critical care - isccm...dr samir jog, pune dr sachin gupta, delhi dr pradeep bhatia, jodhpur dr r....

TM

A B I - M O N T H LY N E W S L E T T E R O F I N D I A N S O C I E T Y O F C R I T I C A L C A R E M E D I C I N E

www.isccm.org

C O M M U N I C A T I O N SCritical Care

Editorial officE

dr Yatin Mehta272 Espace, Nirvana Country, Gurgaon 122001Mobile : +91 9971698149 emails : [email protected]

Published By :

IndIan SocIety of crItIcal care MedIcIneFor Free Circulation Amongst Medical ProfessionalsUnit 6, First Floor, Hind Service Industries Premises Co-operative Society, Near Chaitya Bhoomi, Off Veer Savarkar Marg, Dadar, Mumbai – 400028 Tel. 022-24444737 • Telefax :022-24460348 • email : [email protected]

We request our esteemed readers to send their valued feedback, suggestions & views at [email protected]

Volume 13.1 JANuARY-FeBRuARY 2018

C O N T E N T S

WELCOME TO CRITICARE 2018 Varanasi

2 Editorial

3 President's Desk

3 Editorial Board 2017-2018

4 General Secretary's Desk

4 DCCS 2018

4 INDICAPS - II

5 CRITICARE 2018 - Scientific Program

23 Guidelines: Management of Major Bleeding and Coagulopathy Following Trauma

24 6th Annual Critical Care Refresher Course 2018

25 Journal Scan

26 Image Section

26 Battle of the Brains

27 Welcome New Members to the ISCCM family

28 New Office Bearers of ISCCM Branches

29 CRITICARE 2018

The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine2

HAPPY NEW YEAR

Editorial...

dr yatin MehtaEditor in Chief, The Critical Care CommunicationsPresident-Elect, [email protected]

www.isccm.org

Dear Friends,

It is indeed a pleasure to have this issue of CCC released during annual

conference, especially at the Holy city of Varanasi.

It has been a fruitful year with certain new additions to the CCC which

have been appreciated by all. Also making it online is a major progress,

a potent mix of cost cutting and technology! This is my last copy of

CCC as the Chief Editor and I must thank all of my Editorial board

members for their active and enthusiastic participation for making

CCC a great success. I must thank particularly Dr Yash Javeri without

whose endeavours this was not possible.

I would also like to thank Dr Kapil Zirpe and E.C of ISCCM for their

cooperation. I wish the next editor Dr Subhal Dixit all the best!

Long Live ISCCM!

Welcome All Delegates

CRITICARE 2018V A R A N A S I

The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine 3

HAPPY NEW YEAR

President's Desk...

Dear Friends,

I take this opportunity to welcome you at Varanasi also known as Banaras or Kashi. It is the holiest of the seven sacred cities in Hinduism and Jainism, and played an important role in the development of Buddhism

This will be, by far, the most interesting Critical Care conference. We expect almost 2500 delegates to join us. ISCCM & Varanasi team promise to give you a memorable welcome, hospitality and time during your stay. I am confident that Dr D. K. Singh and his team will be steadfast in addressing the pressing challenges. A veritable scientific feast awaits us all. Scientific committee has selected approximately 250 thematic and 16 plenary topics to be delivered by eminent international and national faculties during 3 days of congress. I am happy to share with you that first time, Dr G C Khilnani will be presenting National guidelines of antimicrobial prescription in ICU patients. These guidelines are prepared on behalf of ISCCM & AIIMS.I am sure everyone of us will be eager to listen him. Also, Prashant Kumar has plan of much awaited international quiz during all 3 days.

Last but not least, Dr D K Singh has made special arrangements for “GANGA ARATI” at Dasashwamedh Ghat. The GANGA ARATI is a spectacular ceremony that takes place every day to thank and praise river. The river is said to wash out all the sins of living.

Please enjoy social functions as well.

I wish the Criticare 2018 a grand success!

dr Kapil ZirpePresident, [email protected]

Editorial Board 2017-2018

EdITor In ChIEfDr Yatin Mehta, Delhi

[email protected]

dEPuTy EdITorS

Dr Yash Javeri, Delhi Dr Rajesh Mishra, AhmeDAbAD

[email protected] [email protected]

EdITorS

Dr Samir Jog, Pune Dr Sachin Gupta, Delhi Dr Pradeep Bhatia, JoDhPur Dr R. Senthil Kumar, ChennAi Dr Suresh Ramasubban, KolKAtA

[email protected] [email protected] [email protected] [email protected] [email protected]

QuIz SECTIon

Dr Yatin Mehta, Delhi Dr Yash Javeri, Delhi

[email protected] [email protected]

Journal SCan

Dr Srinivas Samavedan Dr Prashant [email protected] [email protected]

IMagES SECTIon

Dr Abhinav Gupta Dr Tapas Kumar [email protected] [email protected]

www.isccm.org


dr Subhal dixitgeneral Secretary, ISCCM

Welcome to Criticare 2018.

Welcome to Varanasi Magic.

It is an honor and a pleasure to extend to you, on behalf of the Indian Society of Critical Care Medicine,a warm welcome to our annual conference.

If you chat with a local in Varanasi, you'll soon discover that the city is made up almost entirely of legends. In fact, it is impossible to figure out where myth ends and history begins.

The river Ganges, the temples and the ghats are the sites of many mythological stories from the ancient Puranas, imbuing Varanasi with extraordinary sanctity. Apart from being a sacred Hindu tirtha (crossing-point or ford, literally a place where you cross over into the next world), Varanasi is sacred to Buddhists and Jains as well.

The conference program will offer updated reviews on topics relevant to critical care and allied specialist. Carefully chose topics with best of academicians will make it an academic feast.

I thank all my friends in EC and CB for their generous support during my tenure as general secretary

Enjoy the hospitality at CRITICARE 2018.

General Secretary's Desk

TM

Delhi Critical Care Symposium

16th Annual Conference of SCCM Delhi4th North Zone Critical Care Conference &

ICCMID 2018INTENSIVE CARE CLINICAL MICROBIOLOGY & INFECTIOUS DISEASE COURSE

ICU Administration Certification Course

18th & 19th August 2018 • New Delhi

THEMEMaster class- Beyond The Obvious

ICU Administration Certification Course

HIGHLIGHTS Dedicated Tracks

Critical Care Quality Forum

Medicolegal pearls

Ethics and Communication module

Research Methodologies

Coding and Billing

Publications make easy

Tricks and Trades for safe practice

Safe Practice – Self Safety

Acute Care Quiz – Who is the best?

ICCMID Course Preliminary Programme

Keynote Lectures

Scientific Symposia

Meet-The-Expert Sessions

Picture Quiz

Dr Yash Javeri Dr Saurabh Taneja Dr Prashant Kumar Organising Chairman Treasurer Organising Secretary

CONfereNCe SeCreTArIATSociety of Critical Care Medicine Delhi

(A Branch of Indian Society of Critical Care Medicine)805/59 Shakuntla Tower, Nehru Place, New Delhi 110019

Tel. : 011-41007180 • Mobile: 9811895550e-mail : [email protected]

www.isccmdelhi.com

Abstract Submission Last Date 1st July 2018Send your abstracts to [email protected] & [email protected]

iSccM

INDICAPS - II Indian ICU Case mix and Practice

Patterns Study 2018

Please visit our web-site at www.isccm.org

We are proud to be part of

Established: 09th Oct 1993

Pioneering Multicentre Study by ISCCM.

First Data Entry Week August 6-12, 2018

Second Data entry Week December 10-16, 2018

Please participate and contribute to Indian data. Registrations will open shortly!


CRITICARE 2018 SCIENTIFIC PROGRAM

Wednesday, 7th March 2018

PleNARY SeSSIoNTIme ToPIC SPeAKeR CHAIRPeRSoN8.30-9.00hrs Sepsis 3 : Is it old wine in a new bottle Dr Michael O'Leary

9.00-9.30hrs The Future of Management of Acinetobacter Infection in the ICU: As Seen through the Lens of Current Guidelines

Dr Michael S. Niederman Dilip Karnad

9.30-10.00hrs New antibiotic development: the need versus the costs Dr Tobias Welte Rajiv Soman

10.00-10.30hrs Starches: Have We Given Up Too Soon Dr Prof. Cheng Prof Suryakant

10.30-11.00hrs ISCCM Oration Dr G C Khilnani Dr Zirpe/ Dr Dixit S/ Dr Yatin M

11.00-11.30hrs Presidential Address Dr Kapil Zirpe Dr Dixit S / Dr Yatin Mehta

Hall No. 1 • Sahnai (Ramada)THemATIC SeSSIoNS 1 - INFeCTIoN

TIme ToPIC SPeAKeR CHAIRPeRSoN11.30-11.45hrs Head down v/s head up to prevent VAP Dr Khusrav Bajan Dr Sanjay Pathak

11.45-12.00hrs Diagnosing VAP: Current status Dr Samaria Dr Prithwivas Bhattachary

12.00-12.15hrs HAP/VAP: New guidelines and applicability Dr Dilip Karnad Dr Mohan Gurjar

12.15-12.30hrs DISCUSSION Q/A

12.30-1.30 hrs LUNCH BREAK

01.30-2.30hrs oRAl PReSeNTATIoNS SPeAKeR JudgeS01.30-01.40hrs Energy Balance in Children with severe sepsis using indirect

caloriemetry-A Prospective Cohort StudyDr Javed Ismail Dr Todi Subash /

Prof Lokesh Kashyap

01.40-01.50hrs To evaluate the effect of probiotics on cytokines in critically ill children with severe sepsis

Dr Suresh Kumar A

01.50-2.00hrs Insulin resistance as prognostic indicator in severe sepsis, septic shock and multiorgan dysfunction syndrome

Dr Mohammed Khan

02.00-02.10hrs A randomized controlled trial of 0.9% saline versus plasmalyte as resuscitation fluid in children with septic shock

Dr Shalu Gupta

02.10-02.20hrs Family satisfaction in a medical college multidisciplinary ICU- how we can improve?

Dr Sowmya M J

02.20-.02.30hrs Payment options- do they affect outcome in critically ill: a prospective study

Dr Payel Bose

THemATIC SeSSIoNS 2TIme ToPIC SPeAKeR CHAIRPeRSoN2.30-2.45hrs VAT should it be treated? Dr Pradeep Bhatia Dr Manoj Kumar

2.45-3.00hrs Influenza and Bacterial Superinfection Dr G N Shrivastava Dr Samaria

3.00-3.15hrs Reactivation of viral infection in ICU Dr Ruchira Khasne Dr Kushrav Bajan


TEA/COFFEE SERVED ALL THROUGH AFTERNOON

THemATIC SeSSIoNS 3TIme ToPIC SPeAKeR CHAIRPeRSoN3.30-3.45hrs MIC based therapeutic strategy in ICU. Dr Subash Todi Dr Pravin Amin

3.45-4.00hrs Are MDR/XDR/PDR bacteria more virulent? Dr Michael S. Niederman Dr Rajesh Mishra

4.00-4.15hrs Implementation of antibiotic stewardship in an Open ICU Dr Rajiv Soman Dr Tobias Welte


THemATIC SeSSIoNS 4TIme ToPIC SPeAKeR CHAIRPeRSoN4.30-4.45hrs Fosfomycin : Optimizing its use Dr Rajiv Soman Dr G N Shrivastava

4.45-5.00hrs Combination antibiotic: when to use Dr Mohan Gurjar Prof Bhatia

5.00-5.15hrs Colistin: Optimizing its use Dr Michael S. Niederman Dr Madhukar Rai


Hall No. 2 • Santoor (Ramada)THemATIC SeSSIoNS 5 - ReSPIRAToRY moNIToRINg

TIme ToPIC SPeAKeR CHAIRPeRSoN11.30-11.45hrs Application of Trans pulmonary Pressure measurement in Severe ARDS Dr Vinod Singh Dr Ritendra Mishra

11.45-12.00hrs Monitoring and improving diaphragmatic function in ICU. Dr Marco Ranieri Dr Sameer Jog

12.00-12.15hrs Ultrasound enhanced management of ARDS Dr Jayant Shelgaonkar Dr Nitin Karnik


12.30-1.30hrs LUNCH BREAK


01.30-2.30hrs oRAl PReSeNTATIoNS SPeAKeR JudgeS01.30-01.40hrs Application of Transpulmonary Pressure measurement in Severe ARDS Dr Sameer Jog Dr Pradeep Bhattacharya

/ Dr S N Gupta

01.40-01.50hrs Study of Tidal Volume and PEEP for Alveolar Recruitment using Spirodynamics in mechanically ventilated patient.

Dr Nitish Kumar

01.50-2.00hrs Effect of prone positioning on intraocular pressure (IOP) in patients with acute respiratory distress syndrome (ARDS)

Dr Sai Saran

02.00-02.10hrs Ventilatory strategy in ARDS transpulmonary pressure guided vs conventional ARDS net protocol

Dr Debraj Jash

02.10-02.20hrs Prospective evaluation of human factors during tracheal intubation for children in PICU

Dr Deepak

02.20-.02.30hrs Timely act on ventilator associated-tracheobonchitis, may prevent ventilator associated-pneumonia in neurosurgical tracheostomised patient

Dr Vilas Kushare

THemATIC SeSSIoNS 6TIme ToPIC SPeAKeR CHAIRPeRSoN2.30-2.45hrs Dual modes of mechanical ventilation Dr Rajesh Pande Dr Tapas Chakrabarty

2.45-3.00hrs Automated system and ventilator synchrony. Dr Marco Ranieri Dr Vinod Singh

3.00-3.15hrs Driving pressure in mechanical ventilation: practical application Dr Prayag Shirish Dr Lalit Singh



THemATIC SeSSIoNS 7TIme ToPIC SPeAKeR CHAIRPeRSoN3.30-3.45hrs Spontaneous breathing during mechanical ventilation Dr Welte Dr Jayant Shelgaokar

3.45-4.00hrs Bronchopleural fistula on ventilator: management strategies Dr Afzal Azim Dr A K Singh

4.00-4.15hrs Optimising nebulised bronchodilator in mechanically ventilated patient Dr Shrikanth Shashtrabuddhe Dr Ghanshyam Jagathkar


THemATIC SeSSIoNS 8

TIme ToPIC SPeAKeR CHAIRPeRSoN4.30-4.45hrs The ABCDEF ICU liberation care bundle-Does it really work? Dr Nitin Karnik Dr Vinod Singh

4.45-5.00hrs Weaning after prolonged ventilation: a different cup of tea! Dr Jose Chacko Dr Susruta Bandyopadhyay

5.00-5.15hrs Weaning and cardiac dysfunction. Dr Dilip Karnad Dr Geeta Bhandri


Hall No. 3 • Amrapali (Clark)THemATIC SeSSIoNS 9 - oRgANISATIoN/ eTHICS/eol

TIme ToPIC SPeAKeR CHAIRPeRSoN11.30-11.45hrs Delivering quality critical care in resource limited critical care units. Dr Babu Abraham Dr Mohan Mathew

11.45-12.00hrs Is personalized intensive care the future? Dr Rajesh Mishra Dr Shrinivasan Samvedam

12.00-12.15hrs Simulation based training Dr Sunil Karanth Dr Pradeep Bhattacharya


12.30-1.30HRS LUNCH BREAK

01.30-2.30hrs oRAl PReSeNTATIoNS SPeAKeR JudgeS01.30-01.40hrs I Remember ICU…a prospective cohort study. Dr Swagata Tripathy Dr Babu Abrahim /

Dr Maytree Panday

01.40-01.50hrs A Rare Case Of Cerebral Actinomycosis Dr Rajiv Shah

01.50-2.00hrs End of life issues in the multidisciplinary intensive care unit Dr Palepu Gopal

02.00-02.10hrs Decompressive craniectomy in children with non-traumatic coma – a tertiary care center experience

Dr Vijai Williams

02.10-02.20hrs Reforming Medicine, Medical education and Research in India Dr T Ganesan

02.20-.02.30hrs Outcome of patients with traumatic brain injury in tertiary care ICU in Nepal

Dr Pujan Rajbhandari

THemATIC SeSSIoNS 10TIme YouNg TAleNT SPeAKeR CHAIRPeRSoN2.30-2.45hrs Comparison of Lung Ultrasound (US), based weaning indices with RSBI:

Are they helpful?Dr Abhinav Banerjee Dr Jose Chacko

2.45-3.00hrs Bedside ultrasound of muscle as a tool for assessment Dr Sunil Kumar Jena Dr Neha

3.00-3.15hrs Right Heart failure in Critical care; Assessment & Management Strategies

Dr Gopala Krishnan Dr Deepak Govil



THemATIC SeSSIoNS 11TIme ToPIC SPeAKeR CHAIRPeRSoN3.30-3.45hrs Why we need living will? Dr R K Mani Dr Divatia

