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C I C M A N N U A L S C I E N T I F I C M E E T I N G
CICM2021
V I R T U A LA S M1 s t - 3 r d J U N E 2 0 2 1
R E S P I R A T O R Y
cicm2021asm.delegateconnect.co
#VIRTUALASM2021 #CICM2021ASM
ASM HANDBOOK
MAJOR SPONSOR
For further information and bookings, please contact | Stephanie Gershon | CICM Conference Organiser | 03 9514 2888 | cicm2021asm.delegateconnect.co2
CICM 2021 ASM ORGANISING COMMITTEE 3
WELCOME MESSAGE
• CICM President 4
• CICM 2021 ASM Convener 5
2021 ASM SPONSORS 7
ASM VIRTUAL PROGRAM
• Scientific program 14
• Concurrent and sponsor presentations 17
• Breakfast sessions 21
• Welfare special interest group 21
SPEAKERS
International 23
Australia & Aotearoa New Zealand 27
NEW FELLOWS 34
WHATS ON
• Virtual Social Event: A Night on Broadway 36
• Exhibition Prize Draw 36
EDUCATIONAL & TRAINING SUPPORT 37
EXHIBITION ZONE 38
GENERAL INFORMATION 39
INVITED SPEAKERS’ ABSTRACTS 40
CONTENTS
C I CM 2021 A SM ORGAN IS ING COMMIT TEEASM CONVENERS
Dr Bronwyn Avard
Professor Andrew Udy
SCIENTIFIC COMMITTEE
Dr Allan Beswick
A/Professor Shailesh Bihari
Dr Lewis Campbell
Dr Subodh Ganu
Dr Angelly Martinez
Dr Priya Nair
Dr Paul Young
Dr Kim Yaw
COMMITTEE
Stephanie Gershon
Dr Jess Morgan
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Welcome to the CICM 2021 ASM On behalf of the Board, I extend a warm welcome to all Fellows, trainees and other delegates to the 2021 Virtual Annual Scientific Meeting of the College of Intensive Care Medicine of Australia and Aotearoa New Zealand, our first CICM ASM in a virtual format.
Respiratory: the theme for our 2021 ASM: The Australia and Aotearoa New Zealand organising committee led by Dr Bronwyn Avard and Prof Andrew Udy have created an exciting program that promises to be inspiring and educational. This virtual arena has given us the opportunity to engage with a broad range of international and binational experts as speakers as well as allowing delegates from around the world the opportunity to attend.
Over the next three days, the ASM will provide us with an extensive and diverse program, addressing issues relating to the COVID-19 pandemic, with a national and international perspective and also provide a broader range of respiratory topics relevant to both adult and paediatric intensive care. Other sessions explore survivorship and cultural issues, climate and critical illness, staff wellbeing – critical caring, the right heart as the third lung post ICU and mechanical ventilatory support.
The format includes short presentations, a pro/con debate, breakfast sessions, concurrent & sponsor presentations, live interactive Q&A plus a virtual social event Ä Night on Broadway. We ask you to take the time to visit the virtual Exhibition Zone where you can engage with sponsors and industry representatives and College staff and enter the daily draw to win
an amazing indigenous painting. The interactive sessions, networking rooms and social event provide a much needed opportunity to connect with friends and colleagues and to come together as a community when It’s not possible to meet in-person. A designated host will introduce the program each day and the presentations will be available on demand for a further 12 months.
I would like to acknowledge the time and effort of all who have contributed to this conference and express the sincere appreciation of the Board. In particular I would like to thank Bronwyn Avard, Andrew Udy, Subodh Ganu along with all the members of the organising committee; the keynote speakers from home and abroad; all the presenters, session chairs and the Welfare Special Interest Group. My thanks also go to all our sponsors in particular Pfizer who have joined us for our 10th ASM. I would also like to acknowledge Stephanie Gershon and the CICM staff for their hard work and creativity in preparing such an exciting interactive program in a new format in such a difficult time for us all.
I thank you for your participation and trust that you will enjoy a relevant, engaging and educational meeting. Welcome to the 2021 CICM Virtual ASM.
Dr Mary Pinder PRESIDENT The College of Intensive Care Medicine of Australia and New Zealand
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C I CM P RESIDENT ’S WELCO ME MESSAGE
Welcome to our first ever virtual Annual Scientific Meeting for the College of Intensive Care Medicine of Australia and New Zealand. We are spending three days focusing on the respiratory system and the role of the lungs in critically ill children and adults.
Given the attention for many of us over the past eighteen months has been firmly on the pandemic, COVID will certainly be front and centre in the program. We will spend some time on our first day exploring the responses and experiences of our community during this time across different settings. We will have the opportunity to hear from some of the researchers that moved so quickly to build the evidence to support frontline clinicians in their management of this novel infectious threat, and also hear from the consumers themselves of their experience and perspective at this time.
COVID will not be our only topic however. We have a huge lineup of national and international speakers who will take us through some of the latest diagnostic techniques, treatment options for both common and less common conditions, and debate some of the controversies that continue to face us every day. We have a session on the second day dedicated to rapid fire updates that will be delivered by some of our senior trainees and junior fellows, and we have a session dedicated specifically to longer term outcomes for our patients and their families. There is some time on the second day that allows for reflection on what we may have learnt from our experiences over the past year, especially in relation to the systems in which we work, data science and how we can continue to deliver high quality education despite considerable barriers.
We know the lungs do not work in isolation, and to this end we have a session on our final day focused on heart-lung interactions, including ultrasound, pulmonary
hypertension and thromboembolic disease. With the rising use of extra-corporeal organ support techniques across the world, we have also dedicated some time in the program to focus specifically on ECMO. Paediatric ICU is considered throughout the ASM, with a presentation dedicated to the care of critically ill children scheduled in almost every session.
Our experience over the past year has also emphasized for many of our Fellowship, the importance of our own wellbeing and mental health. To this end we have dedicated a whole session in the program to Clinician Health, but have also scattered reminders of self care throughout the three days. There are opportunities to join us in yoga and Qigong during the lunch break, guided mindful meditation before starting the day and of course our social event on Wednesday evening where you will have the best seats in the house!
We encourage you to celebrate the achievement of our graduating Fellows who are joining our community of practice in a slightly different setting this year. Some will have the opportunity to recognise this in person through local unit and network events during the course of the ASM.
On behalf of the 2021 ASM committee, we hope you enjoy this novel experience of a virtual Annual Scientific Meeting.
Dr Bronwyn Avard & Professor Andrew Udy 2021 ASM Co-Conveners
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C I CM 2021 A SM COMMIT TEE WELCO ME MESSAGE
Pfizer Anti-Infectives has undertakento prioritise research, education anddrug development initiativesdesigned to help address the criticalneed for novel antimicrobialmedicines, a better understanding ofbacterial antibiotic resistance andprojects to enhance antimicrobialstewardship. Find out more atpfizerconnect.com.au
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© 2021 Pfizer Australia Pty Ltd. Sydney, Australia. All rights reserved.Medical Information: 1800 675 229. Product Information is available at www.pfizer.com .au.PP-CRB-AUS-0030. 04/21.
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Every day, Pfizer colleagues work to provide improved health outcomes by supporting preventions, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as a World leading biopharmaceutical company, we collaborate with health care providers, governments and local communities to support and expand access to reliable and affordable health care for the community.
Pfizer Anti-Infectives has undertaken to prioritise research, education and drug development initiatives designed to help address the critical need for novel antimicrobial medicines, a better understanding of bacterial antibiotic resistance and projects to enhance antimicrobial stewardship.
https://www.pfizer.com.au/
MAJOR SPONSORS
The College of Intensive Care Medicine of Australia and New Zealand would like to thank Pfizer for their continued support as our major sponsor for the past 10 years.
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2021 A S M SPONSORSThe College of Intensive Care Medicine of Australia and New Zealand would like to thank our sponsors for their support of our virtual event.
PREMIUM SPONSORS
Since 1992, Device Technologies has been dedicated to improving patients’ lives through leading edge technology and services. Successfully supplying hospitals and healthcare professionals with the finest medical solutions for their patients, we continue to grow, with over 200 trusted brands and over 950 highly skilled staff throughout Australia, New Zealand and South East Asia.
Pioneering possibility is at the epicentre of what we do. We strive for innovation, collaboration, taking ownership, and conducting good business in everything we do.
Our promise is to enable superior health outcomes for patients, providing them with access to the best medical systems available worldwide.
https://www.device.com.au/
GE Healthcare enables clinicians to make faster, more informed decisions through intelligent devices, data analytics, applications and services, supported by its Edison intelligence platform. With over 100 years of healthcare industry experience and around 50,000 employees globally, the company operates at the centre of an ecosystem working toward precision health, digitizing healthcare, helping drive productivity and improve outcomes for patients, providers, health systems and researchers around the world.
https://www.gehealthcare.com.au/
LINET Group is a major European manufacturer of hospital and nursing beds. The company’s portfolio includes solutions designed for intensive care, products for inpatient treatment, birthing, and paediatrics. Moreover, LINET offers smart applications such as Safety Monitor and SafeSense, as well as solutions for gynecology and obstetrics. The LINET range further includes a wide range of accessories such as anti-pressure ulcer mattresses, mobile equipment, healthcare furniture, etc. LINET is maintaining its position out in front of its competitors in hospital bed manufacture. The firm regularly introduces products and services with innovative features and functions that reduce physical demands on staff, enhance the efficacy of care provided and increase patient comfort. LINET works intensively on developing such products in collaboration with healthcare professionals and respected experts in various scientific fields, enabling the firm to keep abreast of new trends in the area of medical care.
https://www.linet.com/en
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VALUED SPONSORS
BD is one of the largest global medical technology companies in the world and is advancing the world of health by improving medical discovery, diagnostics and the delivery of care. The company supports the heroes on the frontlines of health care by developing innovative technology, services and solutions that help advance both clinical therapy for patients and clinical process for health care providers. BD and its 65,000 employees have a passion and commitment to help improve patient outcomes, improve the safety and efficiency of clinicians’ care delivery process, enable laboratory scientists to better diagnose disease and advance researchers’ capabilities to develop the next generation of diagnostics and therapeutics. BD has a presence in virtually every country and partners with organizations around the world to address some of the most challenging global health issues. By working in close collaboration with customers, BD can help enhance outcomes, lower costs, increase efficiencies, improve safety and expand access to health care. In 2017, BD welcomed C. R. Bard and its products into the BD family.
https://www.bd.com/en-au
CSL Behring is a global biotherapeutics leader driven by its promise to save lives. Focused on serving patients’ needs by using the latest technologies, we develop and deliver innovative therapies that are used to treat coagulation disorders, primary immune deficiencies, hereditary angioedema, respiratory disease, and neurological disorders. The company’s products are also used in cardiac surgery, burn treatment and to prevent hemolytic disease of the newborn.
CSL Behring operates one of the world’s largest plasma collection networks, CSL Plasma. The parent company, CSL Limited (ASX:CSL;USOTC:CSLLY), headquartered in Melbourne, Australia, employs more than 25,000 people, and delivers its life-saving therapies to people in more than 70 countries.
For inspiring stories about the promise of biotechnology, visit Vita at
www.cslbehring.com/Vita
Fisher & Paykel Healthcare are a leading designer, manufacturer and marketer of products and systems for use in acute and chronic respiratory care, surgery and the treatment of obstructive sleep apnea. Driven by a strong sense of purpose, we are working to improve patient care and outcomes through inspired and world-leading healthcare solutions. In 1969, Fisher & Paykel Healthcare changed the way the world delivers respiratory care to critically ill patients in hospital by creating a humidifier used in invasive ventilation. Since then, we have expanded our product offering to other clinical applications, including non-invasive ventilation, nasal high flow therapy and surgery, and, today, our products and systems are used in both hospitals and homes in more than 120 countries. In hospitals, our medical devices and technologies help clinicians deliver the best possible patient care, so patients can transition into less-acute care settings, recover faster and avoid more serious conditions. In homes and long-term care settings, our products are used to treat patients with obstructive sleep apnea (OSA) and chronic respiratory illnesses, such as COPD. Each year, we work closely with healthcare providers to improve our products, develop new therapies, change clinical practice and reduce costs for the world’s healthcare systems.
https://www.fphcare.com/au/
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VALUED SPONSORS
Fresenius Medical Care is the world’s leading provider of products and services for people with chronic kidney failure.
Our mission is simple - To create a future worth living for patients worldwide, every day. Around 3.4 million patients with this disease worldwide regularly undergo dialysis treatment and every 0.6 seconds Fresenius Medical Care provide a dialysis treatment somewhere on the globe.We care for more than 342,000 patients in our global network of over 4,000 dialysis clinics. At the same time, we operate 45 production sites on all continents, providing dialysis products such as dialysis machines, dialyzers and related disposables. Fresenius Medical Care has been developing and producing dialysis products for more than four decades.
The Fresenius Medical Care family employs around 120,000 people across 50 countries, who are instrumental in supporting over 50 million dialysis treatments annually.
Locally, our ANZ team supports dialysis products and services to public and private hospitals for patients with chronic or acute kidney failure. We are also one of the largest private dialysis providers, caring for patients across a network of 24 dialysis clinics as well as home therapies programs.
Our global and local strategy is geared toward sustainable growth. We aim to continuously improve the quality of life of patients with kidney disease by offering innovative products and treatment concepts of the highest quality.
https://www.fmc-au.com/
BREAKFAST SESSION SPONSORS
Abiomed is a leading provider of medical devices that provide circulatory support. Our products, the Impella heart pumps, are designed to enable the heart to rest by improving blood flow and performing the pumping of the heart. We continue to develop ground-breaking technologies designed to improve the patient outcomes especially native heart recovery. Founded in 1981 to develop the world’s first artificial heart, Abiomed has remained dedicated to bringing the most advanced and beneficial technology to your patients.
https://www.abiomed.com/
Avant has a proud heritage of protecting the Australian medical profession that spans over 125 years.
Established by a small group of doctors as a mutual in 1893, Avant is now Australia’s leading medical defence organisation, representing over 75,000 healthcare practitioners and students across every state and territory. We’re here for the long term.
We remain a mutual organisation, serving our members, not shareholders, ensuring our members will always be at the heart of everything we do.
https://www.avant.org.au/
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SESSION SPONSOR
We partner with you on the front line of intensive care, so you can deliver accurate and effective treatments with confidence.
Intensive care is a demanding environment where saving lives is a daily reality. Here, no two patients are alike, their conditions are complex and evolving, and clinicians must manage multiple pathologies, therapies and challenges. That’s why Baxter is dedicated to serving the needs of the ICU community with a comprehensive portfolio of blood purification and fluid management products for therapies supporting multiple organs including the new PrisMax Acute Therapy System.
https://www.baxterhealthcare.com.au/
SOCIAL SPONSOR
Vyaire Medical is a relatively new company that has been around for more than 65 years. And while our name may be new, our products have been used in and around medical centres everywhere for decades.
The story of Vyaire began in the 1950s on two different continents, due to the tireless efforts and dedication of two pioneering medical innovators. In the U.S., Forrest Bird invented and refined the mechanical ventilator. Nearly concurrently in Germany, Erich Jaeger developed what would become the first complete laboratory for pulmonary function testing and diagnostics.
Over the years, through both product innovation and mergers and acquisition, our offering grew to include products and services from well-known, respected healthcare brands that include AirLife™, VitalSigns™, Vyntus™, bellavista™, Fabian™, JAEGER™, Pulmonetic Systems, Bird Corporation, SensorMedics™, Viasys™ and others.
Today, unified as a singular company, we are a global workforce operating facilities around the world to manufacture and market more than 27,000 unique products for the diagnosis, treatment and monitoring of respiratory and critical care conditions in every stage of life.
Our passionate, dedicated people bring decades of industry leadership, clinical experience and unrivalled expertise. And with a renewed commitment to harnessing technology to drive innovation, Vyaire is raising the bar on aligning clinical goals in critical care with the efficiencies sought after by medical institutions.
https://www.vyaire.com/
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Infection controlEasy to clean, smooth and seamless surfaces support
Small footprintsMade for maneuverability, Venue Family systems are adaptable and conducive to working in tight spaces.
Ready when you areLong lasting batteries allow systems to move easily between patients without having to stop to charge.
Simple. Fast. Precise.
Venue Family... Made for Critical Moments.
From its straightforward design to its AI-enabled Auto Tools, Venue TM point of care ultrasound systems empower physicians to quickly triage patients and determine a care pathway. The compact footprints and large screens make Venue Family systems ideal for bedside interventional procedures with minimal disruption to patients.
