Damian McNamara

January 17, 2017

HONOLULU — The potential of probiotics to reduce nosocomial infections and ventilator-associated pneumonia in the critically ill and the latest data on readmissions will be among the major research advances presented here at the Society of Critical Care Medicine (SCCM) 46th Critical Care Congress.

Late-breaking research will be presented from the first trial examining the benefit of therapeutic hypothermia after in-hospital cardiac arrest in pediatric patients. A trial looking at outcomes after intubation for adult cardiac arrest is highly anticipated.

And an analysis of the prognostic accuracy of the 2016 Sepsis-3 guidelines will be among the highlights.

If the latest research and Hawaii in January are not enough to draw in attendees, the prospect of experts debating clinical controversies might be.

"We have some interesting topics that lend themselves to pro–con discussions," said Cherylee Chang, MD, from the Queen's Medical Center and the University of Hawaii in Honolulu, who is the SCCM program chair. "Foremost is a late-breaker session on physician-assisted suicide and euthanasia in the intensive care unit," which will be one of about 10 interactive twitter sessions that will be live-streamed on hashtag #SCCMLive.

There will also be debates on the early extubation of critical care patients, pediatric mechanical ventilation, and the role of emergency department extracorporeal membrane oxygenation (ECMO) in end-of-life care. Controversies surrounding ECMO and the withdrawal of therapy will also be examined in a session on extraordinary measures at the end of life.

Mass Casualties

A session on the rapid distribution of "critical care services in response to a surge event with multiple casualties" is designed to help attendees "figure out your critical care resources when a mass-casualty event occurs," Dr Chang explained. The medical response to an active-shooter event will be addressed by several speakers, one of whom was involved in the aftermath of the Pulse nightclub tragedy in Orlando.

For the first time, the SCCM is going all digital and there will be no paper posters, Dr Chang reported. Instead, the more than 2000 abstracts will be presented in research snapshot theaters, which are concurrent, digital, mini-theaters set up around the exhibit area. During Critical Crosstalk sessions — also new this year — the electronic ICU, social media in the ICU, and how an ICU is only as good as its team of clinicians will be among the topics discussed.

"I am especially looking forward to the Peter Safar Memorial Lecture, entitled Fallen: A Transdisciplinary Tale of Disturbance and Recovery," Dr Chang said. It will address what seemingly disparate events — such as forest fires, tropical ecology, prisons, trauma, and critical care — have in common. "This highlights the concepts of the SCCM Thrive Grant," she pointed out, "which supports research aimed at improving patient and family support after critical illness."

Dr Chang said she also plans to attend the SCCM/ESICM Joint Session that will examine the integration of the most recent international guidelines for the management of sepsis and septic shock in adults.

This will be a record-breaking year.

There is a high degree of interest in this year's Congress. "This will be a record-breaking year, with professional registrations expected to be close to 5000, and total numbers of participants expected to be over 6000," she reported. Given the essential need for communication between members of the care team and patient and family, organizers chose the Hawaiian word for communication — kaʻaʻike — as the theme of the meeting.

With so many concurrent talks scheduled over multiple days, Dr Chang suggested that attendees plan their schedule in advance using the SCCM app. The app will also double as an audience-response device during the meeting.

Most sessions are scheduled to run between 6:30 AM and 1:30 PM, which takes into account the time difference participants coming from the mainland United States will experience. However, "there are many activities throughout the day that are not part of the concurrent sessions," she said. The schedule is designed "to give you time to enjoy the beauty and warmth of Hawaii and its people."

In addition to a luau that will be held during the meeting, the Hawaiian islands offer many opportunities for unique activities and sightseeing. Popular options are the Arizona Memorial, whale watching, hiking the Diamond Head trail, and snorkeling at Hanauma Bay in East Honolulu, Dr Chang explained. The ranch adventures tour takes people on ATVs to many locales, including those seen in popular movies, she added, but "I want to make sure everyone wears a helmet so they don't end up in my neuro ICU."

Dr Chang also recommends that people visit the north shore of Oahu, where waves are 20- to 30-feet high in January at the Banzai pipeline. "They're beautiful to see, but don't go in the water," she advised. "The waves come in unimpeded from Alaska and can be very powerful."

And if you're feeling adventurous, take a trip to the Big Island by boat or helicopter. "You can see volcanoes actively running, and some of it hits the water. It hadn't touched the water for about a decade," she pointed out.

"Come here to learn professionally, but also learn about nature; it's just phenomenal," Dr Chang said.

Dr Chang has disclosed no relevant financial relationships.


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