3.45-4.00hrs Palliative care in ICU Dr Suhail Siddiqui Dr Manoj Kohli



Wednesday, 7th March 2018TIme ToPIC SPeAKeR CHAIRPeRSoN4.00-4.15hrs Potentially inapproriate treatment in ICU Dr Nikhil Balankhe Dr Arun Barnawal


THemATIC SeSSIoNS 12TIme ToPIC SPeAKeR CHAIRPeRSoN4.30-4.45hrs Error reporting in ICU Dr Anuj clark Dr Sheila Myatra

4.45-5.00hrs Fire and electric safety in ICU Dr Sharmila Sinha Dr Omender. Singh

5.00-5.15hrs Intra and Inter hospital safe transport Dr Sanjeev Kumar Dr Gopala Krishnan


Hall No. 4 • Sarod (Ramada)THemATIC SeSSIoNS 13 - FluIdS

TIme ToPIC SPeAKeR CHAIRPeRSoN11.30-11.45hrs Deresuscitation strategy in fluid management Dr Sunil Karanth Dr Pradeep Dcosta

11.45-12.00hrs SOSD Phases of fluids resussitation Dr Sheila Myatra Dr Azal Ahmed

12.00-12.15hrs Fluids versus vasopressors in early resuscitation: how to choose Dr Atul Kulkarni Dr Abhinav Banerjee



01.30-2.30hrs oRAl PReSeNTATIoNS SPeAKeR JudgeS

01.30-01.40hrs Diagnosing heart failure among acutely dyspneic patients with cardiac, inferior vena cava, and lung ultrasonography Dr Hari Prasad Dr Rahul Pandit / Dr Suresh

kumar Bhargav

01.40-01.50hrs A simplified ultrasound-based edema score to assess severity of lung injury in dyspneic patients Dr Hari Prasad

01.50-2.00hrs Incidence and risk factors for early post operative arrhythmias following pediatric cardiac surgery Dr Manoj Sahu

02.00-02.10hrs Describing a strategy for echocardiographic assessment of patients in prone position utilizing left pleural effusion. Dr Rajsekar M

02.10-02.20hrsPoint of care ultrasound (pocus) measurement of lean quadriceps muscle thickness (lqmt) for nutritional assessment in critically ill - a pro-spective observational study

Dr Sunil Jena

02.20-.02.30hrs Can ultrasonographic confirmation of venous access placement relpace the need for a chest X-ray ? Dr Anil Kumar

THemATIC SeSSIoNS 14TIme ToPIC SPeAKeR CHAIRPeRSoN2.30-2.45hrs Endothelial dysfuntion; Assessment & Management Dr Jose Chacko Dr Sharmila Sinha

2.45-3.00hrs Non Invasive measurements of fluids responsiveness Dr Deepak Govil DR Ebor Jacob

3.00-3.15hrs Tidal volume challenge for fluids Dr J L Teboul Dr Prof Trilok Chand



THemATIC SeSSIoNS 15TIme ToPIC SPeAKeR CHAIRPeRSoN3.30-3.50hrs Levosimenden v/s Dobutamine: Dr Susruta Bandyopadhyay Dr Satish Dashmana

3.50-4.10hrs Appropriate use of ionotropic agents in ICU in septic shock and non-septic shock scenarios. Dr Sameer Jog Dr Sunil Karanth

4.10-4.30hrs Vasopressors in septic shock: which one and when Dr J L Teboul Dr Ranveer Singh Tyagi


THemATIC SeSSIoNS 16TIme ToPIC SPeAKeR CHAIRPeRSoN4.30-4.45hrs Significance of positive tropinonin in non- cardiac ICU Dr Yatin Mehta Dr Guruprit Singh

4.45-5.00hrs Fluid management in post operative cardiac patietns Dr Ebor Jacob Dr Chandrashish Chakrabarti

5.00-5.15hrs Pearls & Secrets in Dyselectrolytemias Dr Omender Singh Dr Deepak Govil


Hall No. 5 • Shakuntala (Clark)THemATIC SeSSIoNS 17 - NeuRo

TIme ToPIC SPeAKeR CHAIRPeRSoN11.30-11.45hrs Acute thrombolysis: strategies for improving compliance. Dr Bibhukalyani Das Dr Ravindra Sisodia

11.45-12.00hrs Outcome of thrombolysis in stroke. Dr Kapil Zirpe Dr Y P Singh

12.00-12.15hrs Changing paradigm of stroke management: from clot lysis to clot re-move.

Dr Vishwajeet Verma Dr Kayanoosh Kadapatti



01.30-2.30hrs oRAl PReSeNTATIoNS SPeAKeR JudgeS01.30-01.40hrs Pinpoint localised odynophagia (PLO) as a specific symptom of pill in-

duced oesophagitis (PIO) in evaluation of acute retrosternal chest pain.Dr Mukundkumar V. Patel Dr Sushruta Bandopadhyay

/ Dr Narendra Sinha


oRAl PReSeNTATIoNS SPeAKeR JudgeS01.40-01.50hrs An Interesting case of Hair Dye Poisoning Dr Dhiraj kumar Pandey

01.50-2.00hrs Profile of dialysis in intensive care unit Dr Sarina

02.00-02.10hrs Therapeutic plasma exchange in critical illness – indications & outcome in ICU background

Dr Monalisa Mishra

02.10-02.20hrs Validation of P-possum in adult cancer surgery Dr Ankit Kedia

02.20-.02.30hrs To study efficacy of CRRT on ammonia clearance in the Acute liver Fail-ure patients- A single centre study

Dr Ruhi Kohli

THemATIC SeSSIoNS 18TIme ToPIC SPeAKeR CHAIRPeRSoN2.30-2.45hrs “Optimizing sedation in patients with acute brain injury insult - trau-

matic and non-traumatic”Dr Giuseppe.Citerio Dr Monika Kohli

2.45-3.00hrs EEG for the intensivist: Beyond epilepsy Dr Kayanoosh Kadapatti Dr Harsh Sapra

3.00-3.15hrs Multimodal monitoring approach in ICU Dr Giuseppe Citerio Dr Bibhukalyani Das



THemATIC SeSSIoNS 19TIme ToPIC SPeAKeR 3.30-3.50hrs Dysphagia in Neuro ICU: workup and management. Dr Kayanoosh Kadapatti Dr Manoj Giri

3.50-4.10hrs ICU acquired weakness: prevention and management. Dr Y P Singh Dr Kapil Zirpe

4.10-4.30hrs Treatment controversies in management of GBS Dr Harsh Sapra Dr Vijay Mishra


THemATIC SeSSIoNS 20TIme ToPIC SPeAKeR CHAIRPeRSoN4.30-4.45hrs Trauma management in resource limited settings. Dr Subhash Acharya Dr Kapil Chhabra

4.45-5.00hrs Damage control resuscitation Dr Yash Javeri Brig T V S Murthy

5.00-5.15hrs Transfusion Threshholds: Do Outcomes differ for critical care versus post surgical patients ?

Dr Davy Cheng Dr Vishwajeet Verma


Hall No. 6 • Sharangi (Ramada)INduSTRY SeSSIoN

TIme ToPIC SPeAKeR ComPANY CHAIRPeRSoN11.30-12.30, Controversies of Anti infectives in critical care Dr S K Todi

(Moderator)Cipla

12.30-1.00 Management of Hyperglycaemia in Hospital settings – Algorithms and future possibilities

Dr Anuj Maheshwari Novo Nordic Dr N K Aggarwal

1.00-1.30 lunch break lunch break lunch break

1.30-2.30 Looking beyond conventional modes of mechanical ventilation Medtronic Understanding impact of Asynchrony during mechanical ventilation Dr J V Divatia Medtronic

Recognizing shortcomings and limitations of current conventional modes that may be promoting atrophy or exhaustion in patients

Dr Srinivas Samvedam

Medtronic

Closed loop weaning: Current options Dr Deepak Govil Medtronic

2.30-3.30 National Antibiotics ISCCM Guidelines Dr G C Khilnani

3.30-4.00 Expand Defense against CRBSI Dr Yatin Mehta RBM- POLARIS GSK

4.00-4.30 RTI in High Resistance Landscape Dr Bhavesh Kotak RBM- POLARIS GSK

4.30-5.30 The Grand International Critical Care Quiz-2018 Dr Prashant Kumar / Dr. Qurat

Dr. Manish Munjal Dr. Sanjay Dhanuka Dr. Sudhir Khunteta

Hall No. 7 • Siddharth (Clark)PoSTeR PReSeNTATIoNS

CATegoRY ToPIC JudgeS1 Respiratory, Airway, Ventilation, CPR Dr Pramod Sood, Sanjay Dhanuka

2 Cardiology, Hemodynamics, Fluids, USG Dr Rakesh Kumar, Dr Kapil Borawake

3 Neurology, Ethics, End of Life Care, Organ Donation. Dr Farah Husain, Manish Munjal

4 Renal, GI, Toxicology, Oncology, Obstetrics Critical Care Dr Garima Agwarwal, Dr Bajendra Gowhati

5 Administration, Safety, Quality, Infection and Antibiotics Dr Lalita Chaudhary, Dr vandana Gowhati



Thursday, 8th March 2018

PleNARY SeSSIoN TIme ToPIC SPeAKeR CHAIRPeRSoN8.30-9.00hrs 50 years of ARDS Dr Shirish Prayag Dr Atul Kulkarni

9.00-9.30hrs Expanding horizons for ECMO Dr Alain Combes Dr Lalit

9.30-10.00hrs Lung elastance and Transpulmonary pressure v/s Esophageal pressure: What is the best way forward ?

Dr Marco Ranieri Dr R K Mani

10.00-10.30hrs Hemodynamic Variables : How I use for management of Shock Dr JL Teboul Dr Atul Kulkarni /Dr Lalit / Dr Mani R K

10.30-11.00hrs Applying Mindfulness to improve End-of-Life Care Dr Shivakumar Iyer Dr Kapil Z/ Dr Yatin M/ Dr Subhal D

11.00-11.30hrs Hansraj Nayyar Award paper presentation: Diagnosing heart failure among acutely dyspneic patients with cardiac, inferior vena cava, and lung ultrasonography

Dr Hari Prasad Dr Kapil ZIirpe / Dr Dixit S

Hall No. 1 • Sahnai (Ramada)THemATIC SeSSIoNS 1 - CARdIAC

TIme ToPIC SPeAKeR CHAIRPeRSoN11.30-11.45hrs Managing Atrial Fibrillation in medical/surgical ICU Dr Harish MM Dr Gurpreet Singh

11.45-12.00hrs Sinus tachycardia: when it should be treated and how? Dr Shrikant Shashtrabuddhe Dr Rahul Pandit

12.00-12.15hrs Torsades De Pointes Management Dr Diptimala Agarwal Dr Pradeep Rangappa


LUNCH BREAK 12.30-1.30 HRS

01.30-2.30hrs oRAl PReSeNTATIoNS SPeAKeR JudgeS

01.30-01.40hrs

Comparison of hand rub with super oxidised water & alcohol based chlorhexidine for hand hygiene of health care workers in trauma critical care unit to prevent nosocomial infections: a single centric, prospective, cross-over, comparative study

Dr Badri Prasad Dr Shrinivas Samavedam / Dr Bikas Roy

01.40-01.50hrs Alarm survey among the nurses working at Critical Care Units Dr Aelisa Gubhaju

01.50-2.00hrs Transfer time from the intensive care unit (ICU) and patient outcome Dr Sharmila C

02.00-02.10hrs SMR as a measure of ICU performance- is it adequate? Dr Payel Bose

02.10-02.20hrs Analysis of multidrug resistant NDM producing bacteria in ICU Dr Abu Hena Mostafa

02.20-.02.30hrs Protocolized Handover: Quality Improvement Strategy to Reduce Chances of Basic Human Errors. Dr Shila Gurung

THemATIC SeSSIoNS 2TIme ToPIC SPeAKeR CHAIRPeRSoN2.30-2.45hrs Stress Cardiomyopathy Dr Ashit Hegde Dr Alok Singh

2.45-3.00hrs Septic cardiomyopathy. Dr Palepu Gopal Dr Diptimala Agarwal

3.00-3.15hrs Cardiomyopathy in Tropical Infections Dr Suresh Ramasubban Dr Ajay Pande



THemATIC SeSSIoNS 3 TIme ToPIC SPeAKeR CHAIRPeRSoN3.30-3.45hrs Current 2016 CPR guidelines Dr Bande B Dr Vivek Gupta

3.45-4.00hrs ECPR-Relevance in India Dr Rahul Pandit Dr Srinivas Samvedam

4.00-4.15hrs Role of checklist in prevention of acute life threatening events. Dr Michael O’Leary Dr Sanjay Dhnauka


THemATIC SeSSIoNS 4 TIme ToPIC SPeAKeR CHAIRPeRSoN4.30-4.45hrs Veno-venous ECMO in adults with severe ARDS. Dr Alain Combes Dr Sandeep Diwan

4.45-5.00hrs CO2 in CCM Dr Brian k Dr Diptimala Agarwal

5.00-5.15hrs Cardiogenic shock :Drug & device Dr Alain Combes Dr Satish Dashmana


5.30-7.30hrs AGM

Hall No. 2 • Santoor (Ramada)THemATIC SeSSIoNS 5 - ReNAl

TIme ToPIC SPeAKeR CHAIRPeRSoN11.30-11.45hrs Initiating RRT: Early vs late. Dr Sunitha Binu Varghese Dr Shiva Iyer

11.45-12.00hrs Nephrology rapid response team to assess risk of AKI Dr Srinivas Samavedam Dr M N Singh

12.00-12.15hrs Renal Biomarkers Dr Arindam Kar DR D K Sinha



01.30-2.30hrs oRAl PReSeNTATIoNS SPeAKeR JudgeS01.30-01.40hrs Comparison between fibreoptic bronchoscope guided and mini-

surgical technique of percutaneous dilatational tracheostomy in ICUDr Abhijit Kumar Dr Subhal Dixit /

Prof Bhupeh Kumar


TIme ToPIC SPeAKeR CHAIRPeRSoN01.40-01.50hrs 1 year outcome in COPD patients with respiratory failure requiring

ventilationDr Manjunath BG

01.50-2.00hrs Risk factors and Outcome of extubation failure in an Indian ICU Dr Ayush Chawla

02.00-02.10hrs High flow nasal cannula vs non-invasive positive pressure ventilation in pediatric ARDS: a randomized controlled trial

Dr Surabhi Chandra

02.10-02.20hrs IVC distensibility index in supine versus prone position in patients with acute respiratory distress syndrome(ARDS) a comparison with esophageal doppler

Dr Pralay Ghosh

02.20-.02.30hrs Safety of tracheal intubation - Does geography matter? Dr Deepak R

THemATIC SeSSIoNS 6TIme ToPIC SPeAKeR CHAIRPeRSoN2.30-2.45hrs Renal replacement therapy in the PICU: choosing the right modality Dr Praveen Khilnani Dr Nitin

2.45-3.00hrs SLEDD in ICU - current status Dr Deven Juneja Dr Natesh Prabhu

3.00-3.15hrs Weaning RRT Dr Arindam Kar Dr Sunita Vergis



THemATIC SeSSIoNS 7TIme ToPIC SPeAKeR CHAIRPeRSoN3.30-3.45hrs Role of Vaptans intreating hyponatremia in ICU Dr Pradeep Rangappa Dr Anil Ohari

3.45-4.00hrs Thiazide induced hyponatremia: mechanism and management. Dr Shivakumar Iyer Dr Sanjay Gupta

4.00-4.15hrs Hypokalaemia : diagnostic work up in ICU. Dr Moosa Hussain Dr Devan Juneja


THemATIC SeSSIoNS 8TIme ToPIC SPeAKeR CHAIRPeRSoN4.30-4.45hrs Improving outcome after major surgery: Role of intensivist Dr Prakash Shashtri Dr Arindam Kar

4.45-5.00hrs Perioperative goal directed therapy. Dr Natesh Prabhu Dr Pravin Khilani

5.00-5.15hrs Transcathether aortic valve implantation (TAVI)surgery current evidence. Dr Davy Cheng Dr Urmila Palaria


Hall No. 3 • Amrapali (Clark)THemATIC SeSSIoNS 9 - oRgANISATIoN/eTHICS/TRANSPlANT

TIme ToPIC SPeAKeR CHAIRPeRSoN11.30-11.45hrs E ICU in India: current status. Dr Deewan S Dr Palepu Gopal

11.45-12.00hrs Caring for VIP patients in ICU. Dr Khusrav Bajan Dr Anuj Clerk

12.00-12.15hrs Fiscal efficiency in critical care Dr R K Mani Dr Anand Dongre



01.30-2.30hrs oRAl PReSeNTATIoNS SPeAKeR JudgeS01.30-01.40hrs Fulminant Guillain-Barre Syndrome mimicking clinical brain death Dr Monalisa Dr Y P Singh / Dr Birendra

Prashad Sah

01.40-01.50hrs Management of traumatic flail chest in intensive care unit: an experience from tertiary level trauma center ICU.