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Work smarter, not harderPrecise AI tools are designed to enable fast patient assessments
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PRO GR AM
ASM PROGRAM DAY 1 – TUESDAY 1st JUNE: ROOM 1 Host: Dr Bronwyn Avard9:30 – 9:50am Acknowledgement of Country
9:50am WELCOME TO DAY 1CICM VIRTUAL ASM: Dr Mary Pinder & Dr Bronwyn Avard
10:00 – 12:00pm SESSION 1: 2020, What a COVIDastrope!Chair: Professor Andrew UdySession Sponsor: Pfizer
10:00 – 10:15 A patient & family experience Sherene Magana Cruz
COVID Responses around the world
10:15 – 10:25 MelbourneDr Irma Bilgrami
10:25 – 10: 35 Western AustraliaDr Brad Wibrow
10:35 – 10:45 QueenslandAssociate Professor Marc Ziegenfuss
10:45 – 10:55 Australia & New Zealand:Dr Anthony Holley
10:55 – 11:05 Live Q & A Australian Presenters
11:05 – 11:20 United KingdomProfessor Kathy Rowan
11:20 – 11:30 SingaporeAssociate Professor Jason Phua
11:30 – 11:40 International Paediatric COVID experienceAssociate Professor Luregn Schlapbach
11:40 – 11:50 The RECOVERY Trial: go big or go homeProfessor Richard Haynes
11:50 – 12:00 Host response to COVID-19Dr Charlotte Summers
12:00 – 1:00pm LUNCH BREAK SESSIONS
12:05 – 12:25 YOGA SESSION (No Mat Required)
12:25 – 12:45 Premium Sponsor Linet Individualising ventilation care using lateral rotation, EIT and the Linet’s Multicare bed Mikuláš Mlček M.D., Ph.D.
12:25 – 12:57 Intensive Care Foundation UpdateAssociate Professor David Gattas
1:00 – 3:00pm SESSION 2: The lungs: Not so sterileChair: A/Prof Shailesh BihariSession Sponsor Baxter Acute Therapies
1:00 – 1:15 Non-pandemic severe acute respiratory infectionAssociate Professor Rachel Parke
1:15 – 1:30 Effective antibiotic drug dosing for Pneumonia – beyond plasma levelsProfessor Jason Roberts
1:30 – 1:45 Advanced respiratory diagnostic techniquesProfessor Kev Dhaliwal
1:45 – 2:05 Lung ultrasoundDr Rob Arntfield
2:05 – 2:25 Cystic fibrosis and epic battles against the super bugs!Professor Claire Wainwright
2:25 – 2:40 Endoscopic interventional pulmonologyDr Michael Putt
2:40 – 3:00 Live Q & A
3:00 – 3:30pm SHORT BREAK
3:05 – 3:15 New Fellows Graduation Acknowledgment
3:15 – 3:30 Premium Sponsor: Device Technologies AnaConDa setup Professor Anil Hormis
3:30 – 5:00pm SESSION 3: Life after ventilationChair: Dr Paul YoungSession Sponsor: GE Healthcare
3:30 – 3:45 Chronic critical illnessAssociate Professor Hallie Prescott
3:45 – 3:55 Barriers to rehabilitation for intensive care unit survivorsDr Sumeet Rai
3:55 – 4:05 Is it time to see beyond ICU: PaediatricsAssociate Professor Debbie Long
4:05 – 4:20 Embedding research in follow upAssociate Professor Stuart Lane
4:20 – 4:30 Community burden of ICU survivorship Dr Penny Stewart
4:30 – 4:45 Bereavement follow-up: Connecting with those who are left behindDr Kylie Julian
4:45 – 5:00 Live Q+A
5:00 CLOSE DAY 1
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DAY 2 – WEDNESDAY 2nd JUNE: ROOM 1 Host: Dr Rob Bevan8:30 – 9:00am AVANT MUTUAL SESSION
One event, multiple potential outcomes: medico legal essentials for ICU doctors Ruanne Brell
9:00 – 9:30am Introduction to MindfulnessTherese Sheedy (Smiling Minds)Chair: Dr Debra Chalmers
9:55am AEST WELCOME TO DAY 2
10:00 – 12:00pm SESSION 4: Critical Caring – Clinician Health & Wellbeing in a pandemic and beyondChair: Dr Nick Simpson & Dr Debra ChalmersSession Sponsor: Welfare Special Interest Group
10:00 – 10:30 ICU Clinician Workload: The Impact on us and our patientsDr Hayley Gershengorn
10:30 – 11:00 Take your own pulse first: Supporting frontline health workers in a fast-paced work environmentMs Connie Galati & Ms Louise Ramsey
11:00 – 11:30 UK National Project Director Welfare ICSDr Julie Highfield
11:30 – 11:25 Kindness as a Leadership strategyRt Hon Jacinda Ardern: New Zealand PM
11:35 – 12:00 Culture Shock: A panel discussion with CEO Julia Harper and President Mary Pinder
12:00 – 1:00pm LUNCH BREAK SESSIONS
12:10 – 12:30 Premium Sponsor: GE Healthcare Lung Ultrasound – an exploration of new technologies making it simpler and faster. Adrian Way (Ultrasound PoC & USIT Segment Leader)
12:30 – 12:40 CICM Online Education Update
12:45 – 1:00 Premium Sponsor: Device Technology Implementation of AnaConDa Professor Anil Hormis (Rotheram NHS Trust, UK)
1:00 – 3:00pm SESSION 5: The air we breatheChair: Dr Subodh GanuSession Sponsor: LINET
1:00 – 1:15 The Survivors’ StoryPresented by Dr Lewis Campbell
1:15 – 1:25 Te Mana o te Tangata: sharing a story of ICU survivorship and meaningful recovery.Presented by Dr Kim Grayson
1:25 – 1:40 Bush-fire related complicationsDr Anthony Delaney
1:40 – 2:00 Thunderstorm AsthmaProfessor Christine McDonald
2:00 – 3:00pm Rapid Fire Update
2:00 – 2:10 Paediatric AsthmaDr Andrew Tai
2:10 – 2:20 Oxygen management in ICU: a knowledge translation study Ms Diane Mackle
2:20 – 2:30 Interstitial lung disease for the intensivist Dr James Lindstrom
2:30 – 2:40 Oncology related lung diseaseDr Tamishta Hensman
2:40 – 2:50 Bronchopleural fistulaDr Isuru Seneviratne
2:50 – 3:00 COPD: Wake me up when it’s overDr Jane Lewis
3:00 – 3:30pm SHORT BREAK: SESSIONS
3:05pm – 3:25 Premium Sponsor: GE Healthcare Alarm Reporting Tool – making monitoring meaningful. Emma Gall (Applications Specialist - Perioperative & Critical Care)
3:30 – 5:00pm SESSION 6: The New COVID Normal Chair: Dr Lewis CampbellSession Sponsor: Pfizer
3:30 – 4.00 Ethnic Disparities in COVID-19 outcomesDr John Prowle & Dr Yize Wan
4:00 – 4:15 Teaching in the age of Covid-19Associate Professor Chris Nickson
4:15 – 4:30 Systems to deal with a pandemic, what went well, what we can do better?Associate Professor Steve McGloughlin
4:30 – 4.45 NSW modelling. Predictive requirements of ICU beds Dr Nhi Nguyen
4:45 – 5:05 Late breaking session: Insights into India’s current COVID crisis – an interview with Dr Zarir Udwadia
5:05 Live Q & A
5:25pm DAY 2 CLOSE
5:30 – 6:30pm A NIGHT ON BROADWAY – VIRTUAL SOCIAL EVENT
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8:30 – 9:00am ABIOMED : The role of Impella as primary MCS in the ICUAssociate Professor Federico PappalardoFacilitated by Dr Priya Nair
9:00 – 9:30am Positive PsychologyProfessor Dianne Vella-Brodrick
9:55am AEST WELCOME TO DAY 3
10:00 – 12:00pm SESSION 7: Right heart – The third lungChair: Dr Allan Beswick
10:00 – 10:20 Right heart ultrasoundDr Rob Arntfield
10:20 – 10:35 Pulmonary hypertension and RV supportDr Kavitha Muthiah
10:35 – 10:50 Paediatric Right Heart response to pathology Dr Elena Cavazzoni
10:50 – 11:00 Coffee, Stretch & Networking Break
11:00 – 11:05 New Fellow Graduation Acknowledgment (Repeat)
11:05 – 11:30 LIVE DEBATE:Unconventional therapies for submassive PE save lives: Dr Jayshree LavanaV’sUnconventional therapies for submassive PE should not be offered outside research trials: Dr Priya Nair
11:30 – 11:45 Management of Acute Pulmonary Embolism in a regional centreDr Debra Chalmers
11:45 – 12:00 Live Q & A
12:00 – 1:00pm LUNCH BREAK: Sessions
12:05 - 12:25 Relax & Refresh with Qigong
12:25 – 12:40 Premium Sponsor: Device TechnologiesPatient Groups to use AnaConDa Professor Anil Hormis (Rotheram NHS Trust, UK)
12:40 – 12:50 Intensive Care Foundation UpdateAssociate Professor David Gattas (Repeat)
1:00 – 3:00pm SESSION 8: Ventilation – Rage of the machinesChair: Dr Kim YawSession Sponsor: Device Technologies
1:00 – 1:15 Making ventilation safer: Optimizing tidal volume based on driving pressureDr Ewan Goligher
1:15 – 1:30 Can EIT be useful in assessment of regional ventilation blood flow and biofluid movement Professor John Fraser
1:30 – 1:45 Updates on Molecular Phenotypes of ARDSProfessor Carolyn Calfee
1:45 – 2:00 High-Flow Nasal Cannula Oxygen Therapy in Paediatrics: Harmless?Dr Krista Mos
2:00 – 2:15 Re-evaluation of Systemic Early Neuromuscular Blockade for ARDS (ROSE)Dr Taylor Thompson
2:15 – 2:30 Airway pressure release ventilation: Saviour or scourge?Dr Ed Litton
2:30 – 2:45 Advanced airway management.Dr Louise Speedy
2:45 – 3:00 Live Q & A
3:00 – 3:30pm SHORT BREAK
3:10pm – 3:30pm Premium Sponsor: Linet (Repeat)Individualising ventilation care using lateral rotation, EIT and the Linet’s Multicare bed Mikuláš Mlček M.D., Ph.D.
3:30 – 5:00pm AEST
SESSION 9: Start early? ECLS in acute respiratory failureChair: Dr Priya Nair
3:30 – 3:45 Respiratory ECMO for COVID-19Dr Tina Xu
3:45 – 4:00 When to refer for ECMO in acute respiratory failure Dr Sara Allen
4:00 – 4:15 ECMO in paediatric ARDSDr Adrian Mattke
4:15 – 4:30 REDEEM: A Pilot RCT of VV ECMO in moderate -severe respiratory failureDr Aidan Burrell
4:30 – 4:45 Extracorporeal carbon dioxide removal in adults with respiratory failureAssociate Professor Kiran Shekar
4:45 – 5:00 Live Q & A
5:00pm 2022 ASM WELLINGTON: Dr Rob Bevan
5:05 – 5:15pm CLOSING ADDRESS
DAY 3 – THURSDAY 3rd JUNE : ROOM 1 Host: Dr Angelly Martinez
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DAY 1 12:25pm – 12:45pm LINET: Room 1 Main stream Individualising ventilation care using lateral rotation, EIT and the Linet’s Multicare bedPresenter: Mikuláš Mlček M.D., Ph.D.Dr. Mlček, physician and researcher from Charles University, Prague shares what happens when frame-based lateral tilt is used in patients with asymmetrical lung disease to individualise ventilation strategies. He uses a combination of clinical patient cases and volunteer demos in conjunction with electrical impedance tomography to show ventilation changes when lateral tilt is used with the Multicare ICU bed from Linet. Linet’s research team and clinicians work closely together to ensure new developments can translate into clinical practice.
2:05pm – 2:25pm BD Australia & New Zealand: Concurrent Session Room 2 Targeted temperature Management: What good looks like.Presenter: Professor (Assistant) Fabio Taccone, Intensive Care Hospital Erasme in Brussels (Belgium)
2:30pm - 2:40pmPfizer Australia: Concurrent Session Room 2The growing threat of Gram-negative resistancePresenter: Dr Matteo Bassetti
3:15pm – 3:30pm Device Technologies: Room 1 Main stream AnaConDa setupPresenter: Professor Anil Hormis (Rotheram NHS Trust, UK) Professor Anil Hormis (Rotheram NHS Trust, UK) discusses the limitations of and challenges posed by conventional intravenous sedation practice, and the potentil advantages of instead sedating intensive care patients using inhaled volatile anaesthetics. In this short talk Professor Hormis also discusses the equipment and changes to breathing circuit configuration required to safely administer inhaled volatile anaesthetics outside of the operating theatre.
3:55pm – 4:15pm CSL Behring: Concurrent Session Room 2 Small volume resuscitation: rationale and SWIPE trial resultsPresenter: Professor Rinaldo BellomoFluids are one of the most common treatments administered in acute hospitalized patients. Even small differences in fluid management outcomes data can have significant effects on the healthcare system.
In this webinar Prof Rinaldo Bellomo (Professor of Intensive Care, University of Melbourne & Department of Intensive Care Austin Hospital and Royal Melbourne Hospital) presents on the ‘SWIPE’ randomised clinical trial he co-authored, sharing the rationale and data on why small volume fluid resuscitation with albumin 20% is an option for your ICU patients.
4:30pm – 4:50pmFisher & Paykel Healthcare Presentation: Concurrent Session Room 2 High flow nasal cannula for Covid-19 patients; low risk of Bio-aerosol dispersion. Presenter: Dr Jie Li
CONCURRENT & SPONSOR PRESENTATIONS
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DAY 212:10 pm – 12:30 pm GE Healthcare Presentation: Room 1 – Main stream Lung Ultrasound – an exploration of new technologies making it simpler and faster.Presenter: Adrian Way (Ultrasound PoC & USIT Segment Leader)
12:45pm – 1:00pm Device Technology Presentation: Room 1 – Main Stream Implementation of AnaConDaPresenter: Professor Anil Hormis (Rotheram NHS Trust, UK)Professor Anil Hormis (Rotheram NHS Trust, UK) discusses international guidelines for sedation practice and the challenges to be anticipated in advocating for a significant in sedation practice at departmental level. He describes his experience of the adoption of the Sedana AnaConda system for inhalational sedation in his own unit. He further describes the development of local clinical protocols, equipment changes required to ensure safety, and the implementation of ongoing staff education.
2:00pm – 2:12pm Fresenius Medical Care Presentation: Concurrent Session Room 2Introduction into Regional Citrate Anticoagulation (RCA) (Part 1)Presenter: Professor Kindgen-Milles
2:50pm – 3:00pmPfizer Australia: Concurrent Session 2Defining the risk factors for patients with resistant Gram-negative infectionsPresenter: Dr Francesco G. De Rosa
3.05 pm – 3.25pm GE Healthcare Presentation: Room 1 – Main stream Alarm Reporting Tool – making monitoring meaningful. Presenter: Emma Gall (Applications Specialist – Perioperative & Critical Care)
4:00pm – 5:00pm Indigenous Program: Concurrent Session Room 2 Indigenous research. Data MattersData has value. Just ask Facebook or Google. The one constant is that the people who get the access, and the benefit, are rarely the ones who pay. The questions we can ask are constrained by the collective imagination of those who set up the process for data collection, who choose what and when to record; who choose when silence or absence are the only signifiers of things we don’t understand. Clearly this causes problems for the people who are not involved, and if we care about fairness, we should all seek to be involved and to make sure that all voices are heard. If you are on the profit side of this inequality and need more investment, consider that this is not a niche issue, it’s not a minorities issue, it’s a struggle for no less than the nature of reality. And if that’s too dramatic for a webinar, then relax and let the enthusiasm and hope of these speakers carry you to a new level of understanding of why data matters.Presenters: Dr Paul Young and Dr Kalinda Griffiths
CRITICAL CARECHRONIC DISEASE & CANCER
Trainee Symposium & ICU Update: Wednesday 25th MayASM: Thursday 26th May – Saturday 28th May
25-28 May 2022WELLINGTON / NEW ZEALAND
IMPOSSIBLE MISSION?
CICM2022A S M
SAVETHE
DATE
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DAY 310:35am – 10:55am BD Australia & New Zealand: Concurrent Session Room 2 Targeted temperature management workshop – Arctic Sun 5000 Presenter: Louise Leslie – BD Clinical Nurse Educator and Tina van Weelderen – BD National Sales and Clinical Manager
11:30am – 11:50am Fisher & Paykel Healthcare Presentation: Concurrent Session Room 2 The role of high flow nasal cannula as a respiratory support strategy in adults Presenter: Dr Laurent Brochard
12:05pm – 12:25pm CSL Behring Presentation: Concurrent Session Room 2 (Repeat session) Small volume resuscitation: rationale and SWIPE trial results Presenter: Professor Rinaldo BellomoFluids are one of the most common treatments administered in acute hospitalized patients. Even small differences in fluid management outcomes data can have significant effects on the healthcare system.
