The Society of Critical Care Medicine's 39th Critical Care Congress took place Jan. 9 to 13 in Miami and attracted about 6,000 attendees from around the world, including a record 4,400 critical-care professionals. The meeting featured hundreds of invited lectures and presented more than 1,000 abstracts for a diverse audience, including physicians, pediatric interventionists, nurses and respiratory therapists.
The theme of the meeting was Commit. Transform. Improve. "That means recognizing that individual commitment to patient care is the foundation of all the things we do," said meeting co-chair, Michael West, M.D., of the San Francisco General Hospital and Trauma Center. "By making a commitment to patients, we can transform ways we care for them, and ultimately improve their outcomes."
The meeting featured seven unopposed plenary sessions, including a speech entitled "National Priorities and Goals for Transforming Healthcare" by Janet Corrigan, Ph.D., president and CEO of the National Quality Forum in Washington, D.C. "It nicely dovetailed with the theme of the meeting because it informed attendees about health care reform and identified tools we might use to determine whether or not we're improving," West said.
Another plenary session featured Marcelo Amato, M.D., of the University of Sao Paulo in Brazil, who delivered a lecture entitled "Mechanical Lung Protection: Fighting Against Gravity and How Far We Can Go With Air."
"This brilliant talk on regional blood flow refuted one of the basic teachings in pulmonary physiology, which is that blow flow in the lung goes to dependent areas," said meeting co-chair, Bruce Greenwald, M.D., of the Weill Medical College of Cornell University in New York City. "His data showed that blood flow follows the richness of the capillary beds, so that patients in the prone position have more blood flow to the non-dependent areas. It reinforced the practice of putting patients in the prone position to improve oxygenation."
Another highlight was an invited lecture by Richard Brilli, M.D., of the Nationwide Children's Hospital in Columbus, Ohio, who delivered a lecture entitled "Bloodstream Infection Update."
"He presented data showing that hospital-acquired infections and ventilator-associated pneumonia are going down in those intensive care units that adhere to standard practices," Greenwald said. "That's important because a decade ago the Institute of Medicine issued a report theorizing that 100,000 patients died each year from preventable causes due to medical errors and hospital-acquired infections."
A related report presented by Mitchell Levy, M.D., of the Brown University School of Medicine in Providence, R.I., showed that adherence to the Surviving Sepsis Campaign may significantly reduce hospital mortality from severe sepsis and septic shock. The Surviving Sepsis Campaign is an initiative of the Society of Critical Care Medicine, European Society of Intensive Care Medicine, and the International Sepsis Forum.
Other significant research presented at the meeting included a study of 2,977 pediatric patients presented by Sarah Teele, M.D., of the Children's Hospital Boston, showing that the risk of central nervous system injury is significantly greater with carotid artery cannulation for veno-arterial extracorporeal membrane oxygenation (23 percent) than from femoral artery or aorta cannulations (15 and 17 percent, respectively).
Thomas Jack, M.D., of the Hannover Medical School in Germany, presented interim results of a randomized study involving 807 children showing that inline filtration can reduce the incidence of systemic inflammatory response syndrome (SIRS). They found that significantly fewer of the inline filtration group developed SIRS than the control group (145 versus 200).
Another study, presented by Saad Nseir, M.D., of Calmette Hospital in Lille, France, evaluated the use of aerosolized bronchodilators in critically ill patients and risk of ventilator-associated pneumonia.
"Aerosolized bronchodilators are independently associated with increased risk for ventilator-associated pneumonia in critically ill patients," the authors concluded.