Dr Noor Bano

01.50-2.00hrs Incidence of delirium in post cardiac surgery patients : an analysis of possible causes

Dr Sumona Paul

02.00-02.10hrs Outcome of patients with traumatic brain injury in tertiary care ICU in Nepal

Dr Pujan Rajbhnadari

02.10-02.20hrs Decompressive craniectomy in children with non-traumatic coma – a tertiary care center experience

Dr Vijai Williams

02.20-.02.30hrs Packed red blood cell transfusion and health care-associated infections in pediatric intensive care unit in india – a single center experience

Dr Ramachandran Rameshkumar

THemATIC SeSSIoNS 10TIme ToPIC SPeAKeR CHAIRPeRSoN2.30-2.45hrs Machine learning tools in intensive care Dr T Shyam Sunder R Dr Farhad N Kapadia

2.45-3.00hrs Present intensive care workforce and future need in India. Dr Dhruva Chaudhry Dr C K Pandey

3.00-3.15hrs Core indicators of quality care in ICU. Dr Pradeep. Rangappa Dr Samaddar



THemATIC SeSSIoNS 11TIme ToPIC SPeAKeR CHAIRPeRSoN3.30-3.45hrs SOFA Dr Anuj Clerk Dr P L Gautam

3.45-4.00hrs APACHE Dr Anand Dongre Dr Palepu Gopal

4.00-4.15hrs Individualize prognostic patient applicable with the scoring system. Dr Mohan Mathew. Dr Rajnikant Yadav


THemATIC SeSSIoNS 12



Thursday, 8th March 2018TIme ToPIC SPeAKeR CHAIRPeRSoN4.40-4.55hrs Indian network for ICU research: Need of the day. Dr Divatia J Dr R K Mani

4.55-5.10hrs Guidelines on how to use guidelines. Dr Farhad N Kapadia Dr Kapil Borawake

5.10-5.25hrs Big Data Analytics: the future of Data driven decision Prof Chiche Dr T Shyamsunder


Hall No. 4 • Sarod (Ramada)THemATIC SeSSIoNS 13 - gASTRo INTeSTINAl / NuTRITIoNAl

TIme ToPIC SPeAKeR CHAIRPeRSoN11.30-11.45hrs Abdominal compartment syndrome. Dr Dongare Dr Samir Mehata

11.45-12.00hrs Non-infectious diarrhoea in ICU: investigation and management. Dr Samaddar Dr Dipak Saha

12.00-12.15hrs Gut dysfunction in sepsis. Dr Pradip Bhattacharya Dr Ashit Hegade


LUNCH BREAK 12.30-1.30HRS

01.30-2.30hrs oRAl PReSeNTATIoNS SPeAKeR JudgeS01.30-01.40hrs Role Of Urgent Coronary Angiography Followed By Percutaneous

Coronary Intervention( PCI) As a Part of Post Resuscitation Management in Cardiac Arrest Survivors

Dr Anil Kumar Sharma Dr Deepak Govil / Dr Amit Rastogi

01.40-01.50hrs Does real time ultrasonography during bronchoscopy guided percutaneous tracheostomy confer any benefit : a preliminary, randomised controlled trial

Dr Richa Agarwal

01.50-2.00hrs Short versus long axis ultrasound guided approach for internal jugular vein cannulations: a prospective randomised controlled trial

Dr Shakti Mishra

02.00-02.10hrs Randomised double blind study to compare heparin QPS and diclofenac QPS for prevention of superficial thrombophlebitis caused by peripheral thrombophlebitis

Dr Swati

02.10-02.20hrs 0.9% normal saline vs ringer lactate: a prospective comparative study Dr Rajashree Badre

02.20-.02.30hrs Atrial fibrillation after intravenous injection of Ondansetron : a case report

Dr Sindhil Kumar Sahu

THemATIC SeSSIoNS 14TIme ToPIC SPeAKeR CHAIRPeRSoN2.30-2.45hrs Non occlusive mesenteric ischemia. Dr Samir Mahendra Dr Prakash Shastri

2.45-3.00hrs Endovascular management of intractable GI bleed Dr Rajnikant Yadav Dr Amsirh Patel

3.00-3.15hrs Colonic pseudo obstruction Dr Samir Mahendra Dr Naveel Mujaffer



THemATIC SeSSIoNS 15TIme ToPIC SPeAKeR CHAIRPeRSoN3.30-3.50hrs Hepato renal/Hepato pulmonary syndrome: Management. Dr C K Pandey Dr Mohan Mathew

3.50-4.10hrs Liver dysfunction in sepsis. Dr Kapil Borawake Dr Deepak Govil

4.10-4.30hrs Judicious use of antibiotic in acute severe pancreatitis. Dr Palepu Gopal Dr J Srinivas


THemATIC SeSSIoNS 16TIme ToPIC SPeAKeR CHAIRPeRSoN4.40-4.55hrs Immune nutrition: current status Dr Subhal Dixit Dr Sanjit

4.55-5.10hrs Refeeding syndrome: when to suspect and manage Dr Amin Pravin Dr Samir Mahendra

5.10-5.25hrs Hypophosphatemia Dr P L Gautam Dr Ritesh Shah


6.00 pm onwards ANNuAl gNeRAl BodY meeTINg

Hall No. 5 • Shakuntala (Clark)THemATIC SeSSIoNS 17 - eNdoCRINe / oNCologY / ToXICologY

TIme ToPIC SPeAKeR CHAIRPeRSoN11.30-11.45hrs Lipid sink as treatment of poisoning. Dr Omender Singh Dr Subhash Varma

11.45-12.00hrs Interpretation of toxic screening in unknown poisoning. Dr Pradeep Dcosta Dr Saurabh Taneja

12.00-12.15hrs Methemoglobinemia. Dr Mohit Kharbanda Dr Banani Poddar



01.30-2.30hrs oRAl PReSeNTATIoNS SPeAKeR JudgeS01.30-01.40hrs Post Operative Delirium in Cancer patients: Incidence and risk factors - a

prospective observational cohort studyDr Sudipta mukerjee Dr Rajesh Mishra/

Dr Chandani Sinha

01.40-01.50hrs Efficacy of plasmapheresis: beyond the horizon of usual ones. Dr Prachee Makashir

01.50-2.00hrs Paraquat poisoning is treatable Dr Sidhartha Das

02.00-02.10hrs Stress ulcer prophylaxis in the ICU - Are we overdoing it? Dr Archana

02.10-02.20hrs Ventilatory strategy in ARDS: transpulmonary pressure guided vs con-ventional ARDS net protocol

Dr Debraj Jash


TIme ToPIC SPeAKeR CHAIRPeRSoN02.20-.02.30hrs Mono versus combination empiric antibiotic therapy in the treatment of

gram negative infections Dr Arpita Bhakta

THemATIC SeSSIoNS 18TIme ToPIC SPeAKeR CHAIRPeRSoN2.30-2.45hrs Value of the anion gap-current concepts. Dr Shivakumar Iyer Dr Mohit Kharbanda

2.45-3.00hrs Diagnosing cortisol insufficiency in ICU. Dr Sameer Sahu Dr Arghya Majumdar

3.00-3.15hrs Interpreting thyroid function test in critically ill. Dr Vandana Sinha Dr Haidar Abbas



THemATIC SeSSIoNS 19TIme ToPIC SPeAKeR CHAIRPeRSoN3.30-3.50hrs Sodium disturbances in the PICU Dr banani Poddar Dr Anil Sachdev

3.50-4.10hrs Obesity paradox in ICU. Dr Ashit Hegde Dr Vijay K Mishra

4.10-4.30hrs Non diabetic Endocrine emergencies. Dr Prakash Shastri Dr Omender Singh


THemATIC SeSSIoNS 20TIme ToPIC SPeAKeR CHAIRPeRSoN4.40-4.55hrs Newer blood products: PCC/Fibrinogen concentrate/Factor concentrate:

Utility in ICU Dr Deepak Govil Dr Sameer Sahu

4.55-5.10hrs Thrombotic microangiopathy: Therapeutic approach. Dr Arghya Majumdar Dr Vandana Sinha

5.10-5.25hrs Current management of tumorlysis Dr Subhash Varma Dr Pradip Bhattacharya


GENERAL


TIme ToPIC SPeAKeR ComPANY11.30am-12.30am A Novel Carbapenem Sparing Agent Dr Suresh Kumar D, Fusion12.30 pm-1.00 pm What lies ahead in the future of Critical Care in India??? Dr Pradeep Rangappa,

Dr Prakash Shastri, Dr Khusrav Bajan, Dr Suresh Ramasubban, Dr T. S. Ravindra, (Moderator: Dr Arindham Kar)

Micro lab

1.00-1.30 lunch break lunch break lunch break 1.30-2.30 Nasal high flow : what really matters? Dr Tommaso Mauri Fisher & Paykel Healthcare.2.30 pm- 3.30 pm. Panel discussion on Ulinastatin Chairperson- Dr Yatin Mehta

Moderator- Dr Yash JaveriBharat Serums And Vaccines Limited side.

2:30-2:45 How to select patients judiciously for adjuvant therapies in sepsis? Dr Yash Javeri2:45-3:20 Panel Discussion- Sepsis- Glimmer of Hope Panellists:

Dr Anil GurnaniDr Madhusudan JujuDr Khusrav BhajanDr Rajesh MishraDr Mohit KharbandaDr Rajarshi RoyDr Ankit BansalDr Jeetendra Sharma

3:20-3:30 Recommendations Dr Yash Javeri3.30-4.30 Extracorporeal Cytokine Adsorption Device (ECAD): Sepsis & Beyond Moderator:

Dr Vinod Kumar Singh, Panelist: Dr Y. P. Singh, Dr Rajib Paul, Dr Abdul Ansari

Biocon session

4.30-5.30 The Grand International Critical Care Quiz-2018 Dr Prashant Kumar / Dr. Qurat

CHAIRPeRSoN: Dr. Yatin MehtaDr. Subhal Dixit


CATegoRY ToPIC JudgeS1 Respiratory, Airway, Ventilation, CPR Dr Manish Soneja, Dr Gopal Rawal2 Cardiology, Hemodynamics, Fluids, USG Dr Narendra Arya, Dr Arun Barnawal3 Neurology, Ethics, End Of Life Care, Organ Donation Dr Nishant Patel, Dr J Srinivas4 Renal, GI, Toxicology, Oncology, Obstetrics Critical Care Dr Pramod Gupta, Dr vijay Mishra5 Administration, Safety, Quality, Infection and Antibiotics Dr Punit Khanna, Dr Punit Khanna



PleNARY SeSSIoNTIme ToPIC SPeAKeR CHAIRPeRSoN8.30-9.00hrs Death determined by neurological criteria: the next steps Dr Giuseppe.Citerio Dr Dhruv Choudhari

9.00-9.30hrs Dangers of Spontaneous Breathing during Mechanical Ventilation Dr Brian K Dr Rajesh Chawla

9.30-10.00hrs 10 Barriers of EOL in INDIA Dr Divatia J Prof Shivsunder Singh

10.00-10.30hrs Evolution of Technology for Continuous Renal Replacement Therapy: Forty Years of Improvements.

Dr Rajesh Chakravarthi Prof Shivsunder Singh

Hall No. 1 • Sahnai (Ramada)THemATIC SeSSIoNS 1 - TRoPICAl IllNeSS

TIme ToPIC SPeAKeR CHAIRPeRSoN10.30-10.45hrs Hemophagocytic syndrome in tropical infection: when to suspect and

how to manage. Dr Dhruva Chaudhry Dr V K Bhatiya

10.45-11.00hrs Platelet transfusion in Dengue: current strategy. Dr Narendra Rungta Dr JV Peter

11.00-11.15hrs Leptospirosis:when to suspect and how to manage? Dr Shyamsunder Agarwal Dr Kapil Zirpe


THemATIC SeSSIoNS 2TIme ToPIC SPeAKeR CHAIRPeRSoN11.30-11.45hrs Scrub typhus: when to suspect and how to manage? Dr Khalid Dr Raman Sardana

11.45-12.00hrs Management of severe dengue: are WHO guidelines relevant? Dr J.V.Peter Dr Gopalnath

12.00-12.15hrs Management of severe malaria: are WHO guidelines relevant? Dr Madhukar Rai Dr G P Singh



THemATIC SeSSIoNS 2TIme ToPIC SPeAKeR CHAIRPeRSoN1.30-1.45hrs Decontaminating surfaces and medical equipment: what’s new and

practical? Dr Raman Sardana Dr Shyamsunder Agarwal

1.45-2.00hrs Is pseudomonas vaccine in ventilated ICU patients the future? Dr Tobias Welte Dr Mamta

2.00-2.15hrs Isolation or cohorting : which is practical? Dr J V Peter Dr Pradeep D Costa



THemATIC SeSSIoNS 4TIme ToPIC SPeAKeR CHAIRPeRSoN2.30-2.45hrs Immune Encephalitis : Role of intensivist Dr Rajesh Mishra Dr Ritesh Shah

2.45-3.00hrs Scope of bacteriophage in treatment of sepsis Dr Gopalnath Dr Khalid khatib

3.00-3.15hrs Undifferatiated fever in ICU ; Approach Dr Pradip Dcosta Dr B B Bharadwaj


Hall No. 2 • Santoor (RAMADA)THemATIC SeSSIoNS 5 - ReSPIRAToRY moNIToRINg

TIme ToPIC SPeAKeR CHAIRPeRSoN10.30-10.45hrs Airway management during CPR Dr Manish Munjal Dr Anil Sachdev

10.45-11.00hrs Inability to clear secretion: how to manage. Dr Ranveer Tyagi Dr Haider Abbas

11.00-11.15hrs Metabolic and nutrition assessment by Mechanical Ventilation Dr Sanjith Sridharan Dr Banamber Ray


THemATIC SeSSIoNS 6TIme ToPIC SPeAKeR CHAIRPeRSoN11.30-11.45hrs ARDS mimics in ICU Dr Brian K Dr Chawla

11.45-12.00hrs HOV in paediatric ARDS-current status ….. Dr Anil Sachdev Dr Manish Munjal

12.00-12.15hrs PEEP titration: Current status Dr Chitra Mehta Prof Chiche



THemATIC SeSSIoNS 7TIme ToPIC SPeAKeR CHAIRPeRSoN1.30-1.45hrs Berlin definition of ARDS: does it need to be modified? Dr Massimo Antonelli Dr A K Singh

1.45-2.00hrs Fluids, steroids and Neuro muscular blockage in ARDS pts. Dr Ross Freebairn Dr Naveel Mujffer

2.00-2.15hrs Rescue therapy in ARDS (prone and ECMO) Dr Sandeep Deewan Dr Sujit



THemATIC SeSSIoNS 8TIme ToPIC SPeAKeR CHAIRPeRSoN2.30-2.45hrs ARDS: Functional Residual capacity Prof. Chich Dr Yatin Mehata

2.45-3.00hrs Hyperoxia in ICU: implications Dr Banambar Ray Dr Sanjay Kumar

Friday, 9th March 2018


TIme ToPIC SPeAKeR CHAIRPeRSoN3.00-3.15hrs How to improve outcomes in patients requiring NIV for acute Hypox-

emic Respiratory failureDr Rajesh Chawla Dr Rajesh Mishra


Hall No. 3 • Amrapali (Clark)THemATIC SeSSIoNS 09 - geNeRAl CRITICAl CARe

TIme ToPIC SPeAKeR CHAIRPeRSoN10.30-10.45hrs Non pharmacological prophylaxis of VTE: Role in ICU Dr Saurabh Saigal Dr Rajiv Gautam

10.45-11.00hrs Newer anticoagulants Dr Gaurav Jain Dr Binila Chacko

11.00-11.15hrs NON thrombotic Pulmonary embolism (FAT/AIR/AMNIOTIC) Dr Mohan Maharaj Dr Sheil Bhosale


THemATIC SeSSIoNS 10TIme ToPIC deBATe SPeAKeR CHAIRPeRSoN11.30-12.15PM Extracorporeal therapy in sepsis: still place in ICU (con) Dr Yatin mehta Dr Sameer Jog

Extracorporeal therapy in sepsis: still place in ICU (pro) Dr Massimo Antonelli Dr B B Kushwaha



THemATIC SeSSIoNS 11TIme ToPIC SPeAKeR CHAIRPeRSoN1.30-1.45hrs High risk pregnancy: role of intensivist DR Sunil Pandya Dr Y P Singh

1.45-2.00hrs Management of obstetric haemorrhage: Recent advances. Dr Bande B Dr Ziya Arshad