In this webinar Prof Rinaldo Bellomo (Professor of Intensive Care, University of Melbourne & Department of Intensive Care Austin Hospital and Royal Melbourne Hospital) presents on the ‘SWIPE’ randomised clinical trial he co-authored, sharing the rationale and data on why small volume fluid resuscitation with albumin 20% is an option for your ICU patients.
12:25pm – 12:40pm Device Technology Presentation: Room 1 Main StreamPatient Groups to use AnaConDaPresenter: Professor Anil Hormis (Rotheram NHS Trust, UK)Professor Anil Hormis (Rotheram NHS Trust, UK) discusses the clinical indications for inhaled sedation and the selection of patients best suited for this form of sedation. He also describes lessons learned in his unit since the adoption of the Sedana AnaConda system for inhalational sedation.
1:20pm – 1:33pm RCA: Why CVVHD (Part 2)Presenter: Professor Kindgen-Milles Fresenius Medical Care Presentation: Concurrent Session Room 2
1:35pm – 2:00pm Clinical Data – Berlin Protocol (Part 3)Presenter: Professor Kindgen-MillesFresenius Medical Care Presentation: Concurrent Session Room 2
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2:00pm – 3:00pm Indigenous Program: Concurrent Session Room 2Cultural safetyPresenter: Professor Yin ParadiesIt is thought that medical practice cannot be clinically safe without being culturally safe. But what exactly is cultural safety and why is it so important? How can we work towards culturally safe practice and environments for our patients, their families, and our colleagues? Professor Yin Paradies, an expert in Indigenous knowledges and anti-racism theory, policy and practice will explore these questions and stimulate thinking around actions for change.
3:10pm – 3:30pm LINET: Room 1 Main Stream (Repeat session) Individualising ventilation care using lateral rotation, EIT and the Linet’s Multicare bed Presenter: Mikuláš Mlček M.D. Ph.D.Dr. Mlček, physician and researcher from Charles University, Prague shares what happens when frame-based lateral tilt is used in patients with asymmetrical lung disease to individualise ventilation strategies. He uses a combination of clinical patient cases and volunteer demos in conjunction with electrical impedance tomography to show ventilation changes when lateral tilt is used with the Multicare ICU bed from Linet. Linet’s research team and clinicians work closely together to ensure new developments can translate into clinical practice.
3:10pm – 3:45pm Pfizer Australia: Concurrent Session Room 2Real-world use: Perspectives on new agents for MDR Gram negative pathogensPresenter: Associate Professor Ryan Shields
DAY 3 continued
Continuous, Individualized Ventilation CareBy Platform Base Tilt and Electric Impedance Tomography
MulticareOpen Lungs Carefuly and Keep It OpenPre-Proning and Pre-Recruitment Maneuver Care
LINET RESEARCH
EXE
CU
TIV
E S
UM
MA
RY
join us on June 1 @ 12:25 pm or June 3 @ 3:10 pm to learn more (at those times we will have the video by Mikuláš Mlček M.D., Ph.D. & Martin Ričl at the virtual ICU conference here:
cicm2021asm.delegateconnect.co
21_04_Clinical_ALT-EITAN_CICM_australia13x18.indd 1 19.04.2021 8:20:35
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WELFARE SPECIAL INTEREST GROUP: ADDITIONAL SESSIONS
DAY1NETWORKING ROOMS
12:00pm – 2:00pm Dr Denzil Gill, Dr Elizabeth Tran & Dr Derick Adigbli
(On behalf of the Welfare SIG in collaboration with the CICM
Trainees Committee)
DAY 21:00pm – 3:00pm Dr Sara Allen - Welfare Advocate Session
DAY 312:00pm – 1:30pm Q&A Session with Dr Julie Highfield & Welfare Special Interest Group Meeting
BREAKFAST SESSIONS
WEDNESDAY 2nd JUNE 8:30am – 9:00am (Room 1: Main Stream)
One event, multiple potential outcomes: Medico legal essentials for ICU doctors
Presenter: Ruanne Brell – Senior Legal Advisor Advocacy, Education and Research Senior Solicitor Medico-legal Advisory Service.
9:00am – 9:30am (Room 1 Main Stream) Introduction to MindfulnessPresenter: Therese Sheedy (Smiling Minds)
THURSDAY 3rd JUNE8:30am – 9:00am
The role of Impella as primary MCS in the ICU
Presenter: Associate Professor Federico PappalardoDepartment of Anesthesia and Intensive Care at ISMETT (Mediterranean Institute for transplantation and Advanced Therapies) Palermo: Italy.
SPEAKERFacilitator: Dr Priya NairSession Objectives :• Learn the hemodynamics of Impella in relation to
ECMO, IABP and inotropes• MCS in Cardiogenic shock – what is the role of Impella?• MCS in acute decompensated heart failure – what is
the role of Impella?• ECpella – rationale behind the combined use of Impella
& ECMO and management• Selecting the right patient for Impella
9:00am – 9:30am (Room 1 Main Stream)Positive PsychologyPresenter: Professor Dianne Vella-Brodrick
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INTERNATIONALDR ROB ARNTFIELD
Dr Arntfield is an intensivist and traumatologist at Western University where he also serves as the medical director of London
Health Sciences Centre’s Critical Care Trauma Centre. He is co-author of the textbook: Point-of-Care Ultrasound and is director of the critical care ultrasound program at Western University. A past course leader for the American College of Chest Physicians (ACCP) critical care ultrasonography program and a founding member of the National Board of Echocardiography’s exam and certification on critical care echocardiography, Dr. Arntfield is particularly enthusiastic resuscitative ultrasound and applications of transesophageal echocardiography in critical illness and cardiac arrest.
PROFESSOR CAROLYN S CALFEE
Carolyn S. Calfee, MD MAS is Professor of Medicine and Anesthesia at the University of California, San Francisco,
where she attends in the intensive care units. Her primary academic focus is the pathogenesis and treatment of the acute respiratory distress syndrome (ARDS). Current research projects include: (1) molecular subphenotypes of ARDS and precision medicine in critical care; (2) the role of environmental exposures including smoking, air pollution, and novel tobacco products in susceptibility to lung injury; and (3) novel treatments for ARDS. During the COVID-19 pandemic, she has been the UCSF clinical lead and steering committee member for the NIAID-funded Immunophenotyping Assessment in a COVID-19 Cohort (IMPACC) study and she is one of the lead PI’s for the ISPY COVID clinical trial, a Phase 2 adaptive platform clinical trial of novel treatments for COVID-19 associated ARDS.
PROFESSOR KEV DHALIWAL
Kev Dhaliwal MD, PhD, FRCP is Professor of Molecular Imaging & Healthcare Technology at the University
of Edinburgh and a clinically active Consultant Physician in Respiratory Medicine. He has subspecialist clinical interests are in Interventional Medicine and infection.
He leads a research and translational group with an ethos of technology to man with embedded product development, manufacture and clinical evaluation. He is chief investigator on 6 first-in-human trials ranging from the intensive care unit to lung cancer evaluating optical imaging and therapeutic approaches.
He leads the interdisciplinary hub of scientists as part of the Proteus Project (www.proteus.ac.uk), the UK’s largest healthcare bio-photonics project which is an Engineering Physical Sciences Research Council Interdisciplinary
Research Collaboration developing next-generation translational technologies for in situ pulmonary molecular imaging and sensing.
Proteus is developing incisive molecular imaging approaches to delineate key pathophysiological processes in vivo in situ. In particular advances in sensing and characterising distal lung biology during interventional procedures with molecular resolution. He leads a Healthcare Technology Accelerator Facility that is Focussing on Interventional approaches across organ systems and across technology boundaries.
DR HAYLEY GERSHENGORN
Dr Gershengorn is an Associate Professor in the Division of Pulmonary, Critical Care, and Sleep
Medicine at the University of Miami, Miller School of Medicine where she works as a medical intensivist. As Medical Director of
SPEAKERS
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Data Quality Analytics for the University of Miami Hospitals, she has co-led the creation of institution-wide protocols to standardize care for COVID-19 patients. Dr. Gershengorn’s research program focuses on the allocation of ICU resources and the impact such allocation has on the outcomes of critically ill patients. In particular, she is interested in understanding how (1) ICU staffing and (2) practices which may be tied to staffing affect patient morbidity and mortality. She is Associate Editor for Critical Care of the Annals of the American Thoracic Society, serves on the program committee for Critical Care for the American Thoracic Society, and is Chair of the Internal Medicine Section for the Society of Critical Care Medicine.
DR EWAN GOLIGHER
Ewan Goligher MD, PhD is an Assistant Professor in the Interdepartmental Division of Critical Care Medicine at the University
of Toronto and a Scientist at the Toronto General Hospital Research Institute. He leads the Precision Ventilation Lab at Toronto General Hospital, focusing on characterizing the mechanisms and impact of injury to the lung and diaphragm during mechanical ventilation and developing innovative clinical trial designs to test lung and diaphragm-protective ventilation strategies.
PROFESSOR RICHARD HAYNES
Richard Haynes did his pre-clinical medical studies in Cambridge before moving to Oxford for his clinical
studies and qualified in 2000. He came to CTSU for a period of “out of programme” research in 2006 to work on the HPS2-THRIVE trial with Prof Jane Armitage. He completed his training in renal medicine in 2011 and was appointed as an honorary consultant at the Oxford Kidney Unit. Shortly after that he was appointed to the MRC Programme Leader track and he is now Programme Leader in the MRC Population Health Research Unit for the programme in Randomised Trials in Cardiovascular and Metabolic Disease.
DR JULIE HIGHFIELD
Dr Julie Highfield has a long experience of working as a psychologist in medical and health care settings and works closely with staff in
their experience of working in healthcare, as well as advising managers on matters of workforce wellbeing.
She is the Consultant Clinical Psychologist in Adult and Paediatric Critical Care for Cardiff and Vale University Health Board. She works clinically with patients, relatives, and staff. Julie is the lead for staff wellbeing and organisational health in critical care. From December 2017 – June 2020 she was the Associate Director of Adult Critical Care, giving her a strategic position in the development of the unit.
NZ 0508 DEVICE (338 423) [email protected] www.device.co.nz
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She is the co-chair of Psychologists in Intensive Care UK (PINC-UK) and on the board of trustees for ICU Steps.
Since June 2020, Julie became the Intensive Care Society’s National Wellbeing Project Director having played a key part in the ICS Wellbeing and Burnout Working Group. She was on the Intensive Care Society Rehabilitation Working Group for COVID-19, and the Faculty of Intensive Care Medicine Life after Critical Illness Group.
Julie has worked with the British Psychological Society and its Division of Clinical Psychology in Wales. She led the BPS team writing the National Guidance for Staff in the Coronavirus Pandemic.
Julie has been worked with Welsh Assembly Government in various projects, including as the lead for Critical Care Workforce in the 2018-19 Task and Finish Group, and Modelling for Rehabilitation for patients post COVID-19.
ASSOCIATE PROFESSOR JASON PHUA
Jason Phua is an intensivist and respiratory physician at Alexandra Hospital (AH) and National University
Hospital (NUH) of Singapore’s National University Health System (NUHS). He is the Chief Executive Officer of AH, the Deputy Chair of the National Intensive Care Unity Repository (NICUR), the Chair of the Asia Ventilation Forum (AVF), and the Secretary of the Asian Critical Care Clinical Trials (ACCCT) Group. He
previously served as Head of the Division of Respiratory and Critical Care Medicine in NUH, and as President of the Society of Intensive Care Medicine (Singapore).
ASSOCIATE PROFESSOR HALLIE PRESCOTT
Dr. Hallie Prescott is an Associate Professor in Pulmonary & Critical Care Medicine at the University
of Michigan and Ann Arbor Veterans Affairs Hospital. She attends in the medical intensive care unit and outpatient pulmonary clinic. She is an expert in long-term outcomes and recovery after sepsis. She leads current grants on the impacts of accelerating time-to-antibiotics in potential sepsis and novel methods of hospital performance measurement from the US Agency for Healthcare Research and Quality and the US Department of Veteran’s Affairs, respectively. She is physician-lead for a Michigan statewide sepsis quality improvement collaborative with more than 60 participating hospitals. She is a vice-chair of the Surviving Sepsis Campaign guidelines, council member of the International Sepsis Forum, and a former ANZICS Intensive Care Global Rising Star fellow (2015).
DR JOHN R PROWLE
Dr John R Prowle MA MB BChir MSc MD FRCP FFICM is a Senior Lecturer in Intensive Care Medicine at Queen Mary University of London
and an Honorary Consultant Physician
in Intensive Care Medicine and Renal Medicine based in the Adult Critical Care Unit at The Royal London Hospital, Barts Health NHS Trust. Dr Prowle studied medicine at the University of Cambridge and graduated in 1999 with distinction in Medicine, Surgery and Pathology. He went on to complete higher specialist training (board certification) in Intensive Care Medicine, Nephrology and General Internal Medicine in London. From 2007 to 2010 he was as a Clinical Research Fellow and Senior Registrar in Critical Care Medicine at the Austin Hospital, Melbourne, Australia, completing his research doctorate under the supervision of Prof Rinaldo Bellomo.
PROFESSOR KATHY ROWAN
Kathy is Director of the Intensive Care National Audit & Research Centre (ICNARC), Honorary
Professor at the London School of Hygiene & Tropical Medicine and Adjunct Professor (Research) at Monash University, Australia. In 1994, following her PhD from the University of Oxford, Kathy founded ICNARC, an independent, not-for-profit, scientific organisation to facilitate improvements in the structure, process, outcomes and experiences of critical care - for patients and for those who care for them. ICNARC manages a broad programme of clinical audit and clinical/health services research, nationally and internationally. The ICNARC database of over 2.5 million critical care
admissions serves as a resource for multiple studies on the epidemiology and evaluation of critical illness, including sepsis, and informs practice and policy on the provision, service delivery and organisation of critical care within the NHS, most recently playing a key role in the global pandemic of COVID-19. Kathy was awarded the Humphry Davy Medal by the UK Royal College of Anaesthetists (2004), completed a Harkness Fellowship (2005) and received the President’s Prize and honorary life membership of the UK Intensive Care Society (2019) as a mark of distinction for her significant contribution to critical care.
ASSOCIATE PROFESSOR LUREGN SCHLAPBACH
Luregn Schlapbach is Professor and Head of the 41-bed multidisciplinary Paediatric and Neonatal
Intensive Care Unit at the University Children`s Hospital Zurich, Switzerland. After having worked during a decade as paediatric intensivist in Australia including being a Staff Specialist in the PICU at Queensland Children`s Hospital in Brisbane, Australia, he maintains an active research program on Sepsis, Infection, and Inflammation in Critically Ill Children at the Child Health Research Centre, University of Queensland. Luregn is Past Chair of the ANZICS Paediatric Study Group.
Luregn was group head on the Pediatric Surviving Sepsis Campaign, and is Co-Chair of the international Paediatric Sepsis Definition Taskforce, and is in the
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Global Sepsis Alliance Executive. He has been leading observational, genomic, and interventional pediatric sepsis studies and is involved in international consortia on life-threatening childhood infections. Luregn is in the steering board of several NHMRC funded paediatric interventional trials.
Luregn`s research has focused on sepsis and life-threatening infections in critically ill neonates and children, including aspects such as epidemiology, sepsis markers, outcomes and genomics in this highly vulnerable patient group. He is interested in improving our understanding of why some children become critically unwell because of infections, and in developing better approaches to allow early recognition and targeted treatment of sepsis and severe infections in children.
DR CHARLOTTE SUMMERS
Charlotte Summers graduated in both Biomedical Sciences and Medicine from the University of Southampton, and later
undertook a PhD at the University of Cambridge, alongside specialist clinical training in Respiratory (Cambridge) and Intensive Care Medicine (London). She was subsequently appointed as the UK’s first NIHR Clinical Lecturer in Intensive Care Medicine, and awarded a Fulbright All-disciplines Scholar Award and a Wellcome Trust Fellowship for Postdoctoral Clinician Scientists. Charlotte joined the University of Cambridge School of Clinical Medicine in 2015and currently co-leads the Peri-
operative, Acute, Critical Care and Emergency (PACE) medicine Section of the Department of Medicine.
Charlotte is a member of the UK-COVID Therapeutic Advisory Panel, advising the Chief Medical Officer about therapies for deployment in the national platform clinical trials, and Chief Investigator of HEAL-COVID, a national Urgent Public Health platform clinical trial for the post-hospital phase of COVID-19.
DR TAYLOR THOMPSON
Dr Thompson is a Professor of Medicine at Harvard Medical School and the Medical Director of the NHLBI-funded PETAL Clinical
Coordinating Center at the Massachusetts General Hospital. His primary research interests are clinical trials of new therapies for ARDS and sepsis. Dr. Thompson is the former Director of the Medical Intensive Care Unit and the Pulmonary and Critical Care Fellowship Program at MGH has been an NIH funded investigator, practicing intensivist, and educator at MGH and Harvard Medical School for over 30 years.
