pulmonary parenchyma. He recommended us to use prone position for severe ARDS. In the end he repeated his opening sentence - doubt everything. Dr. Müller from Regensburg continued with topic Protective ventilation in ARDS. He started reminding, that it is necessary to distinguish the pulmonary and extrapulmonary acute respiratory distress syndrome. Both kinds are different in etiology, clinical course and mortality. We can see significant increase of interleukins and unfortunately also higher mortality in extrapulmonary cases. We paid attention to therapy too. Dr. Müller told us, that surfactant increase saturation, but doesn´t increase the resultant outcome, so it isn´t indicated for adults. Dr. Plamer from Stockholm tried to show us his approach to ARDS - when I should decide for ECMO? He tried to encourage us to use this method. He showed us on a some cases, how patients can live more than 60 days with EMCO without big limitations. These patients can be consciousness and make easier nursing care. After that he discussed on a topic indications and contraindications of EMCO. Indications include septic shock, ARDS, severe pneumonia and many others. He said goodbye to us, claiming that we really don´t need to fear extracorporal membrane oxygenation.
That´s all from Ostrava. And see you on other AKUTNĚ.CZ actions.