2.00-2.15hrs Managing seizures in ICU Dr Harsh Sapra Dr Mohan Maharaj



THemATIC SeSSIoNS 12TIme ToPIC SPeAKeR CHAIRPeRSoN2.30-2.45hrs When to measure & how to interpret blood lactatein ICU? Dr Shil Bhosale Dr Bande B

2.45-3.00hrs Measuring ScVO2: is it relevant today? Dr Sameer Jog Dr A S M Areef Ahsan

3.00-3.15hrs Dynamic Indices of fluid Responsiveness Dr Binila Chacko Dr Priyanka Khurana


Hall No. 4 • Sarod (Ramada)THemATIC SeSSIoNS 13 - SePSIS

TIme ToPIC SPeAKeR CHAIRPeRSoN10.30-10.45hrs Emerging fungal infections Dr Arunaloke Chakrabarti Dr Farhad Kapadia

10.45-11.00hrs Candidemia in ICU: New guidelines. Dr RK Singh Dr Atul kulkarni

11.00-11.15hrs Management of Mucormycosis Dr Babu Abraham Dr Omar Farookh


THemATIC SeSSIoNS 14TIme Topic Speaker CHAIRPeRSoN11.30-11.45hrs Biomarkers for fungal infection: current status Dr Divatia Dr Rungta

11.45-12.00hrs Antifungal stewardship. Dr Subhash.Todi Dr Todi

12.00-12.15hrs Pk/Pd of antifungal drugs. Dr Suresh Ramasubbam Dr D K Singh


THemATIC SeSSIoNS 15TIme ToPIC SPeAKeR CHAIRPeRSoN1.30-1.45hrs Utility of surveillance bacterial culture in ICU in choosing empiric antibi-

otic. Dr Sanjay Bhattacharya Dr RK Singh

1.45-2.00hrs PCR based diagnostic tools, are they ready for prime time? Dr Farhad Kapadia Dr A K Singh

2.00-2.15hrs Experience with MALDI TOF/PCR. Dr Arunaloke Chakrabart Dr Suresh Ramasubbam



THemATIC SeSSIoNS 16TIme ToPIC SPeAKeR CHAIRPeRSoN2.30-2.45hrs Sepsis guidelines: how to improve compliance. Dr Narendra Rungta Dr Divatia J

2.45-3.00hrs Presepsin : a new biomarker Dr Quirinopiacevoli Dr Rajan Barokar

3.00-3.15hrs New surviving the guidelines: What has changed? Dr Mohd Omar Farook Dr V K Singh





Hall No. 5 • Shakuntala (Clark)THemATIC SeSSIoNS 17 - geNeRAl

TIme ToPIC SPeAKeR CHAIRPeRSoN10.30-10.45hrs Care of bone marrow transplant patient: Role of intensivist Dr Abhinav Gupta Dr Subhal Dixit

10.45-11.00hrs DCD (donation after cardiac death)-current status. Dr Prasad Rajhans Dr Arnil Ahmed

11.00-11.15hrs Management of the potential Organ Donor in the PICU Dr Bala Ramachandran Dr Yash Javeri


THemATIC SeSSIoNS 18TIme ToPIC SPeAKeR CHAIRPeRSoN11.30-11.45hrs Ketamine /Dexmedetomidine/Benzodiazepine/Fentanyl: Analgesia

sedation in ICU: WHICH DRUG? WHERE? Dr Pradip Bhattacharya Dr Babu Abraham

11.45-12.00hrs Therapeutic Drug Monitoring in ICU Dr Rajesh Pande Dr Abhinav Gupta

12.00-12.15hrs ICU Pharmacist: Utility Dr Sumit Ray Dr Ayush Chawla


LUNCH BREAK 12.30-1.30HRS

THemATIC SeSSIoNS 19TIme ToPIC SPeAKeR CHAIRPeRSoN1.30-1.45hrs Use of technology in ICU nutrition Dr Sanjith Sridharan Dr Yash Javeri

1.45-2.00hrs Feeding enterally hemodynamically unstable patient: is it feasible? Dr Subhal Dixit Dr Bala Ramachandran

2.00-2.15hrs Individualising ICU nutrition Dr Pravin Amin Dr Sanjay Kumar



THemATIC SeSSIoNS 20TIme ToPIC SPeAKeR CHAIRPeRSoN2.30-2.45hrs Achieving Glucose control Dr Rajan Barokar Dr Yash Javeri

2.45-3.00hrs Hypoglycaemia in ICU: Detection, prevention and management Dr Shrinivas Samvedan Dr Sumit Ray

3.00-3.15hrs Individualizing glucose control in ICU Dr A S M Areef Ahsan Dr Prasad Rajhans



TIme ToPIC SPeAKeR ComPANY NAme CHAIRPeRSoN11.00-12.00 Simplifying Critical care Complexity : Using the armamen-

tarium effectivelyExpert: Dr S.K.Todi Panelist: Dr Suresh Ramasubban

Pfizer session Dr Shirish Prayag

12.00-1.00 Metabolic monitoring Prof Jean Daniel Chiche Wipro GE Not given

12.30-1.30pm lunch break

1.30 pm - 2.00 pm Will continuous remote monitoring bridge the gap between ICU and Wards?”

Dr Priyank Bhatt stasis labs

Improving patient safety, clinical outcomes and affordability with continuous monitoring in non-ICU settings

Dr Ashwin Kulkarni stasis labs

2.00-2.30pm ROTEM – Rotational Thrombo elastometry for fast and effec-tive bleeding management.

Dr Shweta Singh sharplineint

2.30-3.30pm The Grand International Critical Care Quiz-2018 Dr Prashant Kumar / Dr. Qurat

Dr Y. P. Singh / Dr Yash Javeri

3.30-4 pm Management of Delirium in ICU- A Psychiatric Perspective Dr Abhay kumar Singh


CATegoRY ToPIC JudgeS1 Respiratory, Airway, Ventilation, CPR Dr Ravindra Kaur, Dr Suresh Kumar Bhargava

2 Cardiology, Hemodynamics, Fluids, USG Dr Sachiddanand Jee Bharti, Dr Vinod Kumar

3 Neurology, Ethics, End of Life Care, Organ Donation. Dr Sanjay Kumar,Dr Vipin Kumar Singh

4 Renal, GI, Toxicology, Oncology, Obstetrics Critical Care Dr Sanjeev Sinha, Dr Haidar Abbas

5 Administration, Safety, Quality, Infection and Antibiotics Dr Satendra Narayann Singh, Dr Ashok Singh


CRITICARE 2018 WORKSHOP PROGRAM

Critical Care Review Course (4C) –Varanasi-2018 Registration : 9-10 AM

Day-1 (10th March) Saturday TIme THemATIC SPeAKeRS10- 10:30 Severe Sepsis and Septic shock Dr Dhruv Choudhry

10:30-11 Stroke (CVA) Dr Kapil Zirpe

11:00 - 11:30 AM Onco Emergencies Dr Atul Kulkarni

10 mins Break

11:40 – 12:10 Nutrition Dr Shiva Iyer

12:10-12:40 Pulmonary embolism Dr Yatin Mehta

12:40 – 1:10 AcuteCoronaryCare Dr Rajesh Mishra

1:10-1:40 Lunch

Interactive

1:40-2:2:30 Antibiotics/ Antifungal Dr Afzal

2:30-3:20 Cardiac Arrhythmia in ICU Dr Subhal Dixit

3:20-4:10 ABG Dr Suneel Garg

4:10-4:20 Tea Break

Workshop

4.20-4.50 4stations(4:20-6:20)

(30minutesforeachstation)

Station–I&II Airway Management Dr Jiggi Divatia and team

Station–III&IV Ultrasound/Echo in ICU Dr Srinivas Samavedam and team

4.50-5.20

Day-2 (Day 11th March) TIme THemATIC SPeAKeRS30 mins GI Bleed Dr Rajesh Pandey

30 mins Hyponatremia Dr J.P. Sharma

30 mins Stroke Dr Kapil Zirpe

10 mins Break30 mins Acute Renal Failure Dr R.K. Singh

30 mins Poisioning Dr Omender Singh

30 mins Acute Liver failure Dr Srikant Srinivasan

40 mins LunchInteractive

60 mins Trauma/Head injury/Spinal injury Dr Sumit Ray

60 mins Radiology in ICU Dr Rahul Guha Biswas

Workshop

4 stations(30 minutes for each station)

Station–I&II Hemodynamic monitoring Dr Rahul Guha Biswasand team

Station–III&IV Mechanical Ventilation Dr Sandeep Dewan, Dr Munish Chauhan and Dr Milind Talegaonkar

AIRWAY MANAGEMENT WORKSHOP – “CRITICARE 2018” VARANASHI CHIEF COORDINATOR – Dr PRADIP KUMAR BHATTACHARYA

DAY – 1 (10/03/2018)1 Airway Management in Intensive Care –How and why it is different? 8.00 – 8.15 Dr Pradip Kumar Bhattacharya

2 Physiologic and Pharmacologic Considerations in the Critically Ill 8.15 – 8.30 Dr Syed Nabeel Muzaffar

3 Early Recognition of patients with Airway Problems in ICU 8.30 – 8.45 Dr Ashutosh Bharadwaj

4 Planning before attempting airway in Critical care 8.45 – 9.00 Dr Nikhil Kothari

5 The difficult Airway Trolley/ Gadgets for ICU 9.00 – 9.15 Dr S. M. Ausim

6 Precautions to prevent complications during Emergency Intubation in ICU

9.15 – 9.30 Dr Kanwalpreet Singh

7 Self extubation in ICU an approach to Prevent and Manage 9.30 – 9.45 Dr Rajiv Shukla

8 Management of The High-Risk Airway in ICU 9.45 – 10.00 Dr Pradip Kumar Bhattacharya

CASe dISCuSSIoNS 11.30 TO 13.10 HRS (100 Minutes)

FouR gRouPS 25 mINuTeS RoTATIoN IN eACH TABleTABLE 1 (25 Minutes)

AIRWAY MANAGEMENT IN NEURO-CRITICAL CARE CASES Dr Rajesh Meena

TABLE 2 (25 Minutes) AIRWAY MANAGEMENT IN CARDIAC CRITICAL CARE CASES

Dr Ankit Agrawal

TABLE 3 (25 Minutes) AIRWAY MANAGEMENT IN RESPIRATORY CRITICAL CARE CASES

Dr Gopal Rawal

TABLE 4 (25 Minutes) AIRWAY MANAGEMENT IN MOF & SEPTIC SHOCK

Dr Rahul Anand


luNCH 13.10 HRS To 14.00 HRS

Tea break 10.00 – 10.15 Tea Break9 How do I select my best Airway Gadget in ICU 10.15 – 10.30 Dr Ashok Singh

10 Difficult Airway and inexperienced Hands 10.30 – 10.45 Dr Vinay Singhal

11 Awake Intubation in ICU – Can we, do it? 10.45 – 11.00 Dr Armin Ahmed

12 Cricothyroidotomy /Percutaneous tracheostomy in ICU How & When? 11.00 – 11.15 Dr Asif Ahmed

13 Simulation and Training how does it help? 11.15 – 11.30 Dr V N Tyagi

WoRK STATIoNS 14.00 TO 17.00 HRS (180 Minutes)

FouR gRouPS 45 mINuTeS RoTATIoN IN eACH TABleTABLE 1 (45 Minutes) MASKS, BAGS, AIRWAYS, CIRCUITS, AMBU BAG, TECHNIQUE OF BAG MASK VENTILATION Dr Rahul Anand, Dr Syed Nabeel Muzaffar, Dr P. Bhaskar Rao, Dr Ankit Agrawal

TABLE 2 (45 Minutes) PREPARATIONS FOR AIRWAY, MANAGEMENT, TUBES (DIFFERENT TYPES), LARYNGOSCOPES, TECHNIQUE OF ENDOTRACHEAL INTUBATION Dr Kanwalpreet Sodi, Dr S. M.Ausim, Dr Vinay Singhal Dr Armin Ahmed

TABLE 3 (45 Minutes) PHARMACOLOGICAL AGENTS SUPRAGLOTTIC AIRWAY DEVICES DIFFICULT AIRWAY ALGORITHM Dr Nikhil Kothari, Dr Gopal Rawal, Dr V N Tyagi, Dr Ashok Singh

TABLE 4 (45 Minutes) INTUBATING STYLETS, OTHER EMERGENCY GADGETS, VIDEO ASSISTED LARYNGOSCOPY Dr Pradip Kumar Bhattacharya, Dr Rajiv Shukla, Dr Asif Ahmed, Dr Ashutosh Bharadwaj

AIRWAY MANAGEMENT WORKSHOP – “CRITICARE 2018” VARANASHI CHIEF COORDINATOR – Dr PRADIP KUMAR BHATTACHARYA

DAY – 2 (11/3/2018)PRoBlem BASed dISCuSSIoNS

1 Management of patients with angioedema 9.00 – 9.10 Dr Syed Nabeel Muzaffar

2 Stridor due to upper airway obstruction/mass 9.10 – 9.20 Dr Rahul Anand

3 Airway management in patients with tracheobronchial traumatic injury 9.20 – 9.30 Dr Kanwalpreet Sodi

4 Airway management of the patient with morbid obesity 9.30 – 9.40 Dr Asif Ahmed

5 Management of anterior mediastinal mass 9.40 – 9.50 Dr Armin Ahmed

6 The asthmatic crisis 9.50 – 10.00 Dr Rajiv Shukla

7 Airway management of the pregnant patient 10.00 – 10.10 Dr Ashutosh Bharadwaj

8 Management of patients with laryngospasm 10.10 – 10.20 Dr S. M. Ausim

TEA BREAK 10.20 – 10.50 TEA BREAK

9 Management of blunt and penetrating neck trauma 10.50 – 11.00 Dr Vinay Singhal

10 Airway management of patients with smoke inhalation 11.00 – 11.10 Dr Rajesh Meena

11 Airway management in cervical spine injury 11.10 – 11.20 Dr Ankit Agrawal

12 Airway management in facial trauma 11.20 – 11.30 Dr Nikhil Kothari

13 Management of foreign body aspiration 11.30 – 11.40 Dr Rajiv Shukla

14 Airway compression by expanding hematoma 11.40 – 11.50 Dr Pradip Kumar Bhattacharya

INTRoduCTIoN To BRoNCHoSCoPY 12.00HRS TO 13 HRS (60 MINUTES)

TWo gRouPS 30 mINuTeS RoTATIoN IN eACH TABleTABLE – 1 (30 MINUTES) ANATOMY OF BRONCHOSCOPE AND ANATOMY OF TRACHEO BRONCHEAL TREE– Dr Asif Ahmed

TABLE – 2 (30 MINUTES) TECHNIQUE OF HANDLING AND INSERTING THE BRONCHOSCOPE IN ICU SETUP (LIMITATIONS AND PROBLEMS) – Dr Haider Abbas & Dr Pradip Kumar Bhattacharya

LUNCH – 13.00 HRS TO 14.00 HRS

15 Diagnostic Bronchoscopy in ICU 14.00 – 14.15 Dr Ashok Singh

16 Therapeutic Indications of Bronchoscopy in ICU 14.15 – 14.30 Dr V N Tyagi

17 Broncho-Alveolar Lavage with bronchoscope 14.30 – 14.45 Dr Ashutosh Bharadwaj

18 Anaesthesia and Sedation for Bronchoscopy in ICU 14.45 – 15.00 Dr Gopal Rawal

WoRKSTATIoNS 15.00HRS TO 17.30 HRS (120 MINUTES)

FIVe gRouPS 30 mINuTeS RoTATIoN IN eACH TABleTABLE -1 (30 MINUTES) STERILIZATION CARE AND MAINTENANCE OF BRONCHOSCOPE Dr Syed Nabeel Muzaffar, Dr Rajesh Meena, Dr Ankit Agrawal

TABLE – 2 (30 MINUTES) BRONCHOSCOPIC INTUBATION/BRONCHOSCOPY WITHOUT ENDOTRACHEAL TUBE IN CRITICALLY ILL PATIENT Dr Ashok Singh, Dr Nikhil Kothari, Dr Kanwalpreet Sodi

TABLE – 3 (30 MINUTES) BRONCHOSCOPY DURING INVASIVE VENTILATION WITH ENDOTRACHEAL TUBE – Dr Gopal Rawal, Dr Sayed Ausim, Dr Vinay Singhal

TABLE -4 (30 MINUTES) BRONCHOSCOPY DURING NON-INVASIVE VENTILATION Dr V N Tyagi, Dr Armin Ahmed, Dr Rahul Anand

TABLE – 5 (30 Minutes) CRICOTHYROIDOTOMY/PERCUTANEOUS TRACHEOSTOMY Dr Rajiv Shukla, Dr Asif Ahmed, Dr Ashutosh Bharadwaj