DR YIZE WAN
Dr Yize Wan is a Clinical Lecturer and dual Specialty Registrar in Anaesthesia and Intensive Care Medicine in London. Her research
interests are using epidemiological methods to investigate predictors of poor
outcomes following surgery and critical illness. She has a background in data science and understanding the basis of complex multifactorial disease.
DR ZARIR F UDWADIA
Dr Zarir F Udwadia is a consultant chest physician and MD, DNB, FCCP (USA) and FRCP (London) attached to the
Hinduja Hospital & Research Center, Breach Candy Hospital, and Parsee General Hospitals.
He has struck the unique balance of combining a busy clinical practice with internationally acclaimed medical research. He sees over 10,000 patients annually in his extremely busy clinics. Special interests include TB, MDR-TB, ILD, Asthma, Pneumonia, Sarcoidosis, Sleep disorders, COVID-19 and Bronchoscopy.
He is a prolific researcher and has over 170 PubMed indexed medical research publications in the worlds premier academic medical journals.
Dr Udwadia has been invited to deliver lectures at conferences and universities around the world including the Royal Society of Medicine (London), the Royal College of Physicians (London), the European Respiratory Society, the American College of Chest Physicians, the International TB Union, and several lectures at Harvard University, Boston.
He was the first to report cases to Totally Drug Resistant TB from India.
This stirred up intense medical and media attention in 2012 with 2500 articles in newspapers and news sites across the world including BBC, CNN, Reuters, Times UK, Canadian Globe, Wall Street Journal, Bloomberg, Science, Nature and a special feature on him in the prestigious Lancet.
Dr Udwadia was Invited to join the USAID India End-TB alliance and the Global TB Network (GTN) to pursue global TB elimination.
He has been advisor to the WHO, and was invited to Geneva on several occasions to help formulate the current TB and MDR-TB guidelines.
He is on the Core Committee of doctors elected by the Indian government to inform Bombay’s COVID-19 pandemic response.
In 2017 Open Magazine nominated him as one of their twenty five top minds for his impact on public health.
He had given two TED talks one on Drug Resistant Tuberculosis and the other on COVID-19, both of which have been widely viewed.
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AUSTRALIA AND AOTEAROA NEW ZEALAND SPEAKERSDR SARA ALLEN
Dr Sara Allen is a cardiothoracic intensivist and anaesthetist, who works at Auckland City Hospital in the Cardiothoracic and Vascular
Intensive Care Unit and the Greenlane Department of Cardiothoracic and ORL Anaesthesia. Dr Allen has interests in echocardiography and mechanical support, and welfare, training and education within intensive care and anaesthesia.
DR IRMA BILGRAMI
Irma Bilgrami is an Intensive Care & Medical Donation Specialist at Western Health in Melbourne with a special interest in
medical education and communication skills training, particularly in mentoring, feedback and end of life care.
Over the course of her ICU career, she has had the opportunity to contribute and learn from colleagues in low-middle income countries and is currently the Co-Vice Chair of the newly formed ANZICS/CICM Global Health SIG.
Her favorite holiday destination is the Himalayas and reminiscing about a pre-covid 3-week hike in Nepal made for great entertainment during the Melbourne lockdown.
DR AIDAN BURRELL
Dr Aidan Burrell is an Intensivist at the Alfred Hospital in Melbourne, Australia. He initially trained in vascular surgery, before
moving into intensive care medicine. He completed fellowships in heart failure/cardiac transplantation in 2012 and extracorporeal membrane oxygenation in Germany in 2015. His research interests have focussed on acute heart and respiratory failure, and critical care echocardiography, and in 2019 he completed his PhD investigating the use of ECMO in critically ill patients. He is currently investigating oxygen toxicity during VA ECMO in the BLENDER trial, and the use of VV ECMO in severe acute respiratory infections. In 2020, he joined the SPRINT SARI management team, a national registry of critically ill COVID-19 patients across Australia.
DR ELENA CAVAZZONI
Elena Cavazzoni is a staff specialist working at the Children’s Hospital at Westmead in Sydney and is co-State Medical Director for
the Organ and Tissue Donation Service in New South Wales. She is a fellow of the College of Intensive Care Medicine (CICM), a member of the Royal College of Paediatrics and Child Health (RCPCH) and
had a Graduate Diploma in Palliative Care from the University of Melbourne. Her research interest interests are in organ and tissue donation, transfusion medicine and neurocritical care.
DR DEBRA CHALMERS
Originally from South Africa, Deb moved to New Zealand in 2007 with her partner, Eric, 17 boxes and 2 bicycles. 14 years and 2 Fellowships
(FCICM, FRACP) later, she now orders fush and chups like a local. Her interests include medical ethics, communication and sustainability in health care, and in life. To keep out of mischief, she is the chair of the Welfare Special Interest Group, CICM Supervisor of Training, the NZ National Committee and has a new role with Organ Donation New Zealand. When not at work, Deb is busy embracing her inner hippy, entertaining her 3 fur children and caring for her expanding collection of trees. She is a tuneless singer of 1980’s songs and random songs about frogs and can be followed on twitter @viridescentfrog
DR ANTHONY DELANEY
Anthony Delaney is a father of three and husband to a multi-talented anaesthetist. He is a Fellow of the Australasian College for
Emergency Medicine and the College of
Intensive Care Medicine. He is currently a Professorial Fellow in the Division of Critical Care at the George Institute for Global Health, also holding appointments as Associate Professor at Sydney Medical School, University of Sydney and an adjunct Senior Research Fellow at the Australian and New Zealand Intensive Care Research Centre, in the Department of Epidemiology and Preventative Health at Monash University. He maintains a clinical role as Senior Staff Specialist in the Malcolm Fisher Department of Intensive Care Medicine at The Royal North Shore Hospital.
Associate Professor Delaney’s major research interests are to develop improved methods of resuscitation of patients with sepsis and septic shock and improved outcomes for patients suffering acute severe brain injuries.
PROFESSOR JOHN FRASER
Prof John Fraser (MB ChB, PhD, FRCP(Glas), FFARCSI, FRCA, FCICM) is the Director of the Critical Care Research Group at The Prince Charles
Hospital and University of Queensland, and Director of the Intensive Care Unit at St Andrew’s War Memorial Hospital.
Following his PhD in fetal wound healing, John started the Critical Care Research Group at Australia’s largest cardiac centre - The Prince Charles Hospital.
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The Group has now developed to almost 90 staff and 8 labs. Being awarded the first international Centre for Research Excellence in mechanical support the CCRG has become popular with over 25 nationalities represented. John is also President of APELSO and Chair of the Queensland Cardiovascular Research Network.
John’s extensive global network has helped facilitate the birth of the COVID Consortium, the largest Critical Care community using Artificial Intelligence with colleagues from 54 countries around the world during the COVID-19 Pandemic. Working with over 370 world leading hospitals across the globe John has brought in leaders in AI, Amazon and IBM to accelerate data ingestion. The COVID-19 consortium tool kit developed with Amazon allows data ingestion using visual and audio input. The dashboard, developed by the University of Queensland and augmented by IBM, updates in real time to allow decision support at the bedside. The world leading Journal of American Medical Association hailed this quantum change and highlighted how it may change the process of clinical research not just during the COVID-19 crisis but well into the future in many fields of medicine.
Having noticed a critical funding gap to transport early to mid-stage innovations through to manufacture and commercialisation John has founded De Motu Cordis - an emergency drug delivery device and co-founded the Quantum
Medical Innovation Fund, focussing on medical innovations.
Prof Fraser continues to push at the boundaries of medicine, science and technology.
MS CONNIE GALATI
Connie Galati is a clinical psychologist and the Lead Psychologist at Canberra Health Services. She is also the Assistant Director of
Allied Health in Mental Health, Justice Health, Alcohol & Drug Services. Connie has clinical experience working with people across the spectrum of mental health. She has a special interest in psychological wellbeing during disasters and emergencies, working with people who have experienced psychological trauma, service development, and embedding research into practice. During COVID-19, Connie was redeployed to develop and lead a staff psychological service for her healthcare colleagues working in COVID-19 teams. For this work, Connie and the team were awarded the 2020 ACT Health Award for Allied Health Team Excellence. Connie is currently on secondment to the Health Emergency Control Centre as the Mental Health & Wellbeing Adviser for the ACT COVID-19 response.
DR TAMISHTA HENSMAN
Tamishta Hensman is an ICU Fellow at Royal Darwin Hospital, the Victorian CICM trainee representative and founding co-chair of the
CICM Online Education Program. She has completed most of her training at the Austin Hospital, including a Diploma in Palliative Care Medicine. A faculty member for the Victorian Primary Exam Course for CICM (VPECC) and simulation educator for the University of Melbourne, she has a keen interest in education and training.
DR ANTHONY HOLLEY
Anthony is a senior staff intensivist working at Royal Brisbane and Women’s Hospital. He is a senior lecturer with the University
of Queensland Medical School. Anthony is currently the ANZICS President. He is an examiner for the fellowship of the College of Intensive Care Medicine of Australia and New Zealand. Anthony has authored eight book chapters and 48 peer reviewed publications. He is a supervisor of intensive care training at the Royal Brisbane and Women’s Hospital and is an instructor for BASIC and an EMST (ATLS) course director. He has, in conjunction with colleagues, developed both the Current Concepts in Critical Care and Trauma Traps courses. Anthony serves as a representative for the National Blood Authority Critical Care Group in
developing the Australian Patient Blood Management Guidelines and on the National Steering Committee for the COVID-19 Clinical Evidence Taskforce.
Anthony is a serving Captain in the Royal Australian Navy and has recently been appointed to the role of Director Navy Health-R. He has deployed on multiple occasions including to Afghanistan twice, the Persian Gulf, Iraq for four tours, border protection duties, to the 2020 bushfires aboard HMAS ADELAIDE and most recently, serving as the Senior Medical Officer JTG 629.3 for Operation COVID-19 Assist.
DR KYLIE JULIAN
Dr Kylie Julian is an Intensivist at the Department of Critical Care Medicine (DCCM), Auckland City Hospital.
She is curious about the impact of intensive care on patients and their whaanau/families. She has been involved in the follow up of bereaved whaanau for several years, and recently has become involved in the DCCM patient follow up team.
Kylie is committed to education and mentoring of trainees. She was instrumental in establishing a region wide mentoring programme for CICM trainees in Auckland.
When not at work, Kylie can usually be found pottering about in the garden.
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ASSOCIATE PROFESSOR STUART LANE
Associate Professor Lane is coordinator of clinical studies and chair of the Personal and Professional
Development teaching theme for the Sydney Medical Program, and a Senior Staff Specialist in Intensive Care Medicine at Nepean Hospital. His primary research interest is phenomenological analysis of human experience. He has implemented the first Intensive Care Unit follow-up clinic in NSW, developing knowledge and theory to optimise patient experience and management whilst they are in the ICU and beyond. He is also a keen ocean swimmer, and in 2017 he swam the English Channel, raising $12500 to assist research into chronic critical illness.
DR JAYSHREE LAVANA
Dr Jayshree Lavana is the Acting Director of the Adult Intensive Care Services (AICS) at The Prince Charles Hospital (TPCH) in
Brisbane. TPCH is state referral centre for cardiothoracic transplantation & advanced circulatory therapies and delivers care to the largest number of cardiac surgical patients across Australia and New Zealand annually. Not surprisingly, cardiorespiratory intensive care medicine is a passion. Areas of special interest include mechanical circulatory support therapies, perioperative cardiothoracic transplantation management and infections in patients with extracorporeal
devices. Education and training are other non-clinical areas of interest given her close involvement with trainees for over 8 years as a Supervisor of training prior to taking on the directorial responsibilities.
DR JANE LEWIS
Dr Jane Lewis trained in respiratory medicine and intensive care medicine in the USA before moving to Australia in 2013. She
is an Intensive Care Specialist at Austin Health in Melbourne. Her research interests include respiratory critical care, mechanical ventilation, end of life care and organ donation. In all her free time, she enjoys anything a 7 year old boy loves as well as running, gardening and in theory, traveling.
DR JAMES LINDSTROM
James is a respiratory physician at University Hospital Geelong and an Intensivist with Mercy Health. After completing his medical
degree and BMedSc thesis on ECMO at Monash University, James trained at the Alfred, Austin and Barwon Health services including the Victorian Respiratory Support Service. James has a specific interest in undifferentiated respiratory failure, endobronchial ultrasound and non-invasive and domiciliary invasive ventilation. He has further research interests in the health impacts extreme environmental events and is an adjunct
clinical lecturer with Deakin University. Outside medicine you can find him hiking, diving, running, eating and generally exploring - 88 countries, and counting… Twitter @airgoesinandout || Instagram @wejustwent
DR ED LITTON
Dr Litton is an Intensive Care Specialist at Fiona Stanley Hospital, Perth, Western Australia and current NHMRC Early Career
Fellowship recipient. He is a member of the management committee of the ANZICS CORE – one of the worlds largest registries of ICU patients. He has >100 publications including in the New England Journal of Medicine, JAMA, BMJ and lancet and is in receipt of >$8M in competitive research funding with interests in anaemia, recovery after ICU, sepsis, the microbiome, mechanical ventilation, cardiac surgery and novel trial designs. He is a Board Member of the Intensive Care Foundation of ANZ, a member of the Australian Clinical Trials Alliance reference group on embedding, and a member of the COVID National Living Guidelines critical illness Clinical Evidence Taskforce. He is the father to three young boys and a triathlete whose ambitions far exceed capabilities.
ASSOCIATE PROFESSOR DEBBIE LONG
Debbie Long is an Associate Professor at the Queensland University of Technology. She is an international
expert in the field of paediatric critical care nursing. Assoc Prof Long has a strong track record in post-traumatic stress following paediatric critical illness. Building on her internationally recognized work in sedation and delirium, she has developed a program of research in functional recovery and long-term outcomes in critically ill children. She is currently leading or part of the Steering Group of several RCTs, including the NHMRC funded NITRIC RCT and its MRFF funded follow-up study. Debbie was recently awarded a prestigious Churchill Fellowship on long-term follow up in critically ill children. She is currently part of an international collaborative developing a core outcome set and measures of PICU long-term outcomes. She is an original member of the ANZICS Paediatric Study Group and currently leads their national Long-Term Outcome group. Debbie is currently leading the DAISY study which looks at GP shared care and long term follow up for children in Queensland.
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DIANE MACKLE
Diane is the ICU Programme Manager at the Medical Research Institute of New Zealand and a PhD candidate at the University of Victoria,
Wellington. She is a registered nurse and has been working in ICU clinical research since 2007. She has previously managed several international ICU trials; most recently the ICU-ROX trial, which was a phase 2 study comparing the conservative oxygen management with usual oxygen management in mechanically ventilated adults in Australian and New Zealand ICUs which informs the current study.
Diane is a recipient of the NZ Health Research Council Clinical Training Fellowship for her PhD in the knowledge translation of oxygen management in ICU. She is in the final stages of writing her PhD thesis, which evaluates the knowledge translation of the ICU-ROX trial. The study (ICU-ROX TRIPS) aims to assess the attitudes and practices before, during and after ICU site participation in ICU-ROX, compared to non-participation.
She is member of several multi-centre trial management committees for the Australian and New Zealand Intensive Care Society Clinical Trials Group and is a member of Australia NZ Clinical Trials Group Point Prevalence Steering Committee.
DR ADRIAN MATTKE
Adrian Mattke is a senior staff specialist and deputy director in intensive care at Queensland Children’s Hospital in Queensland.
He is the lead for the Children’s Health Queensland Extracorporeal Life Support Service.
He trained in paediatric intensive care in Germany, Brisbane, Melbourne and Toronto.
He is an examiner for the College of Intensive Care Medicine.
His work-related interests are in clinical research (ECMO, ECPR, Coagulation, cardiac ICU) as well as ICU teaching. Adrian has been involved in teaching in several Asian countries including India and the Philippines.
PROFESSOR CHRISTINE MCDONALD
Professor McDonald AM MBBS(Hons) FRACP PhD FAHMS F Thor Soc is Director of the Department
of Respiratory and Sleep Medicine at Austin Health, and Medical Director of the Institute for Breathing and Sleep. Her research interests include chronic lung disease and its management, including pulmonary rehabilitation and oxygen therapy.
ASSOCIATE PROFESSOR STEVE MCGLOUGHLIN
Steve completed diverse clinical training in intensive care, training in units in the United Kingdom,
Queensland and the Northern Territory. He has completed a paediatric intensive care fellowship at the Mater Children’s Hospital, in Brisbane. He has also worked for the Royal Flying Doctor Service in Northern Queensland. In addition to intensive care he is an infectious diseases specialist and continues to work in this capacity at the Alfred and has completed a Masters of Public Health and Tropical Medicine.
Steve’s specific research and clinical interests include infections in critically ill patients and sepsis. He is the lead author for the Australian Therapeutic Guidelines chapter on Severe Sepsis. His other interests include intensive care workforce planning, staff stress and patient engagement. He leads a collaboration between the Alfred ICU and Colonial War Memorial Hospital ICU in Fiji to assist in providing educational medical and nursing teams to Fiji. He is currently completing a Masters of International Health Leadership at McGill University. Steve was appointed Director of Intensive Care in 2017.
DR KRISTA MOS
Krista Mos is a paediatric intensivist at The Women’s and Children’s Hospital in Adelaide. She is originally from The Netherlands, having
trained in the UK and Australia. Recently she has embraced the vast natural beauty of South Australia after a decade of metropolitan living. Krista shares her time and interest between the hospital and the SAAS MedSTAR Kids Emergency Medical Retrieval Service Adelaide. Other interests are optimising palliative and bereavement care in the acute setting and complex end-of-life decision making. She combines her efforts in the quality improvement arena with time-and-motion research. She is passionate about staff well-being, workplace culture and education, however nothing brings her happiness like her two boys and catching a good wave.
DR KAVITHA MUTHIAH
Dr Kavitha Muthiah is a Staff Specialist in Cardiology (Advanced Heart failure and Transplant) at St Vincent’s Hospital, Sydney .
Following completion of her PhD in Left Ventricular Assist Devices, she undertook several clinical fellowships in the UK (St Bartholomew’s Hospital, London, Kings College Hospital, London, Papworth Hospital, Cambridge). Prior to returning to St Vincent’s in 2017, she completed a further fellowship at the Alfred Hospital in Melbourne in Advanced Heart Failure. She is a conjoint senior lecturer at the
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University of New South Wales and a researcher at the Victor Chang Cardiac Research Institute. She has won several scholarships and grants including the National Heart Foundation Post-Doctoral Scholarship and Innovation Grant in 2018. She was the first female recipient of the International Society of Heart and Lung Transplant Mechanical Circulatory Support Award in Translational Research in 2018. She has over 30 scientific papers in high impact journals and has been invited speaker at major international and national conferences including at the International Society of Heart and Lung Transplant. She served as the heart failure scientific programme stream lead for the Cardiac Society of Australia and New Zealand Scientific Meeting in 2020 and is currently serving as Council Member as cardiac representative for the Transplant Society of Australia and New Zealand.
DR PRIYA NAIR
Priya Nair is a Staff Specialist and Director of Intensive Care at St Vincents Hospital, Sydney. Through her work at St. Vincents- the
state’s cardiopulmonary transplant and mechanical circulatory support referral centre- she has been involved with service development, clinical and research aspects of advanced respiratory and cardiac failure.
In addition to patient care and service delivery which she enjoys greatly, she has interests in clinical research, education and mentoring. She serves on the bi-national board of the College of Intensive Care
Medicine and is currently the Education Officer. Her other major area of research includes vitamin D and bone health in critical illness.
DR NHI NGUYEN
Nhi is an Intensive Care Specialist at Nepean Hospital and Clinical Director of Intensive Care NSW at the Agency for Clinical
Innovation. Recently she has been advisor for the Intensive Care aspects of the NSW Health response to COVID pandemic.
ASSOCIATE PROFESSOR CHRIS NICKSON
Chris is an Intensivist at the Alfred ICU and the Innovation Lead for the Alfred’s Centre for Health Innovation. He has
a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology, human factors and health professions education. He is a member of the CICM First Part Examination Committee, is the Lead for the Intensive Care Foundation’s Clinician Educator Incubator, and is heavily involved in the Alfred ICU’s education and simulation programmes. He created the ‘Critically Ill Airway’ course and teaches
on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and was co-creator of LITFL.com, INTENSIVEblog.com and the SMACC conference. His one great achievement is being the father of two amazing children. On Twitter, he is @precordialthump.
ASSOCIATE PROFESSOR RACHAEL PARKE
Rachael Parke is Associate Professor, University of Auckland and Nurse Senior Research Fellow,
Cardiothoracic and Vascular ICU, Auckland City Hospital, New Zealand. She has been involved in clinical research since 2004 and is New Zealand’s most successful nurse researcher. She has extensive involvement in local and international investigator initiated clinical trials as an investigator and member of the trial steering committee and has an impressive publication and funding record.
Rachael was awarded her PhD from the University of Auckland in 2014. Her thesis “High Flow Nasal Oxygen Therapy in Patients after Cardiac Surgery” was awarded the Vice-Chancellors Award - Best Doctoral Thesis 2014.
She has published over 100 articles and been named on peer reviewed research grants exceeding NZ$9.6 million. Research interests include, oxygen therapy, fluid management after cardiac surgery and cardiac surgery associated acute kidney injury.
Rachael is passionate about establishing the next generation of researchers and has been instrumental in developing two research courses (BASIC Clinical Research and BASIC Research Coordination) which have been run in 7 countries and has a podcast series - Critical 2 Your Success.
DR MICHAEL PUTT
Michael Putt is a dual trained Respiratory Physician an Intensivist currently working at the Royal Brisbane and Women’s Hospital.
He has a keen interest in Acute Respiratory Failure and its management with both non invasive and invasive ventilation. Other interests include interventional bronchoscopy and the diagnosis and management of pulmonary embolism.
DR SUMEET RAI
Dr Sumeet Rai is an intensivist at Canberra Hospital ICU. He has been actively involved with the College of Intensive Care Medicine as a Supervisor
of Training since 2013 and more recently as a fellowship examiner. His clinical interests have focussed on critical care nephrology and extracorporeal life support and is the co-clinical lead responsible for implementing ECMO services at Canberra Hospital. His research interests include long term outcomes of critically ill patients. In addition, he is actively involved in numerous local and multi centre research trials.
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MS LOUISE RAMSAY
Louise Ramsay is a clinical psychologist, qualified family therapist, and experienced clinical supervisor. She is the Clinical Supervisor
for Psychology as well as the Principal Psychologist in Mental Health, Justice Health, Alcohol & Drug Services within Canberra Health Services. Louise decided to train in family therapy to pursue her passion of working systemically. Louise brings this systemic lens to her work with individuals, families, and organisations and enjoys mentoring others in developing a systemic perspective. Louise has worked as a clinical supervisor across several clinical settings within public and private sectors. Louise is passionate about the psychological wellbeing of staff. During COVID-19, Louise was redeployed to be part of a staff psychological service for her healthcare colleagues working in COVID-19 teams. Louise enjoys family life with her husband and four kids; focusing on healthcare worker wellbeing during COVID-19 highlighted the importance of caring for staff who are often managing two worlds.
PROFESSOR JASON ROBERTS
Professor Jason Roberts is a Clinical Pharmacist at Royal Brisbane and Women’s Hospital and an
Australian National Health and Medical Research Council Practitioner Fellow at The University of Queensland. He
is Director of the Centre of Research Excellence REDUCE which aims to develop optimised antibiotic dosing regimens to improve patient outcomes and minimise the emergence of antibiotic-resistant superbugs.
DR ISURU SENEVIRATNE
Dr Seneviratne, or Izzy as he is more commonly known graduated from the University of Auckland; New Zealand in 2008.
Dr. Seneviratne is a dual specialist in both Intensive Care Medicine and Thoracic Medicine as such is a Fellow of CICM and RACP.
Dr Seneviratne moved to Brisbane in 2014 and has worked in clinical centres of excellence across Brisbane and in New Zealand in both of his specialty fields.
With regards to Intensive Care Medicine, Dr Seneviratne has a special interest in Simulation and teaching as well as bronchoscopy within the ICU. From a Respiratory viewpoint his interests include Peri-operative evaluation and optimisation of individuals with respiratory disease, End-stage/Advanced lung disease (regarding this he has done a Fellowship in Lung Transplantation and Pulmonary Hypertension), and Interventional Bronchoscopy.
ASSOCIATE PROFESSOR KIRAN SHEKAR
Kiran Shekar is a Senior Intensive Care Specialist and Director of Clinical Research at the Prince Charles Hospital,
Brisbane, Queensland. He holds academic appointments as Adjunct Professor at Queensland University of Technology and Associate Professor at University of Queensland. Shekar is passionate about addressing the global variability in intensive care and extracorporeal life support outcomes through innovation, research and education.
His research interests include pathophysiology of cardiorespiratory failure and extracorporeal life support. His ongoing research program “The No Tube Project” aims to integrate less invasive respiratory supports with extracorporeal respiratory support to minimise the burden of invasive mechanical ventilation. His ambitious “Budget ICU Project” brings together clinicians, multidisciplinary allied health professionals, engineers, scientists, clinician researchers, educators, health economists, industry, regulators, international humanitarian organisations and policy experts to develop low-cost, high-value, critical care solutions to improve intensive care access in low and middle-income countries.
Shekar contributes to the Scientific Committee of the International ECMO Network and the Education Committee of Asia-Pacific Extracorporeal Life Support Organsiation (ELSO). He leads the Educational Research Working
Group of the Global ELSO Education Task Force. He is the Chair of the ELSO COVID-19 guideline working group and Deputy Co-chair of the National COVID-19 Clinical Evidence Taskforce Hospital and Acute Care Panel. He is also a member of the ANZICS Education Committee and contributes to the CICM Extracorporeal Life Support Special Interest Group.
DR LOUISE SPEEDY
Dr Louise Speedy is an Intensivist and Anaesthetist based at Hawke’s Bay Hospital, New Zealand. She is also a Medical Officer
with the NZ Army, currently a Reserve Force Major with the Deployable Health Organisation. Her work interests include communication and team dynamics and she is currently establishing a multidisciplinary perioperative Goals of Care Clinic. Outside of work Louise enjoys mountain biking and adventure racing.
DR PENNY STEWART
Dr Penny Stewart has worked in Alice Springs Hospital in Intensive Care for the past 15 years. She has joined the college board to help
in the portfolios of Rural Intensive Care and Indigenous Health. Penny believes that intensive care has an important role in stabilising the health workforce in rural areas and has a role in advocating for public health changes where public health issues lead to excess intensive care admissions.
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DR ANDREW TAI
Dr Tai is a Paediatric Respiratory and Sleep Physician, Head of Department at the Women’s and Children’s Hospital
Adelaide and Honorary Senior Lecturer at the University of Adelaide. He completed his advance training at the Royal Children’s Hospital Melbourne and PhD in 2011 following the famous Melbourne childhood asthma cohort to the age of 50 years and was awarded the best Paediatric abstract at the American Thoracic Society conference. Dr Tai is a current board director with the Thoracic Society of Australia and New Zealand (TSANZ) and has served as conference chair for the TSANZ and Asthma Australia conferences. He is also a member of the Paediatric working group contributing to the Australian Asthma Handbook. Dr Tai has an interest in early origins of asthma and longitudinal outcome of childhood asthma, cystic fibrosis research and paediatric respiratory clinical trials. Dr Tai publishes in high impact journals in respiratory medicine such as Journal of Allergy and Clinical Immunology, American Journal of Respiratory and Critical Care Medicine and Thorax.
PROFESSOR CLAIRE WAINWRIGHT
Professor Claire Wainwright is a paediatric respiratory physician and Co-Lead for cystic fibrosis services at
the Queensland Children’s Hospital in Brisbane Australia which manages around
460 children with CF. Claire started her medical training in London and completed her training in paediatric respiratory medicine at the Royal Children’s Hospitals in Brisbane and Melbourne. Her research interests include clinical trials, development of lung disease in CF, airway microbiology, acute viral bronchiolitis, and patient reported outcomes in CF.
DR BRAD WIBROW
Bradley WIbrow is an Intensivist at Sir Charles Gairdner in Western Australia. He is part of the writing group for the ANZICS
COVID-19 guidelines and the National COVID-19 taskforce. He is the Clinical Director of Critical Care for WA Country Health and was involved in setting up a telehealth service as part of WA’s COVID response. He also works as an Emergency Physician and is the ANZICS chair for WA.
DR TINA XU
Dr Tina Xu is a China-trained physician, Australia-trained intensivist and UK-trained extra-corporeal membrane oxygenation (ECMO)
specialist. Having earned her MBBS and master’s degrees in medicine in 1995 and MD-PhD degree in Gastroenterology in 2000, her first senior position was Attending Physician in Gastroenterology at Peking University Medical College Hospital, Beijing. Following her relocation to Australia in 2002 and joining the
intensive care medicine training programme in 2007, she was awarded the Fellowship of the College of Intensive Care Medicine of Australia and New Zealand in 2015 and has been working as a consultant intensivist since.
Tina’s special interest in ECMO led her to work as an advanced trainee in Royal Prince Alfred Hospital, Sydney in 2015 and relocation to the UK in 2017, working as an ECMO Fellow then ECMO consultant at Royal Brompton Hospital, London, a renown national heart and lung centre and one of five NHS-commissioned ECMO centres for severe acute respiratory failure. Her one-year fellowship and 3-year consultancy in this ELSO Centre of Excellence - Platinum Level has recorded more than 100 ECMO retrievals/cannulations personally as well as comprehensive experience in managing complex heart and lung conditions, ECMO and other forms of extra-corporeal life support. She was proudly in the frontline combat with the first wave COVID-19 pandemic in UK and has just returned to Australia having the opportunity of sharing her experience in both conventional and ECMO management for COVID-19.
Outside work, she is a freelance web-designer, an enthusiastic chef and vegetable gardener.
A/PROF MARC ZIEGENFUSS
A/Prof Marc Ziegenfuss is a Senior Intensivist and past ICU Director at the Prince Charles Hospital in Brisbane.
He is also a Past-President of ANZICS and the current Chair of the Queensland State wide Intensive Care Network.
As Network Chair the onus of an efficient, appropriate and effective Intensive Care response to COVID-19 rested on his Shoulders. Queensland was the first State to assemble an Emergency Response to COVID-19 in January of 2020. Co-ordinating a threefold increase in Intensive Care capacity in Queensland involving resource expansion and optimisation; workforce allocation and re-allocation, training and protection; and potentially resource rationing were all rapidly achieved through centralised inventory accounting and purchasing and extensive planning and communication with the Intensive Care Community. Expansion and sustainable Staffing of COVID-19 Pandemic-specific Telemedicine and retrieval Services to support remote areas was achieved. The Queensland Intensive Care response reflected a great Team effort. Marc also assumed national and international roles in the COVID-19 Pandemic response which are ongoing.
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N E W F ELLOWS
Dr Hussam Abdelkarim
Dr Reyas Aboobacker Kaniyamparambil
Dr Himanshu Aneja
Dr David Antognini
Dr Judith Askew
Dr David Baguley
Dr Anup Bansal
Dr Alexander Bates
Dr Bronwyn Bebee
Dr David Bertoni
Dr Tobias Betteridge
Dr Sebastiaan Blank
Dr Emma Bowcock
Dr Edward Briggs
Dr Thomas Burbidge-King
Dr Stephen Burke
Dr Alasdair Burns
Dr Liam Byrne
Dr Sadie Callahan
Dr Mitchell Cameron
Dr Santiago Cegarra Garcia
Dr Jian Wen Chan
Dr Jolly Chandran
Dr Jason Tsun Lung Chapman
Dr Adelaide Charlton
Dr Katherine Chatten
Dr Mitul Purushottam
Chavda
Dr Cheau Wern Chin
Dr Andrew Chow
Dr Rahul Costa-Pinto
Dr Julia Coull
Dr John D’arcy
Dr Sananta Dash
Dr Michael Davies
Dr Sachin Desai
Dr Kate Douglas
Dr Adam Drenzla
Dr Stuart Duffin
Dr Matthew Durie
Dr Khaled El-Khawas
Dr Jonathon Fanning
Dr Mohamed Fayed
Dr Meyrelle Fernandes
Dr Ritesh Firke
Dr Leigh Fitzpatrick
Dr Thomas Flett
Congratulations to all the new CICM graduates and “Welcome to the Fellowship!” Your hard work is admirable, recognised and applauded. The last year brought so many challenges to your professional and personal lives, yet you all continued to work hard to get here today. Many of you have navigated the fellowship exam in the most unusual circumstances, with patience and perseverance. Take a moment to be proud of everything you have achieved!
As intensivists, you will all have so much to contribute to the world of medicine and intensive care. Pursue your professional dreams, embrace your new responsibilities, remember the challenges it took for you to get here and be generous with your time and your experiences so you can mentor your junior colleagues. Aim for balance in your life and self-care, and spend time doing things you love with people you love.
The “real life” graduation ceremony has been delayed for another year, but I am already excited for the great celebration planned for all of you in 2022.
So, when you can’t have all the desired pomp because of the undesired circumstances, I want to wish you all the best of luck in this next exciting phase in your life. You’ve travelled an enormously long road to get here. It is a huge achievement and a real milestone - wherever you are right now, please celebrate your great success!