BPICC Course March 10-11, 2018 at IMS-BHU, Varanasi

Day 1 , 10 March 2018TIme ToPIC FACulTY09.15-09.45 Recognition of the sick child Dr Banani Poddar

09.45-10.15 Basics of mechanical ventilation Dr Praveen Khilnani

10.15-10.30 Discussion

10.30-10.45 Tea break

10.45-11.15 Shock Dr Arun Bansal

11.15-11.45 Fluid and electrolytes Dr Anil Sachdeva

11.45-12.15 Transport of the critically ill child Dr Nameet Jerath

12.15-12.30 Discussion

12.30-01.15 Procedural videos Dr Rahul Kumar Singh

01.15-02.00 Lunch

02.00-05.00 Work stations by rotation

Airway management and RSI Dr Praveen Khilnani, Dr Rahul Kumar Singh

ABG analysis Dr Anil Sachdeva, Dr Sunil Rao

PICU procedures Dr Nameet Jerath, Dr Lokesh Tiwari

Setting up of a ventilator Dr Banani Poddar, Dr Arun Bansal, Dr Vivek Chetal

Day 2, 11 March 201809.00-09.30 Analgesia and sedation Dr Lokesh Tiwari

09.30-10.00 Neurological emergencies Dr Arun Bansal

10.00-10.15 Tea break

10.15-10.45 Antimicrobial therapy n the PICU Dr Vivek Chetal

10.45-11.15 Blood component therapy Dr Sunil Rao

11.15-01.15 Skill stations by rotation

Difficult ventilation scenarios Dr Praveen Khilnani

Hemodynamic monitoring Dr Anil Sachdeva

Neuromonitoring Dr Arun Bansal

01.15-02.00 Lunch

02.00-04.00 Skill stations by rotation

Shock cases Dr Praveen Khilnani, Dr Nameet Jerath, Dr Sunil Rao

CPAP and HFNC Dr Arun Bansal, Dr Lokesh Tiwari, Dr Vivek Chetal

Cardiac emergencies Dr Anil Sachdeva, Dr Banani Poddar, Dr Rahul Kumar

04.00-04.30 BPICC test

04.30-05.00 Distribution of certificatesNational Coordinator: Dr Arun Bansal • Local Coordinators: Dr Sunil Rao, Dr D.M.GuptaBPICC faculty: 1. DrArunBansal,ProfessorinPediatrics,AdvancedPediatricCentre,PGIMER,Chandigarh•email:[email protected]. DrPraveenKhilnani,RainbowChildren’sHospital,NewDelhi•email:[email protected] , [email protected] 3. DrAnilSachdev,DirectorPICUandPulmonology,SGRH,NewDelhi•email:[email protected], [email protected]. DrNameetJerath,DirectorPICU,ApolloHospital,NewDelhi•email:[email protected]. DrLokeshTiwari,AssistantProfessorinPediatrics,AIIMS,Patna•email:[email protected]. DrSunilRao,AssociateProfessorinPediatrics,IMSBHU,Varanasi•email:[email protected]. DrVivekChetal,PediatricIntensivist,Varanasi•email:[email protected]. DrRahulKumarSingh,PediatricIntensivist,Varanasi•email:[email protected]

ECHO and USG Course in ICU-1Day 1: 10th March, 2018

TIme ToPICS SPeAKeRS09:00-09:30 Registration

09:30-09:40 Welcome Dr Shrikanth Srinivasan

09:40-10:00 Introduction to Point-of-care Ultrasound Dr Sachin Gupta

10:00-10:30 Basic Ultrasound Physics and knobology Dr Jayant Shelgaonkar

10:30-11:10 Ultrasound of Airway Sonoanatomy of airway, Relevant Physics, Pathology, Cricothyroidotomy, Percutaneous Tracheotomy

Dr Pradeep D`costa

11:10-11:30 Tea / Coffee Break

11:30-12:40 Lung Ultrasound and beyond Sonoanatomy, Relevant physics, Pathology, Procedures, Protocols, USG of Diaphragm, Recent advances and future directions

Dr Shrikanth Srinivasan

12:40-01:00 Introduction to Echocardiography Cardiac windows and relevant knobology for Transthoracic ECHO

Dr Anuj Clark

13:00-14:00 Lunch Break

14:00-15:00 Focused hemodynamic assessment Assessment of biventricular function, IVC variability and interpretation, Valvular function, Pathology, Procedural guidance, Cardio-circulatory Protocols

Dr Jose Chacko


15:00-17:30 Hands on practice Machine orientation, Sonoanatomy, signs and patterns in Airway, Breathing and Circulation

Dr Jose Chacko Dr Pradeep D`Costa Dr Jayant Shelgaonkar Dr Sachin Gupta Dr Kedar Toraskar Dr Anuj Clark Dr Vivek Kumar Dr Atiharsh Aggrawal Dr Yashpal Dr P.K.Das

17:30 Questions and Answers, Session End

Day 2: 11th March, 2018TIme ToPICS SPeAKeRS

09:00-09:30 Focussed Assessment with Sonography in Trauma FAST,EFAST

Dr Vivek Kumar

09:30-10:00 Abdominal Pathology for the intensivist Cholecystitis, Pancreatitis, Gallstones, Renal Calculus, Hydronephrosis

Dr Kedar Toraskar

10:00-10:20 Abdominal & Thoracic Aortic Aneurysm & Dissection Dr Anuj Clark

10:20-10:40 Deep Venous Thrombosis, Pulmonary Embolism Dr Jose Chacko

Case based discussion

10:40-11:10 Musculoskeletal and Spine Ultrasound Bony, ligament and tendon injuries, muscle tear, hematomas, cellulitis, abscess, foreign bodies, spine sonology and lumbar puncture

Dr Atiharsh Aggrawal

11:15-11:45 Tea / Coffee Break

11:45-12:15 Real time Central Venous Cannulation How to perform real time cannulation, Tips and tricks,Arterial and peripheral venous cannulation

Dr Jayant Shelgaonkar

12:15-13:00 Ultrasound Guided Neurological Assessment Case based discussion, Pupillary reaction, Vitreous haemorrhage, Retinal detachment, ONSD, TCD

Dr Pradeep D`costa

13:00-14:00 Lunch Break

14:00-14:30 Ultrasound guided management of Shock Case based discussion

Dr Sachin Gupta

14:30-15:00 Ultrasound guided fine tuning of mechanical ventilation Assessment of aeration/deaeration, PEEP setting, recruitment, weaning

Dr Shrikanth Srinivasan

15:00-17:00 Hands on practice FAST, abdomen scan, optic ultrasound, aorta scan, cannulation on vascular phantom

Dr Jose Chacko Dr Pradeep D`Costa Dr Jayant Shelgaonkar Dr Sachin Gupta Dr Kedar Toraskar Dr Anuj Clark Dr Vivek Kumar Dr Atiharsh Aggrawal Dr Yashpal Dr P.K.Das

17:00-17:30 Question and answers, Vote of thanks, End of Session

Ultrasound & ECHO in ICUCRITICARE 2018, Varanasi

10th-11th March, 2018

COURSE DIRECTORDr Shrikanth Srinivasan

Mobile: 9560300723, 9899110723Email:[email protected]

NATIONAL FACULTYDr Jose Chacko

Dr Pradeep D`CostaDr Jayant Shelgaonkar

Dr Sachin GuptaDr Kedar Toraskar

Dr Anuj ClarkDr Vivek Kumar

Dr Atiharsh AggrawalDr YashpalDr P.K.Das

NeuRoCRITICAl CARe WoRKSHoP 2018DAY – 1 (10/03/2018)

1 INTRACRANIAL PRESSURE PHYSIOLOGY AND MONITORING 9:30AM -9:55AM Dr Abhishek Pathak

2 MANAGEMENT OF RAISED INTRACRANIAL PRESSURE : FOR WHOM, HOW & WHEN 9:55AM - 10:20AM Dr Ashutosh Bhardwaj

3 VENTILATORY CARE IN NEUROLOGICAL DISORDERS : HOW IT IS DIFFERENT ? 10:20AM -10:45AM Dr Sachin Gupta

TEA BREAK (10:45 AM – 11:15 AM)

4 RESUSCITATION AND NEUROPROGNOSTIC ATION OF CARDIAC ARREST 11:15AM - 11:40AM Dr Y P Singh

5 THERAPEUTIC HYPOTHERMIA-INDUCTION MANAGEMENT AND COMPLICATIONS 11:40AM - 12:05PM Dr Virendra Jain

6 APPROACH TO THE PATIENT IN COMA 12:05PM - 12:30PM Dr SriniwasSamvedam

7 ISCHEMIC STROKE AND THROMBOLYSIS 12:30AM - 12:55AM Dr Kapil Zirpe

8 INTRA CEREBRAL HAEMORRHAGE - DO WE NEED SURGICAL INTERVENTION OR NOT 12:55AM - 01:20AM Dr Manoj giri

LUNCH BREAK (1:20 PM - 2:00 PM)

9 SUBARACHOID HAEMORRHAGE 02:00PM - 02:25PM Dr Akhil Taneja

10 TRAUMATIC BRAIN INJURY 2:25PM - 2:50PM Dr SriniwasSamvedam

11 NON TRAUMATIC WEAKNESS IN ICU 2:50 PM-3:15PM Dr BadriPrasad Das


12 SPINAL CORD COMPRESSION (TRAUMATIC/NON-TRAUMATIC) 3:15PM - 3:40PM Dr Deepika Joshi

TEA BREAK (3:40 PM - 4:10 PM)

CONCLUSION AND Q/A SESSION 4:10PM – 4:30PM

DAY – 2 (11/03/2018)1 MENINGITIS/ENCEPHALITIS 9:00AM - 9:25AM Dr Ashutosh Garg

2 MANAGEMENT OF STATUS EPILEPTICUS (CONVULSIVE /NONCONVULSIVE) 9:25AM – 9:50AM Dr Virendra Jain

TEA BREAK (09:50 AM - 10:15AM)

3 DIAGNOSIS OF BRAIN DEATH ( INDIAN SCENARIO) AND CARE OF ORGAN DONAR 10:15AM - 10:40AM Dr Babu Abraham

4 SEDATION, DELIRIUM GUIDELINE UPDATE AND ROLE OF EARLY MOBILISATION 10:40AM – 11:05AM Dr Arnab Das Gupta

NEUROCRITICAL CARE – SKILL STATIONS (11:15AM - 1.15PM)

ROTATION OF 4 BATCHES - 30 MINS EACH SESSION

1 RAPID BEDSIDE NEUROLOGICAL ASSESSMENT AND CASE SCENERIOS Dr Akhil Taneja/ Dr Babu Abraham/ Dr BadriPrasad Das

2 EEG (CONTINOUS EEG), EMG AND NCV Dr Srinivassamvedam/ Dr Abhishek Pathak/ Dr Deepika Joshi

3 NEUROIMAGING AND ICP MONITORING Dr Manoj Ranjan/ Dr Sachin Gupta/ Dr Manoj giri

4 TRANSCRANIAL DOPPLER Dr Virendra Jain/ Dr Ashutosh Garg/ Dr Arnab das Gupta

LUNCH BREAK (1:15 PM - 2:00 PM)

MCQ BASED EXAMINATION 2:00PM – 3:00PM

EXAM Q/A DISCUSSION 3:00PM – 3:30PM

CERTIFICATE DISTRIBUTION AND CONCLUSION OF WORKSHOP 3:30PM – 4:00PM

TEA BREAK (4:00 PM - 4:30 PM)

Obstetric Critical Care Course CME & WORKSHOP

THEME - “Critically ill parturient - Giving best to both the lives” Dates: 10th& 11th March, 2018

DAY – 1, 10-03-2018TIme leCTuRe / INTeRACTIVe SeSSIoN / SKIll STATIoN SPeAKeRS08.00 – 08.30 Hrs Registrations / Pretest Organisers

08.30 – 09.00 Hrs Inauguration, Objectives and Faculty - Delegate Introduction Dr Sunil T Pandya

09.00 – 09.20 Hrs Maternal Critical Care: Admission profile in India, Is it different? Dr Dilip Karnad

09.20 – 09.40 Hrs Maternal mortality and Near misses in Obstetrics: Indian Scenario Dr V.P.Paily

09.40 – 10.00 Hrs Anatomical and physiological changes during pregnancy: Critical care view point Dr C.Kousalya

10.00 – 10.15 Hrs Audience interaction – Key messages

10.15 – 10.30 Hrs Tea / Coffee with Cookies / Kachori

10.30 – 10.50 Hrs Respiratory Failure in Pregnancy: Common causes – Atypical presentation, Uncommon causes – common presentation: A simplified economical comprehensive algorithmic approach Dr Sunil T Pandya

10.50 – 11.10 Hrs Thrombo-embolism in Pregnancy Dr Sunil Karanth

11.10 – 11.30 Hrs Anticoagulation and Bridging therapy in Obstetric Critical Care Unit Dr Anjan Trikha

11.30 – 11.50 Hrs Heart Failure in a term parturient – Optimising maternal & Neonatal outcome Dr Aruna Parameswari

11.50 – 12.00 Hrs Audience interaction – Key messages

12.00 – 13.00 HrsWORKSTATION – 1: Indications - Demonstration of VV / A: ECMO initiation, Maintenance, Trouble Shooting, Weaning in a Parturient

Dr Praveen Nandagiri Dr Sunil T Pandya

13.00 – 13.30 Hrs Lunch

13.40 – 14.00 Hrs Acute Maternal Collapse – Step by Step analytical and management approach Dr C.Kousalya

14.00 – 14.20 Hrs Decision – Delivery dilemmas & Fetal monitoring in Critical Care unit – When & How to deliver Dr Nuzhat Aziz

14.20 – 14.40 Hrs Blood Gas analysis in a Sick Parturient – Simplified approach Dr Kalpalatha Guntupally

14.40 – 14.45 Hrs Audience Interaction – Key messages

14.45– 16.50 Hrs WORKSTATIONS – ROTATIONS / TEA COUNTERS OPEN, No SPl Tea Break

14.50 – 15.50 HrsWORKSTATION – II A: Hands-on Skill station: Airway in Obstetrics – Basic & Advanced Supraglottic Devices, Video-Laryn-goscopy, Surgical Critico-Thyrotomy (Goats Trachea)

Dr Aruna Parameswari Dr C.Kousalya Dr Siva Kumar

15.50 – 16.50 HrsWORKSTATION – II B: BLS – ACLS – Arrhythmia Simulation - Resuscitative Hysterotomy (Perimortem CS) – Post Resuscita-tion Care

Dr Anjan Trikha Dr B.D.Bande Dr Nuzhat Aziz / Dr V.P.Paily

16.50 – 17.00 Hrs Pearls of Wisdom – Summarizing Day 1 and Objectives of Day II Programme Dr Sunil T Pandya

Day 2, 11th March, 2018TIme leCTuRe / INTeRACTIVe SeSSIoN / SKIll STATIoN SPeAKeRS07.30 – 08.30 Hrs Breakfast Session:

ISCCM – FOGSI – AOA Joint Collaboration – Setting up HDUs / ICU – Help Reducing MMR in India

Moderator: Dr Anjan Trikha Panelists: Dr Kapil Zirpe, Dr Sunil T Pandya, Dr Bande BD, Dr V.P.Paily, Dr Nuzhat Aziz

08.30 – 08.50 Hrs Endocrine emergencies in Pregnancy – Optimizing materno-fetal outcomes Dr Kalpalatha Guntupally


08.50 – 09.10 Hrs Oliguria & AKI in pregnancy: Approach and management Dr Sunil Karanth

09.10 – 09.30 Hrs Approach to a parturient with Jaundice – Obstetric View point Dr Nuzhat Aziz

09.30 – 09.50 Hrs Tropical diseases in a parturient (Malaria, Dengue, Leptospirosis etc) Dr Dilip Karnad


10.00 – 10.15 Hrs Tea Break

10.15 – 10.35 Hrs Lupus – APLA Crisis in Pregnancy Dr Rajesh Mishra

10.35 – 10.55 Hrs Haemoglobinopathies in Obstetric ICU Dr Siva Kumar

10.55 – 11.15 Hrs Peripartum Seizures – An algorithmic approach Dr C.Kousalya


11.30 – 12.45 Hrs WORKSTATION III SIMMOM Simulation & Case Based Interaction and Training: Hypertensive Emergencies – Eclampsia Drill – HELLP – AFLP

Dr Nuzhat Aziz Dr C.Kousalya Dr Aruna Parameswari

12.45 – 13.30 Hrs Lunch

13.30 – 15.00 Hrs WORKSTATION IV SIMMOM Simulation & Case Based Interaction and Training: Catastrophic Obstetric Haemorrhage& Septic Shock Oxytocics – What, When, How much? Initiation & Goals of Fluid Resuscitation, Blood – What, When, How much?, Rapid infusion devices – Demo, Blood warmers, Tranexamic acid – When & Howmuch?, POCT – Rotem Demo, Hemocue – Demo, Continuous Hb HCt Demo, Warming devices demo, SCD / Anti DVT demo, Radiological Intervention – When?, rFVIIa – Is there a role?, Post resuscitation Care

Dr Anjan Trikha Dr B.D.Bande Dr Siva Kumar Dr Nuzhat Aziz Dr V.P.Paily

15.00 – 15.15 Hrs Pearls of wisdom in Obstetric Critical Care Dr Kalpalatha Guntupally

15.15 – 15.30 Hrs Post Test, Feedback, Certificates, Vote of Thanks Organisers

Workshop on Haemodynamic Monitoring & TherapyDay 1: 10th March 2018

National Coordinators: A Kulkarni / Rahul PanditTIme ToPIC08.30-09.00 Registration

09.00-09.35 Physics & Physiology of Arterial Pressure Measurement Dr A Kulkarni

09.35-10.10 Physiology of CVP & PAP monitoring Dr S Jog

10.10-10.40 Principles of cardiac output monitoring Dr R Khasne

10.40-11.00 Tea Break

11.00-13.15 Workshop 1. Techniques & Technology

13.15-14.00 Lunch

14.15-15.00 Does my patient need more fluid?

A. Fluid Challenge in the ICU Dr S Samvedam

B. Fluid responsiveness including PLR Dr Harish MM

15.00-15.15 15.15-15.30

Venous Oximetry Lactate

Dr Neeta Bose Dr Saurabh Saigal

15.00-15.30 Rationale choice of inotropes & Vasopressor in Intensive care Dr R Pandit

15.30-15.50 Tea Break

15.50-18.00 Interactive Case discussion

1. Septic Shock Dr R Khasne/ Dr Natesh Prabu /Dr Alok

2. Cardiogenic Shock Dr R Pandit/ Dr Harish MM

3. Obstructive shock Dr S Jog/ Dr S Siddique /Dr Anil.Verma

Workshop 1: Techniques & TechnologyTABle CoNTeNT FACulTY

1 Arterial cannulation and How to set up a transducer Dr Harish MM / Dr Suhail Siddique

2 PAC: Insertion and interpretation of Data Dr Natesh Prabu / / Dr Neeta Bose

3 Transthoracic Echocardiography: Basic Views and ultrasound guided CVC placement (3 tables) Dr R Pandit / Dr S Srinivasan/ Dr Saurabh Saigal

Day 2: 11th March 2018TIme ToPIC SPeAKeR9.00-9.25 Right Ventricular Dysfunction in Critically ill Dr R Pandit9.25-9.50 Relevance of Intraabdominal Pressure Measurment Dr Natesh Prabu9.50-10.15 Tissue perfusion and Microcirculation Monitoring in Critically ill- lactate/ScVO2 and VCO2 Dr S Jog10.15-10.40 Care of lines and monitors (infection control practices) Dr Suhail Siddique10.40-10.55 Tea10.55-11.20 Echocardiographic assessment of a patient in shock Dr R Pandit11.20-13.25 Workshop 2. Advanced Hemodynamics without PAC 13.25-14.00 Lunch14.00-14.40 Interpreting haemodynamic data: Putting it all together Dr A Kulkarni

Workshop 2. Advanced Hemodynamics without PACTABle No. CoNTeNT FACulTY

1 Volume view technical & Case Scenario Dr Natesh Prabu / Dr Suhail Siddique Dr Neeta Bose2 Flotrac with ScvO2 technical & Case Scenario Dr S Jog / Dr R Khasne/ Dr Saurabh Saigal3 Echocardiographic assessment of a patient in shock (3 tables) Dr Rahul Pandit / Dr S Samvedam/ Dr Saurabh Saigal


meCHANICAl VeNTIlATIoN WoRKSHoP CRITICARe VARANASI 20188.00-9.00 Registrations

dAY 1: 10/3/2018TAlKS: 25 mIN eACH TAlK STARTINg AT 830 Am To 11 Am.

SR. No. NAme oF THe ToPIC FACulTY NAme dATe TImINgS1 MONITERING LUNG MECHANICS AT BED SIDE Dr Kapil Zirpe 10.03.2018 9.00-9.30 (25 min.talks

and 5min. Q&A)

2 CURRENT RECOMMENDATIONS FOR USE OF SEDATION AND MUSCLE RELAXANTS

Dr Shreeniwas Samavedan 10.03.2018 9.30-10.00 (25 min.talks and 5min. Q&A)

3 WEANING: HOW DO I WEAN Dr Babu Abhram 10.03.2018 10.00-10.30 (25 min.talks and 5min. Q&A)

4 TEN THINGS I LEARNT IN MECHANICAL VENTILATION Dr Shirish Prayag 10.03.2018 10.30-11.00 (25 min.talks and 5min. Q&A)

11.00-11.30 Tea break

WORKSTATIONS: 10/3/2018

45 MIN EACH ROTATION FROM 1130AM ,SO ALL FACULTY WILL DO 5 ROTATIONS

Kindly note all the faculties have to be present for all the 5 rotations

SR.No. NAme oF THe ToPIC FACulTY NAme dATe TImINgS1 ABG Dr Shrushut Bandopaddhye /

Dr Ghanshyam Jagatkar

2 BASIC & DIFFICULT AIRWAY Dr Ruchira Kanse / Dr Sudakshina Mulik

Lunch break (1.00 - 2.00 )

3 NIV Dr Subhal Dixit / Dr Y P Singh / Dr Ritesh Shah

4 INITIATION/MODES/TROUBLESHOOTING Dr Rajan Baraokar / Dr Sanjay Dhanuka

5 ANCILLARY THERAPY Dr Bhushan Kinolkar / Dr Ashutosh Bharadwaj/ Dr Venkat

meCHANICAl VeNTIlATIoN WoRKSHoP CRITICARe VARANASI 20188.00-9.00 Registrations

dAY 2: 11/3/2018TAlKS: 25 mIN eACH TAlK STARTINg AT 8.30 Am To 11 Am.

SR.No. NAme oF THe ToPIC FACulTY NAme dATe TImINgS1 CONCEPT OF DRIVING PRESSURE Dr Rajesh Pande 11.03.2018 9.00-9.30 (25 min.talks and 5min. Q&A)

2 HOW DO I PREVENT VILI Dr Manasi Gupta 11.03.2018 9.30-10.00 (25 min.talks and 5min. Q&A)

3 DIAGNOSIS AND PREVENTION OF VAP Dr Samaddar 11.03.2018 10.00-10.30 (25 min.talks and 5min. Q&A)

4 HIGH FLOW NASAL OXYGEN THERAPY IN ICU Dr Sameer Jog 11.03.2018 10.30-11.00 (25 min.talks and 5min. Q&A)

WORKSTATIONS: DAY 2 ; 11/3/2018

45 MIN EACH ROTATION FROM 1130AM ,SO ALL FACULTY WILL DO 4 ROTATIONS

Kindly note all the faculties have to be present for all the 5 rotations

SR.No. NAme oF THe ToPIC FACulTY NAme dATe TImINgS1 DISEASE SPECIFIC VENTILATION(EXCLUDING ARDS) Dr Palepu Gopal /

Dr Kapil Zirpe

2 VENTILATOR GRAPHICS Dr Sachin Gupta / Dr Rajesh Mishra

3 NEWER MODES Dr Rajesh Pande / Dr Manasi Gupta

4 ARDS Dr Shrikant Shriniwas / Dr Brajendra Lakkar


Management of Major Bleeding and Coagulopathy Following Trauma

Critical Care (2016) 20:100

GUIDELINES

I. Initial resuscitation and prevention of further bleeding

1. Minimal elapsed time

Recommendation: Severely injured patients be transported directly to an appropriate trauma facility. (Grade 1B)

The time elapsed between injury and bleeding control be minimised. (Grade 1A)

Rationale: The underlying aims of trauma care organisation is to move patients to a multi-specialist care as early as possible, yet still provide immediate critical interventions.

2. Tourniquet use

Recommendation: Adjunct tourniquet use to stop life-threatening bleeding from open extremity injuries in the pre-surgical setting. (Grade 1B)

Rationale: To control uncontrolled arterial bleeding from a penetrating or a blast injury wound, Tourniquet is a simple and an efficient method. Tourniquet should be left in place until the bleeding has been controlled surgically, although this time lag should be short.

3. Ventilation

Recommendation: Avoidance of hypoxaemia. (Grade 1A)

Normoventilation of trauma patients (Grade 1B). Also suggest hyperventilation in the presence of signs of imminent cerebral herniation. (Grade 2C)

Rationale: Avoidance of secondary brain injury in patients with traumatic brain injury has been well postulated. Similarly transient hyperventilation to induce hypocapnia in patients with imminent brain herniation has been found to be useful.

II. Diagnosis and monitoring of bleeding

1. Initial assessment

Recommendation: The clinician should assess the extent of haemorrhage by aseessing the patient physiology, nature of injury and the patient’s response to initial resuscitation. (Grade 1C)

Rationale: The scores like ATLS score for assessment of blood loss and ATLS score for assessment of fluid responsiveness should be used to assess the physiology of patients and also it tells the extent of trauma.

2. Immediate intervention

Recommendation: Patients presenting with haemorrhagic shock and an identified source of bleeding undergo an immediate

bleeding control procedure unless initial resuscitation measures are successful. (Grade 1B)

Rationale: The source of bleeding may be immediately obvious, and penetrating injuries are more likely to require surgical bleeding control. The mechanism of blunt trauma guides the clinician that will the source of bleeding regarding surgical intervention. Traffic accidents are the leading cause of pelvic injury. Pelvic injury and abdominal injury are generally inter-related. Thoracotomy is indicated for ongoing bleeding and chest tube output >1500 ml within 24 h or >200 ml for 3 consecutive hours.

3. Further investigation

Recommendation: Patients presenting with haemorrhagic shock and an unidentified source of bleeding undergo immediate further investigation. (Grade 1B)

4. Imaging

Recommendation: Early imaging (ultrasonography or contrast-enhanced CT) for the detection of free fluid in patients with suspected torso trauma. (Grade 1B)

CT assessment should be done for haemodynamically stable patients. (Grade 1B)

5. Intervention

Recommendation: Patients with significant intra-thoracic, intra-abdominal or retroperitoneal bleeding and haemodynamic instability undergo urgent intervention. (Grade 1A)

6. Haemoglobin

Recommendation: A low initial Hb should be considered as an indicator for severe bleeding associated with coagulopathy. (Grade 1B)

The use of repeated Hb measurements as a laboratory marker for bleeding, as an initial Hb value in the normal range may mask bleeding. (Grade 1B)

Rationale: Although absolute Hb or Hct values are a matter of debate as triggers for blood transfusion in trauma but initial low Hb is a strong indicator of severe bleeding. Similarly falling Hb after fluid resuscitation should be considered as an indicator of ongoing bleeding.

7. Serum lactate and base deficit

Recommendation: Serum lactate and/or base deficit measurements should be measured as sensitive tests to estimate and monitor the extent of bleeding and shock. (Grade 1B)

Rationale: The amount of lactate produced

by anaerobic glycolysis is an indirect marker of oxygen debt, tissue hypoperfusion and the severity of haemorrhagic shock. Similarly, base deficit values derived from arterial blood gas analysis provide an indirect estimation of global tissue acidosis due to impaired perfusion.

8. Coagulation monitoring

Recommendation: Routine and repeated tests of coagulation like prothrombin time (PT), activated partial thromboplastin time (APTT) platelet counts and fibrinogen should be measured (Grade 1A). Other test that can be done are viscoelastic methods. (Grade 1C)

III. Tissue oxygenation, type of fluid and temperature management

1. Tissue oxygenation

Recommendation: A target systolic blood pressure of 80–90 mmHg should be targeted until major bleeding has been stopped in the initial phase following trauma without brain injury. (Grade 1C)

In patients with severe TBI (GCS ≤8), a mean arterial pressure ≥80 mmHg be maintained. (Grade 1C)

2. Restricted volume replacement

Recommendation: The use of a restricted volume replacement strategy should be adopted to achieve target blood pressure until bleeding can be controlled. (Grade 1B)

3. Vasopressors and inotropic agents

Recommendation: In the presence of life threatening hypotension, administration of vasopressors should be done in addition to fluids to maintain target arterial pressure. (Grade 1C)

An inotropic agent should be used in the presence of myocardial dysfunction. (Grade 1C)

Rationale: Over aggressive fluid resuscitation may increase the hydrostatic pressure on the wound, cause dislodgement of blood clots, a dilution of coagulation factors and undesirable cooling of the patient. The concept of “damage control resuscitation” aims to achieve a lower than normal blood pressure, also called “permissive hypotension”, and thereby avoid the adverse effects of early aggressive resuscitation using high doses of fluids. Norepinephrine should be used to increase MAP if hypotension continues despite adequate resuscitation.

4. Type of fluid

Recommendation: Fluid therapy using isotonic crystalloid solutions be initiated in the hypotensive bleeding trauma patient.


(Grade 1A)

Hypotonic solutions like Ringer’s lactate be avoided in severe head trauma (Grade 1C). Use of colloids be restricted due to the adverse effects on haemostasis (Grade 2C)

5. Erythrocytes

Recommendation: A target Hb of 7 to 9 g/dl should be targeted. (Grade 1C)

IV. Rapid control of bleeding

1. Damage control surgery

Recommendation: Damage control surgery should be employed in the severely injured patient presenting with deep haemorrhagic shock, signs of ongoing bleeding and coagulopathy. (Grade 1B)

Hemodynamically stable patients should undergo primary definitive surgical management. (Grade 1C)

Rationale: This is particularly true for patients who present with uncontrolled bleeding due to multiple penetrating injuries or patients with major abdominal injury and unstable pelvic fractures with bleeding from fracture sites and retroperitoneal vessels.

2. Pelvic ring closure and stabilisation

Recommendation: Patients with pelvic ring disruption in haemorrhagic shock should undergo immediate pelvic ring closure and stabilisation. (Grade 1B)

3. Packing, embolisation and surgery

Recommendation: Patients with ongoing haemodynamic instability despite adequate pelvic ring stabilisation should receive early preperitoneal packing, angiographic embolisation and/or surgical bleeding control. (Grade 1B)

V. Initial management of bleeding and coagulopathy

1. Initial coagulation resuscitation

Recommendation: In the initial management of patients with expected massive haemorrhage, one of the two following strategies should be done:

•Plasma (FFP or pathogen-inactivatedplasma) in a plasma–RBC ratio of at least 1:2 as needed. (Grade 1B)

•Fibrinogen concentrate and RBCaccording to Hb level. (Grade 1C)

2. Antifibrinolytic agents

Recommendation: Tranexamic acid should be administered as early as possible to the trauma patient who is bleeding or at risk of significant haemorrhage at a loading dose of 1 g infused over 10 min, followed by an i.v. infusion of 1 g over 8 h. (Grade 1A). It should be administered to the bleeding trauma patient within 3 h after injury. (Grade 1B)

VI. Further resuscitation

1. Fresh frozen plasma

Recommendation: Plasma (FFP or pathogen-inactivated plasma) should be administered to maintain PT and APTT <1.5 times the normal control only in patients with substantial bleeding. (Grade 1C)

2. Fibrinogen and cryoprecipitate

Recommendation: Fibrinogen concentrate or cryoprecipitate should be given if significant bleeding is accompanied by viscoelastic signs of a functional fibrinogen deficit or a plasma fibrinogen level of less than 1.5–2.0 g/l. (Grade 1C)

An initial fibrinogen supplementation of 3–4 g should be given. This is equivalent to

15–20 single donor units of cryoprecipitate or 3–4 g fibrinogen concentrate. Repeat doses must be guided by viscoelastic monitoring and laboratory assessment of fibrinogen levels. (Grade 2C)

3. Platelets

Recommendation: Platelets should be administered to maintain a platelet count above 50 × 103 u/dl. (Grade 1C).

4. Desmopressin

Recommendation: Desmopressin (0.3 μg/kg) be administered in patients treated with platelet-inhibiting drugs or with von Willebrand disease but not routinely in trauma bleeding patients. (Grade 2C)

5. Prothrombin complex concentrate

Recommendation: Early use of prothrombin complex concentrate (PCC) should be used for the emergency reversal of vitamin K-dependent oral anticoagulants. (Grade 1A)

Rationale: The recommendation for blood product transfusion has come up with various trials conducted in trauma victims. The erythrocyte transfusion trigger was established with the TRICC trial. Similarly other trials like CRASH-2 trial for tranexamic acid and PROPR trial for ratio of plasma, platelet and red blood cells.

6. Thromboprophylaxis

Recommendation: Pharmacological thromboprophylaxis can be given within 24 h after bleeding has been controlled. (Grade 1B). Early mechanical thromboprophylaxis with intermittent pneumatic compression (IPC) can be given (Grade 1C).