Dr Nicky Dobos Intensivist, Western Health VIC
CICM New Fellows Representative
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Dr Anamika Ganju
Dr Ashley Garnett
Dr Tessa Garside
Dr Michelle Gilchrist
Dr Denzil Gill
Dr Corynn Goh
Dr Siddharth Goswami
Dr Christopher Grealy
Dr Jatinder Grewal
Dr Leanda Griffin
Dr Vishal Gupta
Dr Andrew Haggerty
Dr Alyssia Haling
Dr Emily Harman
Dr Kristin Hayres
Dr Simon Hellings
Dr Alexander Hussey
Dr Arun Ilancheran
Dr Melanie Jansen
Dr Guido Janssen
Dr Dominic Jeffcote
Dr Barry Johnston
Dr Melissa Johnston
Dr Jade Jones
Dr Angelo Justus
Dr Kalai Kanagasingham
Dr Erin Kelland
Dr Montaha Khan
Dr Hooi Hooi Koay
Dr Aashish Kumar
Dr Hamish Lala
Dr Ka Yi Lam
Dr Jessica Lane
Dr Kevin Laupland
Dr Steven Lindstrom
Dr Lowell Ling
Dr Joanna Longley
Dr Sandra Lussier
Dr Shona Mair
Dr James Malycha
Dr Vong Prasith Mao
Dr Prashanti Marella
Dr Philippa McIlroy
Dr Ronan McKenna
Dr Lewis McLean
Dr Rukhshad Mehta
Dr Juliette Mewton
Dr Helen Miles
Dr Owen Milne
Dr Ravi Mistry
Dr Cara Moore
Dr Juan Mora
Dr Thea Morris
Dr Idunn Morris
Dr Robert Morrow
Dr Krista Mos
Dr Gerard Moynihan
Dr Renesh Nair
Dr Wai Tsan Ng
Dr Diarmuid O Briain
Dr Robert Olver
Dr Yuichiro Ono
Dr Matthew Ostwald
Dr Daniel Owens
Dr Rajesh Pachchigar
Dr Nagaraj Pandharikar
Dr Samarasimha Pandhem
Dr Reena Patel
Dr Fiona Perelini
Dr Claire Pickering
Dr Mark Plummer
Dr Michael Purvis-Smith
Dr Lachlan Quick
Dr Christine Quigley
Dr Liam Quinn
Dr Hannah Reynolds
Dr Sebastian Rimpau
Dr Hayley Robinson
Dr Hannah Rotherham
Dr Shanaz Matthew Sajeed
Dr Ryan Salter
Dr Behnoosh Samadi
Dr Luis Schulz
Dr Marie Scott
Dr Jannien Senekal
Dr Sandeep Sethi
Dr Avinash Sharma
Dr Kalpana Sharma
Dr Mark Shea
Dr Benjamin Silbert
Dr David Silverman
Dr Kai Sin
Dr Sile Smith
Dr Matthew Spotswood
Dr Fiona Stanley
Dr Julian Sunario
Dr Sing Tan
Dr Jonathon Taylor
Dr Rojan Thomas
Dr Michael Toolis
Dr Katherine Triplett
Dr Rajshree Trivedi
Dr Michaela Waak
Dr Atul Wagh
Dr Vidyesh Wakade
Dr Ryan Watts
Dr Mark Weeden
Dr Pieter Weemaes
Dr Stephen Whebell
Dr Kyle White
Dr Joseph Wilbers
Dr Wai Tat Wong
Dr Elliott Worku
Dr Tracey Wraight
Dr Nikki Yeo
Dr George Zhou
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WHATS ON
VIRTUAL SOCIAL EVENT5:30 - 6:30pm WEDNESDAY JUNE 2nd
JOIN US FOR A NIGHT ON BROADWAYPull out that ballgown and dinner suit, take a seat at your desk chair, dim those lights and let us entertain you for a Night On Broadway, in the comfort of your home. Featuring songs from off-Broadway hits to the mega-musicals, performed by Australian artists. As a onetime offer, you will have the best seats in the house, up close and personal with our stars for our virtual concert. A number of Australian Companies have provided performances from current stage shows for your enjoyment.
SONGS FEATURED WILL INCLUDE
Maria – West Side Story
Till I hear you Sing – Phantom of the Opera
Lily’s Eyes – Secret Garden
Evermore – Beauty and the Beast
And many more…
FEATURING: Australian Artists
Hew Wagner
Michaela Burger
Paul Brand
Michael Cassel Group
Global Creatures
EXHIBITION PRIZE DRAWVisit our sponsors and exhibitors within the exhibition zone and complete the daily prize draw form to go in the draw to win an amazing indigenous painting. The paintings represent Australia and Aotearoa New Zealand Indigenous art.
Simply download a daily form from the Exhibition Passport tab on the left of your screen and enter each day. See full terms and conditions of entry.
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ENTER DAILY TO
WIN VISIT OUR SPONSORS
AND EXHIBITORS IN THE
EXHIBITION ZONE
If you are looking for support for your educational programs, whether it be equipment or financial, please consider offering our ASM sponsors and exhibitors first opportunity. Our sponsors and exhibitors would welcome the opportunity to participate in educational initiatives in your department or hospital.
E DU C ATIONAL & T R AINING SUPPORT
ABIOMED Colette Chew / David Fletcher+6597569842 / [email protected] / [email protected]
ANZICS Brent Kingston03 9340 [email protected]
AVANT Mutual Group
1800 226 268Complete Online Contact form www.avant.org.au/Contact-Us/
BD Australia & New Zealand
Louise Leslie0429 789 [email protected]
Baxter Healthcare Acute Therapies
Gordon Ramsay1800 BAXTER [email protected]
CSL Behring Adele Kelly0438 794 [email protected]
Device Technologies
Nicholas Arnold+61 427 016 [email protected]
Draeger Australia Craig Ovzinsky+61 438 559 [email protected]
Fisher & Paykel Healthcare
John Rogan0437 991 [email protected]
Fresenius Medical Care Australia
Jun Yong+61 0413 151 [email protected]
GE Healthcare Ben Edwards 0449 639 [email protected]
Linet Breanna Fountain0432 959 [email protected]
Nikkiso Medical Xanthe Skinner0438 426 [email protected]
Pfizer Australia Melissa Hardy, Medical Scientific Liaison+61 466 793 [email protected]
Vyaire Medical Beau Geekie0414 108 [email protected]
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E XHIBITION ZONE
Colette Chew / Richard Hattam+6597569842 / [email protected] / [email protected]
Brent Kingston03 9340 [email protected]
1800 226 268Complete Online Contact form www.avant.org.au/Contact-Us/
Michele Cayley 0428 875 [email protected] www.bd.com/en-au
Baxter Healthcare Acute TherapiesGordon Ramsay1800 [email protected]
Rob Williams0481 858 [email protected]
Nicholas Arnold1300 DEVICE (338 423) / +61 427 016 [email protected]
Craig Ovzinsky+61 438 559 [email protected]/en_aunz/Hospital/Intensive-Care
John Rogan0437 991 [email protected]
Jun Yong+61 0413 151 [email protected]
03 9514 2888 www.cicm.org.au
Ben Edwards 0449 639 [email protected]
Breanna Fountain0432 959 757Breanna.fountain@ linetgroup.comwww.linetaustralia.com
Xanthe Skinner0438426985xskinner@nikkisomedical.comwww.nikkisomedical.com
Gary Ellis+61 419 294 [email protected]
Beau Geekie0414 108 [email protected]
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G E NER AL INFORMATIONCPD POINTSCertificates of Attendance will be emailed out post event. The ASM -2A Passive Group Learning – 1 point per hour.
EVALUATIONSAn online evaluation link will be emailed out post event.
HELP DESKIf you require assistance during the ASM, go to the ASM virtual Platform page, https://cicm2021asm.delegateconnect.co/
simply click on the pink bubble at the bottom right of your screen and a delegate connect person will be there to help. Alternatively contact [email protected]
ON-DEMANDPresentations will be available to registered delegates for a period of 12 months. Content will be determined by speakers’ permission to include their presentation.
SOCIAL EVENTSA number of sponsored dinners have been organised. Attendees will have been contacted with this information. If you are no longer able to attend, please contact the person looking after your dinner.
Dinners will be subject to state based COVID restrictions and guests who are registered through us to attend will be notified of any changes.
VIRTUAL SOCIAL EVENT
Join us for Ä Night On Broadway’, featuring amazing Australian talent. Simply visit the virtual platform, click on Day 2 of the program, scroll to Virtual Social Event and click on the heading to watch our preview.
TWITTER #VIRTUALASM2021
#CICM2021ASM
VIRTUAL ETIQUETTEThe safety and wellbeing of participants before, during and after the conference is a key priority.
We intend that this conference, like all College events, to be an inclusive, anti-discriminatory and anti-racist space.
This conference will bring together dedicated and passionate individuals. With this in mind, we ask that all interactions be respectful, mindful of the diversity of other delegates’ experiences and
conscious of your interactions through this technology. We positively promote wellbeing and cultural safety. It is also important to take care of yourself while participating in the conference.
As this is a virtual conference, we remind all delegates to ensure they are safe, positive and constructive in both offline and online spaces.
Anyone who displays disrespectful, hateful, or harmful language or conduct will be removed from the conference and have their user profile blocked and cancelled.
WHAT I NEED TO ATTEND THE VIRTUAL ASMUser Login and password
(All registered attendees will receive an email from Delegate Connect no later than 1 week prior to the event. This will prompt you to create a user password and profile and then you can log in. You will then have access to all the live sessions from 1-3 June and On-Demand post event for 12 months).
Log in will be available from Tuesday 25th May. Make your profile public so others can chat to receive event notifications and to enter the exhibition passport daily draw.
• A desktop computer, laptop, iPad, mobile phone.
• A reliable WIFI connection
• Microphone, Headphones • A digital copy of the ASM Handbook
(Coming Soon)• A comfortable space and plenty of
refreshments
Please Note: Headphones, microphone, and standard device camera are recommended to improve your attendance and to make the most out of our live Q & A, visiting our exhibitors and networking.
IMPORTANT INFORMATION
The email address you registered with is the email address you must use to create your profile.
We strongly recommend you set your profile up and test your log in prior to Tuesday 1st June:
This is to ensure you have no IT issues on Day 1.
You have one registration: one device.
This platform is mobile, ipad, desktop and laptop friendly.
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I NVITED SPEAKERS PRES ENTATION SYNOPSIS
TUESDAY 1st JUNE
SESSION 1: COVID Responses around the world10:00AM – 12:00PM AEST
TITLE: A patient & family experience
In her own words, we invite Sherene, an aged-care worker, wife, and mother of two, to share her experience of severe COVID-19 pneumonia. Spending over a month in hospital, including requiring VV-ECMO for refractory hypoxia, Sherene outlines her healthcare journey, her key recollections from ICU, the toll COVID-19 has taken on her overall health and family, and what we can learn from her experience.
PRESENTED BY: Professor Andrew Udy
PRESENTER: Dr Irma Bilgrami
TITLE: Melbourne
STAYING APART KEEPS US TOGETHERVictoria reported its first case of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on 25th January 2020. What followed was a roller coaster ride for Victorians involving hard lockdowns, curfews and border closures.
Over the course of the year, 20,000 people were infected, 271 patients needed ICU and 820 lives were lost. 2599 health care workers (HCW) in Victoria were infected with SARS-CoV-2 in the healthcare setting the majority of whom worked in aged care, as nurses or aged-care workers.
Both the virus and the restrictions affected the most vulnerable. The economic and social inequalities were laid bare. Melbourne’s northern and western suburbs, home to a majority low income, casualized workforce, bore the brunt. One health service in the western suburbs managed 21% of Victorians requiring ICU. The Victorian Cluster Response, initiated by ICU Directors and supported by ANZICS worked closely with Adult Retrieval Victoria (ARV)
and transferred patients within the state to ensure best care. Consequently, no ICU in the state operated above capacity.
Everyone stepped up. The general public, who stayed home and the frontline workers, who showed up to work. A drive to improve the workplaces and protect HCWs led to innovations. The ‘Patient Isolation Hood’, invented for use in an open ICU was TGA approved and shown to reduce aerosol counts by 98%.
In the ICU, nursing and medical staff worked 12 hour shifts and skillfully managed the critically unwell, providing reassurance to families over a computer screen. They juggled patient care with information overload from constantly changing guidelines and the fear of lack of PPE in the early days. Anxiety, fear, dread, exhaustion- just some of the emotions many described.
All Victorians have worked hard. Currently, there are no cases of community transmission. Perhaps, it is now time to bravely reflect on 2020 to address the social inequalities in our community and the systems that struggled to protect our HCWs. The work needs to continue to keep us together.
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PRESENTER: Dr Brad Wibrow
TITLE: Western Australia
Western Australia has been extremely fortunate in the COVID pandemic with almost no community transmission due to our relative isolation and hard border. However, we did have a cohort of sick cruise ship patients relatively early in Australia’s experience including the first COVID death. Preparation in WA brought unique issues trying to cover such a large area with multiple small communities. At the end of the day, like elsewhere, this involved a lot of logistics, luck and good will from the critical care and wider medical community
PRESENTER: Associate Professor Marc Ziegenfuss
TITLE: Queensland
The Queensland Intensive Care Network Covid-19 Pandemic response centred around minimising avoidable loss of life in Intensive Care Units due to the Virus.
Paramount was protecting the Intensive Care Workforce through provision of adequate and appropriate knowledge of the ever-evolving disease, equipment for care, potential rationing of care, and improving centralised organisation, communication and support to all ICUs, to as such “make the whole greater than the sum of its parts’.
The relationship between Clinicians and Politicians was rapidly cemented to facilitate flexibility and adaptability to the emerging threats
PRESENTER: Associate Professor Jason Phua
TITLE: Singapore
Perhaps contrary to popular belief, COVID-19 did not spare Singapore. Not long after a relatively good start at keeping the disease at bay, the number of cases ballooned across the island nation, in large part due to outbreaks in dormitories for migrant workers. This notwithstanding, Singapore’s case fatality rate and number of deaths per 100,000 population remained by far some of the lowest in the world. This talk will describe Singapore’s public health response, with a focus on its intensive care community’s approach, towards the pandemic.
PRESENTER: Associate Professor Luregn Schlapbach
TITLE: International Paediatric COVID experience
While the COVID-19 pandemic has resulted in an unprecedented challenge to healthcare systems and ICU resources mainly for adult patients, the ways the pandemic affected critically ill children globally have often received less attention. Contrary to previous pandemics such as the H1N1 flu, direct COVID-19-related critical illness in paediatric age groups has remained rare. Large epidemiological studies from the US and Europe indicate that the vast majority of children infected with COVID-19 remain asymptomatic. We will discuss phenotypes of COVID-19 manifestations in critically ill children and neonates, but then focus more on a unique paediatric-specific phenomenon associated with COVID-19, namely Paediatric Inflammatory Multisystem Syndrom (PIMS-TS, or MIS-C), and highlight lessons learnt from this condition. Finally, we will explore indirect impacts of the pandemic on critically ill children, including aspects such as the dilemma of restricting parental access to acutely ill children, altered non-COVID epidemiology, socioeconomic issues, and finally, how the pandemic may change the future of paediatric research.
PRESENTER: Professor Richard Haynes
TITLE: The RECOVERY Trial: go big or go home
In order to distinguish moderate treatment effects of a treatment from no effect, randomization of large numbers of patients is required. The RECOVERY trial was set-up rapidly as the COVID-19 pandemic reached the UK to ensure that large numbers of patients from hospitals across the UK could be recruited without interfering with the clinical care of the patients while the hospitals were under significant stress. By keeping the trial procedures simple and only asking hospitals to do what was absolutely required, the RECOVERY trial randomized 10,000 patients in 8 weeks and provided robust information on three potential treatments within 3 months. The methods used in RECOVERY could and should be applied to many other diseases beyond COVID-19 and address many of the important uncertainties in patient care and population health.
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SESSION 2: The lungs: Not so sterile1:00 – 3:00pm AEST
PRESENTER: Associate Professor Rachel Parke
TITLE: Non-pandemic severe acute respiratory infection.
Remember back to a time 18 months ago when COVID was not a word you were familiar with.
When severe acute respiratory infection (SARI) meant influenza, community acquired pneumonia or perhaps if you were lucky, some really unusual type of pneumonia! We didn’t know about lockdowns, bubbles, flattening the curve or Zoom.
What do we know about SARI incidence and treatment innovations in the last year? How may SARI therapies perhaps change given our pandemic experience? What will the world post-COVID look like in terms of management of SARI and how are we studying this now?
PRESENTER: Professor Jason Roberts
TITLE: Effective antibiotic drug dosing for Pneumonia – beyond plasma levels.
Pneumonia remains a global healthcare challenge associated with substantial morbidity and mortality. Antimicrobial therapy is the primary intervention used by clinicians, but variable effectiveness exists which in part can be related sub-optimal dosing. To be maximally effective, antimicrobial dosing should ensure therapeutic concentrations at the site of infection, which in the context of pneumonia, is measured in the epithelial lining fluid (ELF). Of course, defining which concentration is ‘therapeutic’ is affected by the susceptibility of the pathogen to the antimicrobial (pharmacodynamics). Concentrations in the ELF for most antimicrobial are affected by typical factors like renal function and body size, as well as sickness severity, lung inflammation and
presence of fibrosis from chronic pathologies like chronic obstructive airways disease. Careful interpretation of data is also important as concentration-time profiles in the lung do not match plasma and so singular time-point comparisons can provided misleading estimates of drug penetration. Available data demonstrates highly variable antimicrobial exposures in ELF, both between antimicrobials and between patients receiving the same antimicrobial. Antimicrobials considered to have consistently adequate penetration into the lung include linezolid and macrolides like azithromycin. Beta-lactams have variable penetration (e.g. meropenem ELF exposure is <5% to >200% in ventilator associated pneumonia patients). Other drugs have low and variable penetration including glycopeptides, whilst the aminoglycosides have such low penetration that they are considered not a clinical option in monotherapy. The importance of antimicrobial penetration into the lung is being recognized by pharmaceutical industry, with some drugs like ceftolozane-tazobactam now having a pneumonia-specific dose which is twice the urinary tract and intra-abdominal infection doses to account for ~50% lung penetration.
PRESENTER: Dr Rob Arntfield
TITLE: Lung Ultrasound
Described a mere 25 years ago, our understanding of lung ultrasound and how it can be used to inform rapid, bedside diagnosis and management of the critically ill is growing rapidly. From basic B lines to advanced techniques – this education-focused talk will, in addition to providing examples of all key lung ultrasound findings, will discuss integrating these findings, practical tips and future directions.
PRESENTER: Dr Michael Putt
TITLE: Endoscopic interventional pulmonology.
Interventional pulmonology techniques and procedures have become more complex over the past decade. There are a multitude of procedures for both diagnostic and therapeutic purposes available to the clinician. These range from Endobronchial Ultrasound (EBUS) for accurate diagnosis of malignant and non-malignant conditions, to Bronchial Thermoplasty for therapy in moderate to severe asthma, to stent insertion for airway obstruction or tracheo-oesophageal fistula. Not all procedures are relevant to current Intensive Care Medicine practice.
This presentation will focus on three procedures relevant to Intensive Care Medicine. Firstly, the use of endobronchial valves in the management of persistent air leaks from broncho/alveolar-pleural fistulae. This technique allows resolution of air leaks in patients on mechanical ventilation, who may not be fit for surgical intervention. This is a novel use of these devices, which were originally designed for endoscopic lung volume reduction in COPD. Secondly, the technique of cryobiopsy for diagnosis of parenchymal lung disease and the risk of pneumothorax and significant haemorrhage with this procedure. Significant haemorrhage has been described after cryobiopsy and may need ICU admission, if life threatening. The use of a bronchial blocker at the time of the procedure reduces bleeding risk. Lastly, the therapeutic modality of bronchial thermoplasty (BT) for moderate to severe asthma and the risk of exacerbation post procedure. BT requires three separate bronchoscopic procedures, three weeks apart. Patients are at risk of exacerbations of asthma up until six weeks after the last procedure. A lower FEV1 predicts the risk for post procedure hospitalisation.
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SESSION 3: Life after ventilation3:30 - 5:00PM AEST
PRESENTER: Associate Professor Hallie Prescott
TITLE: Chronic critical illness.
This talk will review the definition, burden, and prognosis of chronic and persistent critical illness. Historically, prolonged ICU stays have been thought of as being synonymous with prolonged mechanical ventilation, which was termed “chronic critical illness”. However, many patients remain stuck in the ICU for reasons other than persistent mechanical ventilation. While some patients have persistent organ failure necessitating ICU care, other patients experience a cascade of problems, such that what keeps them in the ICU may differ substantially from what brought them to the ICU in the first place. A new syndrome of “persistent critical illness” has been defined to encompass the broad scenarios by which patients remain ICU-dependent due to ongoing illness and clinical instability that is no longer directly attributable to the original organ dysfunction prompting ICU admission. In several large-scale epidemiologic studies across multiple countries, persistent critical illness had been empirically determiend to begin around 10 days after ICU admission. This is the point at which characteristics at ICU admission (admission diagnoses and physiologic derangements) are no longer more predictive of mortality than antecedent characteristics (age, sex, chronic health status). While persistent critical illness occurs in just 5% of ICU admissions, it has a disproportionate impact on ICU resource use—accounting for nearly a third of all ICU bed-days. Furthermore, rates of persistent critical illness vary more than 3-fold across hospitals, suggesting the importance of contextual as well as patient factors in the development of persistent critical illness.
PRESENTER: Dr Sumeet Rai
TITLE: Barriers to rehabilitation.
Despite emerging awareness of Post Intensive Care Syndrome (PICS), there is lack of robust evidence on optimal rehabilitation strategies for ICU survivors. The precise timing of initiation, duration, frequency (dose) of early physical rehabilitation remains unclear. Studies that focus on psychological rehabilitation of ICU survivors are sparse and show mixed benefit.
There are multiple modifiable barriers to the ongoing rehabilitation of ICU survivors in acute care hospitals. Some of the barriers to in-hospital rehabilitation include:A. Patient factors: delirium, weakness, frailty,
physiological safetyB. Knowledge and skills: knowledge of PICS; general
knowledge and skills around mobilisation; inadequate training and adherence to pain, agitation and delirium guidelines
C. Environment and resources: Inadequate staffing/equipment/space/funding
D. Behavioural: Lack of mobility champions, absence of protocol/medical order for mobilisation, lack of interprofessional communication
Addressing these barriers and investing in future research related to rehabilitation strategies may have benefits for the ongoing care of ICU survivors.
PRESENTER: Associate Professor Debbie Long
TITLE: Is it time to see beyond ICU: Paediatrics
Most children are surviving critical illness in highly resourced paediatric intensive care units (PICUs). However, in research studies, many of these children survive with multi-domain health sequelae that has the potential to affect development and be life-long, termed post-intensive care syndrome-paediatrics (PICS-p). Clinically, there are no recommendations for the assessment and follow-up of children with critical illness
as exists for the premature neonatal and congenital heart disease populations.
To date, primary and secondary outcomes have been largely assessed at or prior to hospital discharge, disregarding post-hospital outcomes important to PICU stakeholders. Incorporating longer term outcomes into clinical and research programs, however, can no longer be overlooked. Barriers to outcomes assessments are varied and generalized vs. individualized, but some PICU centres are discovering how to overcome them and are providing this service to families – sometimes specific populations - in need. Research programs and funders are increasingly recognizing the value and need to assess long-term outcomes post-PICU.
The considerations, challenges and barriers to long-term follow-up following paediatric critical illness will be explored and current national and international approaches to research and clinical follow-up discussed.
PRESENTER: Associate Professor Stuart Lane
TITLE: Embedding research in follow up.
THE USE OF PHENOMENOLOGY AND INTERPRETATIVE PHENOMENOLOGCICAL ANALYSIS TO STUDY INTENSIVE CARE PATIENTS’ EXPERIENCES AT POST-ICU DISCHARGE FOLLOW-UP: ENSURING COMMUNICATION AND EMPATHY AS THE CORNERSTONES TO GOOD CLINICAL PRACTICE
IntroductionPost Intensive Care Syndrome (PICS) describes the health problems that remain after critical illness. There is an increasing interest in the human experiences of Intensive Care Unit (ICU) patients, to ensure greater holistic care and management.
Research questionWhat is the lived experience of patients with critical illness in the ICU?
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DesignPhenomenological study.
SampleThe first fifteen patients referred to a post-ICU follow-up clinic.
Data collection and analysisFace-to-face interviews with Interpretative Phenomenological Analysis.
Results and methodological insightsTwo superordinate themes were identified. The superordinate-theme ‘I have a voice, you’re just not listening’ had three themes: ‘Patience, not predictive text’, ‘Yes, I did just say that’, and ‘Talk to the hand’. The superordinate-theme ‘Wear my shoes-empathic understanding’ had three themes: ‘Care not pity’, ‘From the minute I wake up’, and ‘Small things are massive’.
Whilst empathy and communication are often discussed as vital aspects of patient care, this study provides context and examples of how they impact everyday practice for all healthcare staff. The methodology and methods used in this study, phenomenological and IPA are ideally suited to the patient experience and will be critical in future analysis of ‘long-COVID’ patients, which are currently being studied in COVID-recovery.
The use of phenomenology and interpretative phenomenological analysis to study intensive care patients’ experiences at post-ICU discharge follow-up: ensuring communication and empathy as the cornerstones to good clinical practice
PRESENTER: Dr Kylie Julian
TITLE: Bereavement follow-up: Connecting with those who are left behind.
As we look beyond ICU to the impact of critical illness and intensive care therapy on survivors, we also recognise the impact on the bereaved. Complicated or difficult grief and post traumatic distress are common experiences after a bereavement in ICU. Follow up by intensive care teams can help address questions that may be barriers to grieving. Learning more about the experience of the bereaved in our units can help us improve the care we provide to dying patients and their families, and the support we provide to clinicians caring for patients.
This presentation will discuss what we know about grief after a death in ICU. The evidence for bereavement follow up will be reviewed. Guiding principles for follow up teams, which acknowledge the limitations of the evidence and the vulnerability of those followed up, will be discussed.
WEDNESDAY 2nd JUNE
SESSION 5: The air we breathe
TITLE: The Survivors’ Story
Focusing on a dialogue with ICU survivors from the Top End of Australia, we will explore what survival means.
In ICU, we have moved on from a culture of making value judgments on behalf of others. At the same time, the decisions we make are often very technical and there is just not time to phrase the information in a way that patients and their families can use to make decisions. What we are left with, in this situation, is not some new problem caused by technology. It is the simple human realities that cosmopolitan societies have always faced:
• How do we create a joint description of reality? • How do we take decisions together when one side will
always have more information, and the other has greater need of that information?
• How do we find out what another person cares for when we can little imagine it?
Among the many advantages of the CICM is in the duty of its Fellows to serve people who live a cosmopolitan life every day, between two or five different languages, traditions of law and economic models. We will describe this project which aims to expand our imaginations beyond the answers we are able to demand with simple questions, to what we must intuit as humans.
PRESENTED BY: Dr Lewis Campbell
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TITLE: Te Mana o te Tangata: sharing a story of ICU survivorship and meaningful recovery
Gary and his whānau have shown great resilience in adversity and we honour and respect their perspective.
Gary is a 70 year old retired lawyer who spent two months in Wellington ICU during lockdown. He had a ruptured AAA requiring emergency surgery. His stay was complicated by severe multi-organ failure, septic and vasoplegic shock, ischaemic colitis, open abdomen, infarcted omentum, ischaemic rectus muscle, bilious ascites, intra-abdominal collections and adhesions, stoma breakdown, TPN-induced pancreatitis, delirium, ventilator-acquired pneumonias and 1399 hours of ventilation. Gary, his wife Philippa and daughter, Rahera tell their whānau’s story of their time in ICU and a year long road to recovery.
PRESENTED BY: Dr Kim Grayson
PRESENTER: Dr Anthony Delaney
TITLE: Bush-fire related complications
The management of patients who have suffered burn injury in bushfires can have a significant impact on an ICU. This impact is both in terms of the volume of critically ill patients with the local and systemic manifestation of severe thermal injury, but also respiratory complications related inhalational injury. Burns injury is a multisystem disease, with the ICU team playing a key role in providing wholistic care. The adverse effects of bushfires related to the increase in air pollution across a range of conditions is yet to be determined.
PRESENTER: Professor Christine McDonald
TITLE: Thunderstorm Asthma
Thunderstorm asthma is the triggering of an asthma attack by environmental conditions directly caused by a local thunderstorm. During thunderstorms in spring or summer, when there is a lot of pollen in the air and
the weather is dry and windy, pollen grains can absorb moisture and then burst into much smaller fragments which are easily dispersed by wind. While larger pollen grains are usually filtered in the nose, the smaller pollen fragments are able to pass through and enter the lungs, triggering an asthma attack. Risk factors for emergency department presentation with thunderstorm during the largest recorded episode of epidemic thunderstorm asthma in the world in Melbourne, Australia on November 21st 2016, included Asian or Indian ethnicity, presence of allergic rhinitis with marked rye grass pollen sensitisation, and unrecognised or under-treated asthma. Management of thunderstorm asthma includes preventive therapy for management of asthma and asthma triggered in this way responds to standard management. This presentation will describe the epidemiology of epidemic thunderstorm asthma, will discuss the findings from the 2016 severe epidemic thunderstorm asthma event in Melbourne and will describe the upgraded environmental monitoring and feedback to Victorians about possible epidemic thunderstorm asthma events in the context of pollen monitoring.
RAPID FIRE SESSION PRESENTER: Dr Andrew Tai
TITLE: Paediatric Asthma
This session will provide an update regarding asthma prevalence in the community and mortality rates in children over the last 10 years. The session will also highlight some of the outcomes of patients who have been admitted into Paediatric Intensive Care Units for asthma and the risk factors that lead to these presentations. Asthma adherence continues to be an ongoing problem in children with asthma, despite their level of severity and we will highlight some simple strategies to improve adherence. We will be reviewing the concept of asthma remission for children with
different levels of asthma severity. Lastly we will be reviewing emerging therapies used in paediatric asthma, with a particular focus on the use of biologics.
PRESENTER: Ms Diane Mackle
TITLE: Oxygen management in ICU: a knowledge translation study
Background: Knowledge translation literature shows a lag between publication and uptake of research findings into clinical practice. There is uncertainty about whether this lag exists in the ICU context and whether participation in research influences changes in clinical practice. Knowing whether ICU participation in research increases the likelihood of research findings being used in clinical care is important to funders, researchers and patients.
Research question: The overarching research question was whether participating as an ICU in a randomised controlled trial about oxygen (ICU-ROX), changes the attitudes and practices regarding oxygen management in an ICU, compared to not participating in ICU-ROX.
Methods: The research question was examined using three different methods: a practitioner attitudes survey and an inception cohort study before ICU-ROX started; after ICU-ROX finished but before the results were known, and again after publication of the ICU-ROX results. A retrospective cohort study (using the ANZICS Australia and New Zealand ICU adult patient database) was also conducted.
Focus of this presentation: An overview of the methods and results of the three studies (survey, inception cohort study and retrospective cohort study) will be presented.
Mackle, D1,2; Beasley1, R; Nelson, K2; Young, P1,3,4.1 Medical Research Institute of New Zealand, Wellington, NZ2 Victoria University of Wellington, Wellington, New Zealand3 Intensive Care Unit, Wellington Hospital, New Zealand4 Department of Critical Care, University of Melbourne, Parkville, Victoria,
Australia.
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PRESENTER: Dr James Lindstrom
TITLE: Rapid-fire update: Interstitial lung disease for the intensivist
Patients with interstitial lung disease (ILD) are often considered high-risk for prolonged stay and mortality in the intensive care unit, but ILD is a heterogenous group of diagnoses with vastly different prognoses and responsiveness to therapy. This rapid-fire update will focus on: • ILD classification for the intensivist• Will my patient with ILD benefit from intensive care
management?• Diagnosing ILD in the intensive care unit – focusing on
management-altering principles• Emerging management options for ILD
PRESENTER: Dr Tamishta Hensman
TITLE: Oncology related lung disease
As therapy improves, more cancer patients are being admitted to the intensive care unit. This update will review the concepts of radiation-associated lung injury and chemotherapy-associated lung injuries before finishing with a brief outline of the latest data relating to outcomes of patients admitted to ICU with lung cancer.
PRESENTER: Dr Isuru (Izzy) Seneviratne
TITLE: Bronchopleural fistula
A bronchopleural fistula is an unnatural communication between the bronchial tree (at the level of the main stem, lobar or segmental bronchus) and pleural space as evidenced by continued and persistent air leak into the pleural cavity. It is a source of significant morbidity and mortality and can be difficult to manage/treat.
In this rapid fire up-date we will briefly look at potential aetiologies and the diagnostic evaluation of bronchopleural fistula but spend most time reviewing management strategies. We will evaluate escalating
management options for bronchopleural fistulas from chest drains to pneumonectomy and everything in between with particular attention to potential bronchscopic interventions such as occlusive devices and endobronchial stents.
PRESENTER: Dr Jane Lewis
TITLE: COPD: Wake me up when it’s over
COPD is currently the fourth leading cause of death worldwide. This rapid-fire session will look at updates in chronic obstructive lung disease and how it relates to our care of these patients in ICU.