The routine use of inferior vena cava filters as thromboprophylaxis should not be done. (Grade 1C)

6th Annual Critical Care Refresher Course 2018 The 6th Annual Critical Care Refresher Course held on 17th to 21st January 2018 under the aegis of Delhi NCR chapter of ISCCM was conducted by the Gastro and Liver Transplant Critical Care Team of Medanta The Medicity. For the first time, the course was spread over five days and covered various aspects of the subject in more than 75 lectures designed specifically for the exam going students. The Course Director, Dr Sachin Gupta, along with Dr Mozammil Shafi, Course Co-ordinator made the course student friendly and sail it smoothly. Dr Yatin Mehta, Chairman of Critical Care Institute at Medanta The Medicity and President Elect of ISCCM inaugurated the event along with the ever encouraging and excellent teacher, Dr Deepak Govil, Director Critical Care at Medanta The Medicity and Vice Chancellor, Indian College of Critical Care. The students had the opportunity to interact with varied imminent International (Australia) and National faculty based

at Delhi NCR. The participation touched around 187 candidates from all parts of the country and appearing in various National and International Critical Care exams and was appreciated thoroughly.

The candidates were handed over the relevant study material and all the presentations in the form of audio visual clips as a Google drive link.


dr Srinivas SamavedamMd, dnB, frCP, fnB, EdIC, fICCMdiploma in health Care Quality Management,diploma in Medical law and Ethics,head, Critical Care unit, Virinchi hospitals, hyderabadMobile: +919866343632e-mail: [email protected]

dr Prashant KumarMd, IdCCM, fnB (Critical Care), EdIC, PgdPha, doaEditor 'Critical Care Waarticles'Senior Consultant Critical Care, Medanta The Medicity, global health Private ltd, Sector - 38, gurgaon 122001, haryana, IndiaMobile: +919899302959 e-mail: [email protected]

JOUR

NAL SCAN

Fighting Acinetobacter

Antimicrobials for the treatment of drug resistant Acinetobacter baumannii pneumonia in critically ill patients: a systemic review and Bayesian network meta-analysis

Jung et al. Critical Care (2017) 21:319

Nosocomial Pneumonia with Acinetobacter is a problem faced by intensivists world wide. Antimicrobical practices for this problem are heterogenous. Combination therapy is generally preferred. Jung et al performed a meta analysis to evaluate the effectiveness of currently available therapeutic options for this problem. They also attempted to compare monotherapy with the commonly practiced combination therapy to overcome VAP caused by XDRA/MDRA. A total of 23 studies were identified of which 16 were retrospective studies. This is probably the first systematic review of various therapies for the treatment of MDRA/XDRA. This review found a superiority for Sulbactam in terms of all cause mortality among patients with VAP caused by MDRA / XDRA. Combination of Fosfomycin and Colistin and combined inhalational and IV Colistin showed next best results. The commonly used Carbapenem + Colistin combination did not show significant mortality benefit.

Reviewer’s comment: The findings of this study seem to question the common practice of combining carbapenem with colistin for the treatment of MDRA / XDRA. Although Sulbactam has shown superiority, using it is a monotherapy needs further experience. A combination of Fosfomycin and Colistin raises concerns about toxicity, which needs to be balanced against clinical benefit.

The Last nail for the steroid debate?

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock

Venkatesh et al NEJM January 19, 2018

The debate of the relevance of corticosteroids in the treatment of Septic shock has continued for decades. No conclusive evidence exists either to support or condemn the use of steroids among patients with septic shock. Venkatesh et al carried out a multicenter RCT to evaluate whether the use of hydrocortisone decreases the 90 day mortality among patients being treated for septic shock. Secondary outcomes studies were 28 day mortality, time to shock resolution, recurrence of shock, ICU LOS, frequency and duration of

mechanical ventilation and RRT, transfusion requirements and incidence of new onset bacteremia and fungemia. Hydrocortisone was used an infusion @ 200mg/day. A little more than 1800 patients were allocated to treatment and placebo groups. Although the patients who received hydrocortisone had shorter stays on ventilator and in the ICU, the effect of these aspects on outcome were not significant. Overall 90 and 28 day mortality was equal in both the groups.

Reviewer’s comments: Based on this reasonably big and well structured RCT, it does appear that the role of steroids in the management of Septic Shock has run its time. Maybe, patients who were already on steroids for some other indication prior to ICU admission for Sepsis or have received Etomidate would still need the drug. But, one more long standing grey zone in sepsis seems to have cleared now.

Anyone for fresh blood?

Cook et al ; Red blood cell storage and in-hospital mortality: a secondary analysis of the INFORM randomised controlled trial

The Lancet Hematology Volume 4, No. 11, e544–e552, November 2017

One of the misconceptions about blood transfusions is about the perceived advantage of “fresh blood”. This often results in stress on the blood bank as well as wastage of a scarce resource. Cook et al attempted to answer the question whether blood that has been stored for greater than 45 days has a potential of causing harm to critically ill patients. This is probably the first RCT to attempt to answer this question. This is a secondary analysis of data collected for the Multi Centre INFORM study. The primary end point studied was in hospital mortality. The age of transfused blood was categorized as < 7 days old, 8-35 days old and > 35 yrs old. More than 24000 patients were involved in the analysis with more than 3/4ths receiving blood which was 8-35 days old. Median follow up was 11 days. Mortality rates were no different between the three groups. Patients who received the oldest stored blood did not have higher mortality. This study concluded that transfusion of blood stored for longer than 35 days has no effect on in-hospital mortality.

Reviewer’s comments: This RCT establishes the fact that “old” stored blood is not harmful. However, further studies including end points like Oxygen delivery and wound healing rates are probably needed before the concept of

“fresh” blood disappears from prescriptions for critically ill patients

Is the last bastion falling?

Mazer et al; Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery

N Engl J Med , 377:2133-2144 November 30 2017

One of the areas where liberal blood transfusion triggers are still in practice is Cardiothoracic surgical unit. Cook et al tried to evaluate the effect of intraoperative conservative (<7.5gm/dl) vs liberal ( <9.5gm/dl) on outcomes. The outcomes studied were all cause mortality, MI, Stroke or new onset renal failure needing dialysis at 28 days or at discharge. As expected, patients allocated to the liberal transfusion strategy needed higher number of transfusions. But the primary outcomes were no different between the conservatively transfused and the liberally transfused patients. The authors argue for a conservative transfusion trigger for patients undergoing cardiac surgery and have a moderate to high risk of death.

Reviewer’s comments: The last bastion for liberal transfusion strategy – cardiac surgery – has now come under siege. Only concern is the fact that this was an intra-operative cohort while most liberal transfusions happen during the post operative period with the presumed aim of increasing myocardial oxygen supply and promoting wound healing

One size for all?

Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock

Lamontagne et al; Intensive Care Med (2018) 44:12–21

Targets for resuscitation have always been a source of debate and controversy. One of the questions that is often asked is whether a target MAP of 65 mm Hg is enough for patients who have a higher baseline blood pressure in health. Lamontagne et al attempted to answer this question through a pooled analysis of studies evaluating higher targets for blood pressure versus those using conventional targets. The primary outcome was 28 day mortality while 90 day mortality, organ dysfunctions and arrhythmias were amongst the secondary outcomes included in the analysis. After screening more than 8000 studies, the authors could only identify two


studies which met their scrutiny criteria!. The SEPSISPAM and the OVATION studies were the ones which ended up being analysed. This analysis found no harm in targeting a lower threshold of 65 mm Hg in hypertensive patients. However, if the target blood pressure was 70 mm Hg or higher and the duration of vasopressors was greater than 6 hrs the mortality appeared to be higher.

Reviewer’s comments: Targeting higher MAP on the basis of preexisting hypertension doesn’t seem to be necessary. Longer time to achieve the higher targets also seems to add to the risk of mortality.

The diaphragm in focus

Mechanical Ventilation–induced Diaphragm Atrophy Strongly Impacts Clinical Outcomes

Golligher et al, AJRCCM Vol. 197, No. 2 | Jan 15, 2018

The role of the diaphragm and its thickness during the process of weaning has increasingly become prominent. Golligher et al evaluated 211 patients with diaphragmatic thickness assessment against the time to weaning and liberation from mechanical ventilation. The thickness of the diaphragm decreased by more than 10% in close to 45% of patients by day 4. This correlated well with the delay in the weaning process. Interestingly, increase

in thickness also was associated with longer weaning times. The authors hypothesized that increased work of breathing stimulates hypertrophy. This study found that the diaphragmatic thickening fraction between 15-30% is the best indicator of successful weaning. This is similar to the thickening fraction that is seen at rest.

Reviewer’s comments: One more parameter gets added to the list of useful indices which can be obtained at the bedside in an ICU using an ultrasound machine

Fluid responsiveness predictors?

Leisman et al;

Predictors, Prevalence, and Outcomes of Early Crystalloid Responsiveness Among Initially Hypotensive Patients With Sepsis and Septic Shock

Critical Care Medicine. 46 (2): 189–198, FEB 2018

It is often mentioned that not all those who need fluid are fluid responsive. Positive fluid balance is also increasingly being recognized as a predictor of adverse outcomes among critically ill patients. Leisman et al carried out a secondary analysis of a prospective multicenter study. It was spread over a long period of nine years. They identified hypothermia, immunocompromise and

coagulopathy as determinants of fluid unresponsiveness.

Reviewer’s comments: Some commonly prevalent manifestations seem to predict those who should not be overloaded with fluids

Battle of the Brainsdr yatin Mehta and dr yash Javeri

Please mail the answers at the earliest to [email protected]

Correct answers with the name of first two correct entries will be published in next issue

1. What is ideal space area for an ICU bed?

2. What is IMPACT system?

3. Which is the most poisonous snake?

4. Identify the device

Answers of November-December 2017 Issue1. The opportunities offered by assisted

ventilation technologies and other advanced developments such as extra-corporeal life support have led to the introduction of new criteria to define two approaches adopted for the determination of death: brain death or circulatory death. In Europe, the term Nonheart-Beating Donor (NHBD) was used initially to describe an organ donor after cardio-

5. What is Mottling Score criteria?

6. LUS aeration/ deaeration Score

7. Secondary BSI Attribution Period

8. What is Richmod bolt

9. Define Tertiary ACS

10. Repeated-death Phenomenon

respiratory arrest. This term was adopted in 1995 during the first International Workshop on Nonheart-Beating donors in Maastricht (Netherlands), leading to the so-called Maastricht Classification

2. FEMg can reflect tubular function for both the ability of tubules for reabsorption of the filtered magnesium and for retaining the intracellular magnesium, FEMg can be used as a marker to detect early stages of chronic renal injury.

3. The nasogastric tube syndrome is a potentially life-threatening complication of an indwelling nasogastric (NG) tube. The syndrome is thought to result from ulceration and infection of the posterior cricoid region with subsequent dysfunction of vocal cord abduction. This dysfunction may present as complete loss of vocal cord abduction manifested as serious airway compromise.

4. OVERWHELMING POST SPLENECTOMY SEPSIS

5. An outbreak called DOMBIVALI FEVER started in March 1990 and spread rapidly all over Bombay and adjoining area. A concomitant and steady increase in MULTIDRUG RESISTANT SALMONELLA TYPHI isolation was observed

6. What unit is used to measure EAA? No units. It is a ratio.

7. Section 304-A of The Indian Penal Code

8. Identify the drug- Penicillin

9. Angiotensin-II (Ang2) is now an FDA approved vasopressor. Ang2 is a vasopressor via agonist actions on the AT1 receptor is an oversimplification.

10. Line Listing- This is a methodology in infection control root cause analysis and outbreak analysis.All nosocomial infection episodes should be followed by line listing.

Correct Answer

Dr Yusuf S Bhambhani LM-13/B-456

Image Section

ANSwER TO LAST IMAGE SECTION

The pneumomediastinum is usually

most evident in the upper mediastinum

(white arrows). The mediastinal air

often tracks through soft tissue planes

and is demonstrated as subcutaneous

emphysema on plain film chest imaging.