SESSION 6: The New COVID Normal
PRESENTERS: Dr John Prowle & Dr Yize Wan
TITLE: Ethnic Disparities in COVID-19 outcomes
The influence of ethnic background on incidence and outcomes in COVID-19 is an evolving story with strong socio-political as well as clinical repercussions. Definitions and perception of ethnic background is an enormously complex topic which vary greatly within and between countries. Given the importance placed on ethnic identification and the persistent healthcare inequalities experienced by minority ethnic groups in many nations it is important to address these issues in the context of the current pandemic.
To illuminate these issues, we present a summary of analyses describing disparate outcomes between ethnic groups in almost 2000 COVID-19 associated admissions during the first wave to Barts Health NHS Trust. With a catchment of around 2.5 million people living in east London, Barts Health serves one of the most ethnically and economically diverse communities in the UK. In the first wave patients from (South) Asian and Black backgrounds had higher age-adjusted mortality from COVID-19 infection despite controlling for all previously identified confounders and frailty. These patient groups suffered disproportionate rates of premature death from COVID-19 and greater acute disease severity.
Importantly since the first wave of COVID-19 there have been changes in public behaviours, COVID-19 treatments and processes of care. Analysis of patients admitted in the second wave demonstrated that although hospital outcomes and overall mortality were improving, increased risk of death associated with Asian ethnicity persisted. Furthermore, Asian and Black patients continued to have higher rates of admission and acquired more severe disease at a younger age. Comparative
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analysis of acute hospital admissions over a 6-year period preceding COVID-19 showed an earlier age at presentation and distinct and earlier burden of comorbid disease in patients from minority ethnic groups. Some of these features may explain the adverse outcomes seen in COVID-19 in our community.
PRESENTER: Associate Professor Chris Nickson
TITLE: Teaching in the age of Covid-19
The COVID19 pandemic has posed numerous challenges to education generally (as any parent of school age children will know!), and intensive care education is no exception. These challenges called for rapid adaptation and many of the changes introduced are likely to remain the norm in the future. As all intensivists are teachers, we will use this perspective to explore the impact of the pandemic on trainees and intensive care training, and how as teachers we have had to rethink what we teach, innovate how we teach it, and develop as teachers.
PRESENTER: Dr Steve McGloughlin
TITLE: Systems to Deal With a Pandemic – What went well and what can we do better?
The challenges of the 2020 and now 2021 have been unique in our lifetimes. There has been an extra-ordinary loss of life globally and an incredible impact on every individual’s way of life. It must be said that there at every level of the pandemic response there are areas to improve and do better.
While treating individual patients at the bedside is the mainstay of intensive care practice the pandemic is teaching us that working in a safe, reliable system impacts on the quality of the individual’s patient care and also the safety and well-being of our staff. It is the development of systems at the bedside, the intensive care unit, the hospital and the region that we need to urgently develop and improve.
PRESENTER: Dr Nhi Nguyen
TITLE: NSW modelling. Predictive requirements of ICU beds
As part of the NSW response to COVID-19 Pandemic we explored what was required to quadruple ICU capacity. It involved hospitals identifying surge capacity, ordering of essential equipment and the Intensive Care Operations Team as part of the overall Health response having visibility of all aspects of planning. As expected, true ICU capacity is not dependent so much on the physical ICU bed and ventilators but workforce (skill mix as well as availability), baseline non-COVID ICU activity as well as availability of PPE. Further, the impact of COVID on ICU capacity would not be uniform across the state. Lead by the Agency of Clinical Innovation, in conjunction with the Ministry of Health and the Sax Institute, modelling was developed to demonstrate predicted ICU capacity using ANZICS Adult Patient Database and workforce information in response to different levels of COVID surge as well as staff availability. The proof-of-concept modelling has far reaching potential for ICU service planning beyond responding to threats such as a pandemic.
THURSDAY 3rd JUNE
SESSION 7: Right heart – The third lung
PRESENTER: Dr Rob Arntfield
TITLE: Right heart ultrasound
The forgotten ventricle no longer, the right heart is easily interrogated by the intensivist using bedside echocardiography. In this talk, the how and why of the right sided evaluation using ultrasound will be discussed and heavily supported by plenty of examples that take us through basic and advanced techniques for the intensivist.
PRESENTER: Dr Kavitha Muthiah
TITLE: Pulmonary hypertension and RV support.
This talk covers mechanisms of right ventricular failure in relation to pulmonary hypertension and both medical and mechanical options for support.
PRESENTER: Dr Debra Chalmers
TITLE: Management of Acute Pulmonary Embolism in a Regional Centre
Collegial Intensive Care: A practical approach for centres where access to Cardiothoracics, Interventional Radiology, dedicated Cardiology or Respiratory On Call, CTPA and even echo may be a challenge.
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SESSION 8: Ventilation – Rage of the machines
PRESENTER: Dr Ewan Goligher
TITLE: Making Ventilation Safer: Optimizing Tidal Volume Based on Driving Pressure
Ventilator-induced lung injury is a widely appreciated clinical problem in mechanically ventilated patients with acute hypoxemic respiratory failure. Lung-protective ventilation has traditionally focused on limiting tidal volume based on the findings of seminal clinical trials and clinical practice guideline recommendations. The driving pressure hypothesis suggests that lung-protective ventilation should focus on the pressure distending the lung as a consequence of tidal volume rather than the tidal volume per se. This issue has been examined in multiple observational studies and more recently in a re-analysis of clinical trials. This presentation will summarize the evidence in support of the driving pressure hypothesis and discuss clinical implications for setting the ventilator during both passive and assisted mechanical ventilation. I will argue that a focus on driving pressure over tidal volume may improve outcomes in patients with both low elastance (permitting higher tidal volumes reduces sedation requirements and facilitates spontaneous breathing) and high elastance (targeting driving pressure will limit injurious lung stress and strain). Methods for assessing driving pressure during both passive and assisted ventilation will be briefly described.
PRESENTER: Professor John Fraser
TITLE: Can EIT be Useful in Assessment of Regional Ventilation Blood Flow and Biofluid Movement
The lungs are a complex organ. In sickness, they behave as a multi compartment model. Positive pressure ventilation and a myriad of ICU interventions are applied without the ability to safely and repeatedly assess the effect of these techniques on regional ventilation within the lung.
A great deal has been learned through CT of the lungs in mechanically ventilated patients and how ventilation is not distributed equally. However, practicalities dictate that these hazardous and expensive procedures cannot be performed repeatedly after every intervention, particularly in the most unstable patients with ARDS, in whom the information on regional ventilation is perhaps the most useful.
The advent of electrical impedance tomography (EIT) has brought the ability to assess in a real time fashion, radiation-free monitoring of lung ventilation and perhaps of perfusion, at the bedside of critically-ill mechanically ventilated patients. The technique’s dependence on measurement of the delta impedance allows it to assess anything within the chest whose impedance changes. Primarily this change in impedance correlates to change in lung volume. but more work is improving its ability to assess regional changes in blood flow too – and in doing so, providing a low fidelity ventilation-perfusion assessment tool at the bed side.
Further work is being conducted to assess the ability of EIT to track the movement of noxious biofluid within the lung through nebulisation of electrically conductive solutions. The combination of an improved ability to assess in a more holistic fashion the movement of gas, blood and biofluid within the lung in a dynamic fashion may lead to improved ability to monitor and treat patients with ARDS.
PRESENTER: Professor Carolyn Calfee
TITLE: Updates on Molecular Phenotypes of ARDS
This presentation will briefly review previously published research on molecular phenotypes of ARDS, including the hyper-inflammatory and hypo-inflammatory phenotypes identified using latent class analysis, as background. The majority of the presentation will focus on recently published or unpublished new data on ARDS molecular phenotypes, including data related to generalizability, feasibility of identification, potential mechanisms, and relevance to COVID-19 ARDS. The presentation will conclude with some thoughts on future directions in research on this topic and how molecular phenotypes might be targeted in clinical trials.
PRESENTER: Dr Taylor Thompson
TITLE: Re-evaluation of Systemic Early Neuromuscular Blockade for ARDS (ROSE)
Papazian and colleagues reported lower mortality (NNT ~10) with a 48-hour infusion of high dose cisatracurium (ED95) versus heavy sedation in patients with moderate to severe ARDS (PMID: 20843245). The ROSE trial examined the same dose/duration of cisatracurium versus a lower sedation approach for a similar ARDS population (PMID: 31112383). Both ROSE arms received the same mechanical ventilation strategies including a higher PEEP strategy. ROSE enrolled 1006 patients early after onset of moderate-to-severe ARDS (median: 7.6 hours). During the first 48 hours, 97.4%) patients in the intervention group received cisatracurium (median duration: 47.8 hours; median dose: 1807 mg), whereas 17.0%) of patients in the control group received neuromuscular blockade (median dose: 38 mg, usually bolus dosing). The primary endpoint of 90-day all-cause in-hospital mortality was 42.5% and 42.8% in the intervention and control groups (difference: -0.3 percentage points, 95% CI: -6.4% to 5.9%, p=0.93). The intervention group was less physically active and developed more cardiovascular adverse events while
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in hospital. There were no consistent between-group differences in long term outcomes assessed at three, six, and twelve months. The reasons for the discordant results between these two studies are unclear and may lie in differences in the control arms, as will be discussed in this presentation. Based on the ROSE trial results, for patients with moderate-to-severe ARDS managed with a higher PEEP and a lower sedation strategy, routine use of an early and continuous cisatracurium infusion is not recommended.
PRESENTER: Dr Ed Litton
TITLE: Airway Pressure Release Ventilation: Saviour or Scourge?
Should we still worry about modes of ventilation and do we really (really?!) still need more research? Airway Pressure Release Ventilation (APRV) is a mode of ventilation that has been around for years. Endorsed by proponents as a useful tool to improve oxygenation. Derived by detractors as a modality lacking evidence of benefit and associated with safety concerns. Like many questions in modern ICU practice, the answers may be nuanced and uncertain. Nevertheless, new studies inform the understanding of the potential role of APRV. Recent evidence can help assist in considering where to place this therapy amongst the options in addressing hypoxia in mechanically ventilated patients.
SESSION 9: Start early? ECLS in acute respiratory failure
PRESENTER: Dr Tina Xu
TITLE: Respiratory ECMO for COVID-19
In March 2020, the United Kingdom was hit by the first wave COVID-19 outbreak. COVID-19-associated ARDS led to unprecedent numbers of referrals to ECMO services. Royal Brompton Hospital, one of the five NHS-commissioned ECMO centres, following NHS-modified inclusion/exclusion criteria during COVID-19 pandemic, retrieved and managed 52 respiratory ECMO patients with a 6-month survival of 84.6%. This presentation will review a single-centre experience in referrals, clinical progression and outcome of respiratory ECMO for COVID-19 patients.
PRESENTER: Dr Sara Allen
TITLE: When to refer for ECMO in acute respiratory failure
ECMO is a well-established therapy for patients with potentially reversible severe respiratory failure that is not responding to conventional management. Due to the high risk nature of ECMO support, and the specialised knowledge and experience required to efficiently and effectively manage patients receiving support, as well as the ancillary services usually required in the care of patients, ECMO is usually provided by regional or national centres. Other regional or national centres therefore refer patients for consideration of retrieval and ECMO therapy. This presentation will discuss the current potential indications for support with ECMO in patients with a range of pathologies causing respiratory failure, and will highlight conditions with a high risk of requiring ECMO support. Contraindications and cautions prior to
providing ECMO support will also be outlined. Pragmatic considerations and potential dilemmas will be briefly discussed, along with regional variation, with reference to cases and literature. Early communication, discussion, and ongoing clinical review will be emphasised.
PRESENTER: Dr Adrian Mattke
TITLE: ECMO in Paediatric ARDS
Paediatric acute respiratory distress syndrome accounts for 1-10% of paediatric intensive care admissions. PARDS carries a mortality risk between 10 and 15% for mild or moderate and up to 33% for severe presentations. ECMO, either as veno-venous or veno-arterial support has been a long established treatment modality for PARDS. Several randomised controlled trials showed a mortality benefit of ECMO for PARDS in neonates, with one trial showing a halved relative risk of death with the use of ECMO. However, recent trials in adult patients with ARDS (most recently the EOLIA trial) did not demonstrate a survival benefit with the use of ECMO. Albeit retrospective, but with the largest cohort of children, the recently published RESTORE trial (2449 children) did not show a benefit of ECMO treatment in PARDS. In few of these trials ventilation at time of ECMO support has been vigorously standardised. A recent survey in 59 PICUs in 12 countries demonstrated that lung protective ventilation is often not followed. During ECMO support several ventilation strategies have been investigated such as limiting the peak inspiratory pressures, using ultralow tidal volume ventilation, high PEEP or mechanical-power-asserted-on-the-lungs targeted ventilation. Unfortunately, none of these strategies have shown conclusively to be of survival benefit during ECMO support. There is a need for prospective randomised trials to identify the benefit of ECMO for PARDS and to define which ventilation strategies during the time of ECMO support will benefit patients most.
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PRESENTER: Dr Aidan Burrell
TITLE: REDEEM: A Pilot RCT of VV ECMO in moderate -severe respiratory failure
Venovenous extracorporeal membrane oxygenation (ECMO) has been shown to improve mortality in critically ill patients with the most severe forms of acute respiratory failure. However whether ECMO provides benefit in less severe forms of respiratory failure remains uncertain. On the one hand, the use of ECMO in less severe disease may facilitate protective lung ventilation without the need for sedation, intubation and neuromuscular blockade, which themselves have been associated with prolonged mechanical ventilation and complications. On the other hand, ECMO is costly, and may be associated with other important complications, particularly bleeding. The REDEEM pilot is an Australian-initiated, registry-based, 2 centre, randomised controlled pilot study designed to determine if a strategy of ECMO in moderate to severe respiratory failure (with desedation, early extubation, and mobilisation), in comparison to standard care (including mechanical ventilation with rescue ECMO if required), is safe and feasible. The results of this study will inform a larger international trial designed to investigate key patient centred outcomes, such as patient related quality of life and health care costs, and has the potential to change the way we manage moderate to severe respiratory failure in the ICU.
PRESENTER: Dr Kiran Shekar
TITLE: Extracorporeal carbon dioxide removal in adults with respiratory failure1Adult Intensive Care Services, the Prince Charles Hospital, Metro North Hospital and Health Service, Brisbane, Queensland, Australia. 2Queensland University of Technology, Brisbane; University of Queensland, Brisbane and Bond University, Gold Coast, Queensland, Australia.
Extracorporeal carbon dioxide removal (ECCO2R) devices are specialised extracorporeal respiratory support devices that predominantly focus on CO2 removal using smaller vascular access catheters and lower blood flows. ECCO2R can also be achieved with standard extracorporeal membrane oxygenation (ECMO) circuitry that provides an added advantage of utilising much higher blood flows for extracorporeal oxygenation support if needed. Although, hypercapnia is permissible to an extent and it may enable better lung healing by reducing inflammation, it becomes problematic in patients with raised intracranial pressure or in those with right heart failure.
Reducing partial pressure of arterial (PaCO2) with ECCO2R, not only mitigates ventilator induced lung injury (VILI) by allowing more protective lung protection, it also reduces the work of breathing and may prevent fatigue in those breathing spontaneously. It may also reduce pulmonary vascular resistance and improve right ventricular performance. Thus ECCO2R may have a potential role in both acute respiratory distress syndrome (ARDS) and in those with more chronic forms of hypercapnic respiratory failure such as chronic obstructive pulmonary disease (COPD).
A strategy of lung protective ventilation that limits tidal volume and inspiratory pressures, mitigates VILI, and has been shown to improve outcomes in patients with ARDS. ECCO2R may facilitate ultra-protective ventilation, with even lower tidal volumes and driving pressures.
However, heterogeneity amongst ECCO2R studies, a lack of supporting evidence from randomised controlled trials, and variable safety reporting in studies have been barriers for widespread adoption of ECCO2R in this setting. Apart from identification of the ARDS sub-population that is likely to benefit, prospective evaluation of optimal device operating characteristics and anticoagulation strategies in high quality studies is required.
In patients who present with exacerbations of COPD, ventilation support can be provided both non-invasively or invasively, of which the former has shown a better prognosis. Although non-invasive ventilation (NIV) has been shown to reduce mortality when compared with invasive mechanical ventilation (IMV), 25-50% of this population initially supported with NIV, eventually requires IMV over time. These patients often wean slowly from IMV, and, consequently have a prolonged hospital stay. In patients on NIV, ECCO2R has been shown to prevent the need for IMV significantly in some studies. The use of ECCO2R in patients requiring IMV may allow earlier extubation, rehabilitation and may be an useful bridge to lung transplantation in selected patients. Once again, the uptake of ECCO2R in patients with exacerbations of COPD is limited due to lack of robust evidence.
There are ongoing clinical trails that are evaluating the efficacy of ECCO2R in both ARDS and COPD populations.
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CICM2021