Welcome New Members to the ISCCM family1 Sanjeev Kumar, Palakkad LM-17/K-958

2 Balakrishna Palnati, Guntur LM-17/P-894

3 Rupali Lahoria, Chandigarh LM-17/L-103

4 Dhiraj Pol, Nipani LM-17/P-889

5 Abdul Parey, Jammu ALM-17/P-916

6 Megha Brahmavar, Bangalore ALM-17/B-699

7 Shilpa Autkar, Nagpur ALM-17/A-575

8 Sunil Krishnappa, Bangalore LM-17/K-953

9 Kamlesh Shekhawat, Udaipur LM-17/S-1562

10 Veereswara S K, Chennai LM-17/S-1557

11 Pawan Jain, Raipur LM-17/J-466

12 Pratik Jain, Bhilai LM-17/J-464

13 Dewan Roshan Singh, Bangalore LM-17/S-1564

14 Faizur Rahman, Dehradun LM-17/R-570

15 Kushal Parikh, Nadiad ALM-17/P-910

16 Ravindran V, bellandur LM-17/V-330

17 Ravichandran R.P, Pudukkottai LM-17/R-576

18 Akash Shah, Ahmedabad LM-17/S-1552

19 Atiranjan Kumar, Ranchi ALM-17/K-963

20 Vamsi Anupa, Tirupathi LM-17/A-566

21 Prachee Makashir, Pune LM-17/M-855

22 Anil Gupta, Jaipur LM-17/G-719

23 Karthik Arigela, Nellore LM-17/A-572

24 Ankit Kumar, Kanpur nagar LM-17/K-961

25 Sandeep Gundu, godavarikhani LM-17/G-721

26 Karan Gagneja, Faridabad LM-17/G-708

27 Sudarshan Lakhe, Gulbarga LM-17/L-104

28 A Hari Prasad, Berhampur LM-17/P-883

29 Aditi Takale, Miraj LM-17/T-329

30 Geo John, Kuttappuzha LM-17/J-462

31 Sireesha Maddukuri, Hyderabad LM-17/M-839

32 Himanshu Jangid, Alwar LM-17/J-463

33 Deepthi Papineni, S.R.Nagar ALM-17/P-884

34 Manyam Sridhar, Somaikot LM-17/S-1549

35 Raju Ganesan, Chennai LM-17/G-706

36 Utpal Sarma, New Delhi LM-17/S-1550

37 Shivangi Mishra, Bangalore LM-17/M-840

38 Kunal Talreja, Jalgaon LM-17/T-330

39 Mahesh Patil, Osmanabad LM-17/P-885

40 Haider Abbas, Lucknow LM-17/A-560

41 Poonam Chaudhari, Chinchwad ALM-17/C-450

42 Vijaya Muthayala, Nellore LM-17/M-849

43 Jyothi Hattiholi, Belgaum LM-17/H-132

44 Gynendra Gautam, Kanpur LM-17/G-728

45 Santosh Boppidi, Hyderabad LM-17/B-703

46 Anitha Sanapala, Visakhapatnam LM-17/S-1567

47 Chinmaya Panda, Raipur LM-17/P-906

48 Vibhavari Naik, Hyderabad LM-17/N-288

49 Padma Priya Vemulapalli, Vijayawada LM-17/V-323

50 Neha Pareek, Jaipur LM-17/P-886

51 Poornachand Anne, Hyderabad LM-17/A-561

52 Nagaraju Munagala, Hyderabad LM-17/M-841

53 Harshilkumar Gandhi, Ahmedabad LM-17/G-707

54 Masood Mohammed, Hyderabad LM-17/M-842

55 Jithendra C, Bangalore LM-17/C-451

56 Shyam Prasad M S, Hyderabad LM-17/M-843

57 Praveen Kodisharapu, Kondapur LM-17/K-951

58 M.Asiel Christopher, Hyderabad LM-17/C-452

59 Priya Nayak, Hyderabad LM-17/N-289

60 Rajesh Baranwal, Gorakhpur LM-17/B-691

61 Shivam Puniyani, Nagpur LM-17/P-887

62 Prashant Mandilwar, Ranchi LM-17/M-844

63 Mitesh Patel, Gondiya LM-17/P-888

64 Sudhanshu Singhraul, Raipur LM-17/S-1551

65 Senthil Ramasamy, Dindigul LM-17/R-569

66 Ankit Mangla, New Delhi LM-17/M-845

67 Debatra Bose, Hooghly LM-17/B-692

68 Nisarg Oza, Vadodara LM-17/O-21

69 Nitesh Singh, Ghazipur LM-17/S-1553

70 MD Rehan Alam, Aligarh LM-17/A-562

71 Sudhakar Ghattamaneni, Vijayawada LM-17/G-709

72 Prashant Akulwar, Nanded LM-17/A-563

73 Deepak Chandra, Howrah LM-17/C-453

74 Shriswaroop Kulkarni, Kolhapur LM-17/K-952

75 Naresh V, Secunderabad LM-17/V-324

76 Sandeep Devulapally, Warangal LM-17/D-561

77 Mohan Narava, Visakhapatnam LM-17/N-290

78 Lokesh Gutta, Godavari LM-17/G-710

79 Sumanth M.V, Hyderabad LM-17/M-846

80 Mahender Voruganti, Karimnagar LM-17/V-325

81 Suman Nandi, Kamrup Rural LM-17/N-291

82 Shreyas Bhor, Ahmednagar LM-17/B-693

83 Chetan Mahajan, Jalgaon LM-17/M-847

84 Vivek Durai, Hosur LM-17/D-562

85 Aejaz Ahmad Ansari, Dhule ALM-17/A-564

86 Pavan Gautam, Raipur ALM-17/G-711

87 Sumita Sumita, Jaipur LM-17/S-1554

88 Shuvranu Ghosh, Tripura LM-17/G-712

89 Shailesh Gaikwad, Akluj LM-17/G-713

90 Jithin Jose, Shillong LM-17/J-465

91 Raju Shakya, Shillong LM-17/S-1555

92 Dhruva Sharma, Hathras LM-17/S-1556

93 Sony Vyas, New Delhi LM-17/V-326

94 Anwar Hassain, Thrikkakara LM-17/H-133

95 Madhur Joshi, Jaipur LM-17/J-467

96 Abhishek Kotalwar, Nanded LM-17/K-954

97 Pankaj Roy, Patna LM-17/R-571

98 Pavan Rahangdale, Bhopal LM-17/R-572

99 Sanjeev Yadav, Agra LM-17/Y-63

100 Tanmayee Tailam, Hyderabad LM-17/T-331

101 Supriya Pusapati, Hyderabad LM-17/P-890

102 Anurag Chavan, Miraj LM-17/C-454

103 Abhishek Singh, Nagpur LM-17/S-1558

104 Rakesh Mamilla, Hyderabad LM-17/M-848

105 Varun Gutti, Hyderabad LM-17/G-714

106 Kulesh Patir, Faridabad LM-17/P-891

107 Sanjay Kumar, Ranchi LM-17/K-955

108 Dheeraj Dumir, Panchkula LM-17/D-563

109 Deepa Agarwal, Kota LM-17/A-565

110 Manoj S, Chennai LM-17/S-1559

111 Usha N.C, Chennai LM-17/N-292

112 Samrat Verma, New Delhi LM-17/V-327

113 Krishan Thakur, Bhopal LM-17/T-332

114 Jais Sasidharan, Chennai LM-17/S-1560

115 Shilpee Kumari, New Delhi LM-17/K-956

116 Smit Bhongade, Yavatmal LM-17/B-694

117 Ankita Rajput, Nagpur LM-17/R-573

118 Sreeroop K.S, Thrissur LM-17/K-957

119 Naimish Chavada, Ahmedabad LM-17/C-455

120 Narasimha B C, Bangalore LM-17/B-695

121 Surendra Agarwala, Guwahati LM-17/A-567

122 Shivaraddi Bhandi, Hubli LM-17/B-696

123 Rahul Patne, Nanded LM-17/P-892

124 Prince Gupta, Gwalior LM-17/G-715

125 Aditi Prabhu, Chennai LM-17/P-893

126 Pallavi Rane, Jalgaon LM-17/R-574

127 Manisha Bhardwaj, Chandigarh LM-17/B-697

128 Jigar Dodiya, Rajkot LM-17/D-564

129 Rushyendra B, Nellore LM-17/B-698

130 Ramesh Agarwal, Faridabad ALM-17/A-568

131 Ginu Mathew, Palakkad LM-17/M-850

132 Naman Jain, New Delhi ALM-17/J-468

133 Nitin Kasana, Ghaziabad ALM-17/K-959

134 Gautam Parmar, Junagadh ALM-17/P-895

135 Tushar Charkha, Akola ALM-17/C-456

136 Anirban Bhattacharya, Haldia ALM-17/B-700

137 ShaikMohd Hidayathullah, Hyderabad ALM-17/H-134

138 Nipun Agrawal, Bareilly ALM-17/A-569

139 Tanu Shree, Bhopal LM-17/S-1561

140 Vashishth Patel, Sabarkantha LM-17/P-896

141 Anjana Gopinath, Kutch LM-17/G-716

142 Arun Bathena, Nellore LM-17/B-701

143 Siddhartha Hanjura, Jammu LM-17/H-135

144 Appu Jose, Idukki LM-17/J-469

145 Kunjesh Rupapara, Rajkot LM-17/R-575

146 Manas Bindra, Chhindwara LM-17/B-702

147 Dilpreet Kaur, Patiala LM-17/K-960

148 Deepti Thudamaladinne, Secunderabad LM-17/T-333

149 ManishKumar Variya, Surat LM-17/V-328

150 Sahil Sood, Faridabad LM-17/S-1563

151 Romi Prasad, Pune LM-17/P-897

152 Chirag Gilitwala, Surat LM-17/G-717

153 Gnaneshwar Arra Bhattu, Balapur LM-17/A-570

154 Thaha Hussain, Coimbatore LM-17/H-136

155 Harsha Makwaana, Ahmedabad LM-17/M-851

156 Apoorva Garhwal, Wani LM-17/G-718

157 Mohd Mustahsin, Pilibhit LM-17/M-857

158 Sanjoy George, Kottayam LM-17/G-720

159 Mohamed Arif S.A, Chennai LM-17/A-571

160 Amit Kothari, Pune LM-17/K-962

161 ArpitKumar Patel, Mehsana LM-17/P-898

162 Dhruv Upadhyay, Ahmedabad LM-17/U-58

163 Rajesh Patil, Jalgaon LM-17/P-900

164 Darshanbhai Satapara, Surendranagar LM-17/S-1565

165 Maharshi Pandya, Ahmedabad LM-17/P-901

166 Guruprasad H S, Bangalore LM-17/H-137

167 Sonali Ghosh, Faridabad LM-17/G-722

168 Ghanshyam Chandak, Parbhani LM-17/C-457

169 Krishna Patil, Jalgaon LM-17/P-899

170 Ramu Mulampaka, Visakhapatnam LM-17/M-852

171 Rohini Gulhane, Nagpur LM-17/G-723

172 Sangeeta Basu, New Delhi LM-17/B-704

173 Vibin Vasudevan, New Delhi LM-17/V-329

174 Sandeep Gurugubelli, Srikakulam LM-17/G-724

175 Ankur Ohri, Noida LM-17/O-22

176 Sudipta Joy, New Delhi LM-17/J-470

177 Sourav Dhara, Howrah LM-17/D-565

178 Pankaj Mishra, New Delhi LM-17/M-853

179 Sonal Gajbhiye, Chennai LM-17/G-725

180 Arvind Prakash, New Delhi LM-17/P-902

181 Inderjeet Ahuja, Kanpur LM-17/A-573

182 Latheef P, Karuvissery LM-17/P-903

183 Bhattaram Gopalakrishna, Nellore LM-17/G-726

184 Banoth Naik, Chennai LM-17/N-293

185 Sriharika Chejerla, Nellore LM-17/C-458

186 Dhanraj P, Kannur LM-17/P-904

187 Hemansukumar Patel, Surat LM-17/P-905

188 Prem Gade, Hyderabad LM-17/G-727

189 Naresh Munot, Pune LM-17/M-854

190 Arun Saxena, Jaipur LM-17/S-1566

191 Shijukumar C, Trivandrum LM-17/C-459

192 Gaurav Acharya, bhopal LM-17/A-579

193 Radhika Dash, Chennai LM-17/D-569

194 Vandana Tyagi, Jaipur LM-17/T-334

195 Payal Saxena, Agra LM-17/S-1568

196 Kranthi Gedala, Bhadrachalam LM-17/G-729

197 Priyanka Patel, Surat ALM-17/P-907

198 Mirza Beg, New Delhi ALM-17/B-705

199 Jerestyn Khapoliwala, Mumbai ALM-17/K-964

200 Sana Abedin, Gurgaon ALM-17/A-574

201 R.Jagan Rao, Secunderabad ALM-17/R-577

202 Shamandeep Kaur, Kharar ALM-17/K-965

203 Seethiraju Bhargava, Guntur ALM-17/B-706

204 Vijay Gupta, Jaipur ALM-17/G-730

205 Preeti Chaudhary, Jaipur ALM-17/C-460

206 Anita Jangid, Bhilwara ALM-17/J-471

207 Hassan Khan, Mumbai ALM-17/K-966


208 Ajinkya Patil, Kolhapur ALM-17/P-908

209 Navinkumar Kore, Mumbai ALM-17/K-967

210 Sajida Sultana, Sixmile ALM-17/S-1569

211 Dhrumil Parekh, Navsari ALM-17/P-909

212 Pooja Arora, Jaipur ALM-17/A-576

213 Prahalad Kumawat, Nagaur ALM-17/K-968

214 Jaipratap Chouhan, Jaipur ALM-17/C-461

215 Siboprosad Bhattacharjee, ambari ALM-17/B-707

216 Jakir Mansuri, Jaipur ALM-17/M-856

217 Smridhi Gupta, Faridabad ALM-17/G-731

218 Rajesh Das, Kolkata ALM-17/D-566

219 Sravanthi Chaluvadi, Hyderabad ALM-17/C-462

220 Ritu Sen, Bhopal ALM-17/S-1570

221 Avinash Chaudhari, Amravati LM-17/C-464

222 Zehra Bagliwala, Mumbai ALM-17/B-708

223 Nikhilesh Pawaskar, Mumbai ALM-17/P-911

224 Parth Shah, Mumbai ALM-17/S-1571

225 Neha Srivastava, Bangalore LM-17/S-1572

226 Shivali Panwar, New Delhi LM-17/P-912

227 Vishalkumar Vaghani, Surat LM-17/V-331

228 Raj Deokule, Nagpur ALM-17/D-567

229 Sunil Sethi, Karnal LM-17/S-1573

230 Kamal Charaya, Karnal LM-17/C-463

231 Praveen Gupta, Karnal LM-17/G-732

232 Raghu Singh, Karnal LM-17/S-1574

233 Kaushal Gagan, Karnal LM-17/G-733

234 Bhoomika Patel, Surat LM-17/P-913

235 Parul Vadgama, Surat LM-17/V-332

236 Chandrapriya Khobragade, Chennai LM-17/K-969

237 Deepak Dhummansure, Bidar LM-17/D-568

238 Khyati Shamaliya, Surat LM-17/S-1575

239 Gousuddin Arif, Gulbarga LM-17/A-577

240 Kaja Sriramamurthy, Kalaburagi LM-17/S-1576

241 Pratima Patil, Kalaburgi LM-17/P-914

242 Manjunath Patil, Kalaburagi LM-17/P-915

243 Manjula Bapugol, Kalaburgi LM-17/B-709

244 Mohammed Inamdar, Kalaburgi LM-17/I-46

245 Mallikarjuna Holakunde, Kalaburagi LM-17/H-138

246 Paary T.T.S, Hosur LM-17/T-335

247 Kaushal Kumar, Ranchi LM-17/K-970

248 Liyakhath Ali, Gulbarga LM-17/A-578

249 Payal Patel, Valsad LM-17/P-917

250 Jayram Navade, Thane LM-17/N-294

251 Vishnu Gautam, Tonk ALM-17/G-734

252 Greeshma Issac, Kottayam LM-17/I-47

253 Lal Prasad, Noida LM-17/P-918

254 Pratik Tantia, Udaipur LM-17/T-336

255 Surmila Khoirom, Imphal LM-17/K-971

256 Seni Potsangbam, Imphal LM-17/P-919

257 Monika Thokchom, Imphal LM-17/T-337

258 Kangabam Devi, Imphal LM-17/D-570

259 Thuibahenba Singh, Imphal LM-17/S-1577

260 Soibam Meitei, Imphal LM-17/M-858

261 Potsangbam Singh, Imphal LM-17/S-1578

262 Maharabam Binarani, Imphal LM-17/B-710

263 Longjam Eshori, Imphal LM-17/E-23

264 Sinam Devi, Imphal LM-17/D-571

265 Smita Smita, Durg ALM-17/S-1579

266 Shailesh Kalamkar, Navi Mumbai LM-17/K-972

267 Mandar Jamdar, Nagpur LM-17/J-472

268 Rajesh Shah, Mumbai LM-17/S-1580

269 Sadhana Srivastava, Varanasi LM-17/S-1581

270 Pragathesh Palaniappan, Vellore ALM-17/P-920

271 Rinu Kashyap, Saharanpur ALM-17/K-973

272 Jaison Sunny, Kottayam LM-17/S-1582

273 Ajay Kumar, Chittoor LM-17/K-974

274 Loveleen Mangla, Lucknow LM-17/M-859

275 Munesh Maheswari, Jaipur ALM-17/M-860

276 Rishabh Priyadarshi, Bangalore ALM-17/P-921

277 Ajay Kumar, New Delhi LM-17/K-975

278 Sathisha Sathisha, Bangalore LM-17/S-1583

279 Rameshkumar Malam, Junagadh LM-17/M-861

280 Arvinder Pal Singh, Amritsar LM-17/S-1584

281 Sirshendu Pal, Siliguri LM-17/P-922

282 Srinivasa M, Mysore LM-17/M-862

283 Baidya Rajak, Ramgarh ALM-17/R-578

New Office Bearers of ISCCM Branches

HisarChaIrMan

Dr Ravindra Gupta

SECrETary

Dr Mahender Singh

TrEaSurEr

Dr Naresh Khanna

ExECuTIVE CoMMITTEE MEMBErS

Dr Narinder Khetarpaul

Dr Ajay Singh

Dr Yashveer Arya

Dr Ritu Chopra

Dr Shekhar Sinha

Welcome All Delegates

CRITICARE 2018V A R A N A S I


CRITICARE 2018 7-11 March, 2018 • Varanasi

SWaGatHaM!

Friends,

I am honoured and privileged to assume the role of Chairperson of the 24th Annual Congress at Varanasi.

Situated on the bank of River Ganga. Varanasi is the oldest living city & considered as the holiest and most sacred place on this planet. Mark Twain once said, "Varanasi is older than history, older than tradition, older even than legend & looks twice as old as all of them put together." It is also an important industrial center, famous for its carpet, silk fabrics, perfumes, ivory works & sculptures.

Banaras Hindu University is an internationally reputed temple of learning. It was founded by the great nationalist leader, Pt. Madan Mohan Malviya, in 1916. It played a stellar role in the independence

dr Kapil ZirpenaTIonal PrESIdEnT, ISCCM &

ChaIrMan SCIEnTIfIC CoMMITTEE

movement & has developed into one of the greatest center of learning. It has produced many a great freedom fighters, renowned scholars, artists, scientists & technologist all contributing immensely towards the

progress of modern India. We also proud to be associated with six Bharat Ratna Award.

I am confident that we will be steadfast in addressing the pressing challenges. On behalf of all of us, I am most pleased to welcome Prof. D K Singh who is organizing secretary of 24 TH Annual Congress of ISCCM. Over his years of service in BHU, he has distinguished himself as a person with dedication, integrity, and professionalism. We are confident that he and his team will continue to make outstanding contributions to ISCCM.

Thus, on the behalf of Organizing Committee, Varanasi City Branch & BHU, I invite you all to join this excellent scientific feast at Varanasi in 2018. The city is eager to greet with you with spiritual music to enlighten your soul with learning & knowledge.

Dr Michael S Niederman Dr Michale Oleary Dr Rupert Pearse Dr Vito Marco Ranieri Dr Claudio Ronco

Prof. Alain Combes Prof. Dr Med. Tobias Welte Prof. Giuseppe Citerio Prof. Jean-Louis Teboul Prof. Paul Wischmeyer

INTERNATIONAL FACULTY

Editorial officEdr Yatin Mehta

272 Espace, Nirvana Country, Gurgaon 122001Mobile : +91 9971698149

[email protected]

Published By : IndIan SocIety of crItIcal care MedIcIneFor Free Circulation Amongst Medical Professionals

Unit 6, First Floor, Hind Service Industries Premises Co-operative Society, Near Chaitya Bhoomi, Off Veer Savarkar Marg, Dadar, Mumbai – 400028

Tel.: 022-24444737 • Telefax: 022-24460348 • email: [email protected] • [email protected]

Printed at : urvi compugraphics • 022-2494 5863 • email : [email protected]

7-11 March, 2018 • Varanasi

Venue:Hotel Ramada, The Mall, Cantonment, Mall Rd, Varanasi, Uttar Pradesh 221002

Hotel Clarks, Cantt The Mall, Mall Road, Varanas, Uttar pradesh 221002

www.criticare2018.com

critical care - isccm...dr samir jog, pune dr sachin gupta, delhi dr pradeep bhatia, jodhpur dr r....

Documents