209 - THE TOP 5 ICU TRIALS IN 2021-2022 FOR THE CLINICAL CARDIOLOGIST

Saturday, October 29, 2022

4:30 PM – 5:15 PM EDT

Location: Room 214

Target Audience: Critical care practitioners, Community cardiologists, Trainee (clinical)

Co-Chair(s)

Chris Overgaard, MD (he/him/his)

Director, Complex PCI Program, Southlake Regional Healthcare Centre
Southlake Regional Healthcare Centre
CANCARE
Toronto, Ontario, Canada
Sean Van Diepen, MD, MSc

Physician
University of Alberta
University of Alberta
Edmonton, Alberta, Canada

Planning Committee Member(s)

Craig Ainsworth, n/a

Associate Professor of Medicine
CANCARE
McMaster University
Hamilton, Ontario, Canada
Maude Peretz-Larochelle, MDCM, FRCPC

Cardiologist and Intensivist
CANCARE
McGill University
Montreal, Quebec, Canada
Janek Senaratne

Cardiologist, Intensivist
University of Alberta
University of Alberta
Edmonton, Alberta, Canada
Jeff Shaw, FRCPC, MSc

Cardiologist critical care Physician
CANCARE
Libin Cardiovascular institute
Calgary, Alberta, Canada

Disclosure(s):

Chris Overgaard, MD: No financial relationships to disclose

Sean Van Diepen, MD, MSc: No financial relationships to disclose

Craig Ainsworth, n/a: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Maude Peretz-Larochelle, MDCM, FRCPC: No financial relationships to disclose

Janek Senaratne: No financial relationships to disclose

Jeff Shaw, FRCPC, MSc: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Learning Objectives:

At the conclusion of this session, participants will be able to:

evaluate whether post cardiac arrest targeted temperature management goals should be revised;
identify the strength and limitations of a trial reporting improved return of spontaneous circulation with the addition of methyl prednisone and vasopressin to standard care in in-hospital cardiac arrest;
critically appraise whether of the two most recent randomized trials on extracorporeal CPR should change clinical practice;
evaluate if Propofol or Precedex is the preferred sedation agent for patient with cardiovascular disease undergoing mechanical ventilation; and
incorporate ways to reduce family grieving when patients with cardiovascular disease receive palliative care.

In a previous successful format introduced at the CCC, this fast-paced presentation workshop will pair 5 trainees (or junior attendings in their first year of clinical practice) with 5 practicing intensivists to review the top 5 ICU trials published in the last year to 18 months. Each trainee will present a brief 1.5 min Cardiovascular Intensive Care Unit (CICU) case that highlights the potential impact of the major ICU clinical trial on CICU practice. The senior cardiac intensivists will provide a brief overview of the trial and discuss the applicability of the trial to CICU patient care. Both the junior and senior faculty will participate in the audience question and answer period. Please see attached run of the show for topics and presenters.

This workshop is timely and relevant to CICU patient care given many large centers have evolved from acute coronary syndrome monitoring units and cardiac surgery post-operative units into intensive care units for critically ill cardiovascular patients. Cardiologists and cardiac surgeons in tertiary non-academic and academic centers are caring for patients with non-cardiovascular complications and multi-system organ failure. A recently published statement authored by the Canadian CICU director’s group and endorsed by the CAIC advocated for ongoing critical care continuing medical education (CME) for cardiologists practicing in the CICU. A prior Canadian survey by the CICU director’s group identified that only 20% of tertiary non-academic CICUs and 46% of academic CICUs have available maintenance of competency for CICU practitioners. The purpose of this workshop is to provide a focused and relevant overview of recent critical care advances for the cardiac specialist. We are replicating a workshop that was extremely well received at the Canadian Cardiovascular Congress (CCC) in 2020. The session received very strong reviews though the CCC app and multiple attendees expressed the need for ongoing ICU-based CME in their clinical practice.

Presentations:

4:30 PM – 4:36 PM EDT

CASE PRESENTATION: TARGETED TEMPERATURE MANAGEMENT 2 AND CAPITAL CHILL
Presenter: Jeff Shaw, FRCPC, MSc – CANCARE
Discussant: Christopher B. Fordyce, MD, MHS, MSc – University of British Columbia
4:36 PM – 4:42 PM EDT

CASE PRESENTATION: ECPR FOR OUT OF HOSPITAL CARDIAC ARREST (JAMA 2022) AND ARREST TRIAL (LANCET)
Presenter: Erin Rayner-Hartley, MD FRCPC – CANCARE
Discussant: Peter Lugomirski, MD, FRCPC – Southlake Regional Health Centre
4:42 PM – 4:48 PM EDT

CASE PRESENTATION: VASOPRESSIN & METHYL PREDNISONE FOR IN HOSPITAL CARDIAC ARREST
Presenter: Rebecca Mathew, MD, FRCPC – University of Ottawa Heart Institute
Discussant: Lior Bibas, MD FRCPC – CANCARE
4:48 PM – 4:54 PM EDT

CASE PRESENTATION: DEXMEDETOMIDINE OR PROPOFOL FOR SEDATION IN MECHANICALLY VENTILATED ADULTS WITH SEPSIS (MIDEX AND PRODEX JAMA 2021)
Presenter: Mia Bertic, MD FRCPC ABIM – Trillium Health Partners
Discussant: Adriana Luk, MD, MSc, FRCPC – University Health Network
4:54 PM – 5:00 PM EDT

CASE PRESENTATION: A THREE-STEP SUPPORT STRATEGY FOR RELATIVES OF PATIENTS DYING IN THE INTENSIVE CARE UNIT (LANCET 2022)
Presenter: Thomas M. Roston, MD, PhD, FRCPC – UBC
Discussant: Janek Senaratne – University of Alberta
5:00 PM – 5:15 PM EDT

Q&A
Co-Chair: Chris Overgaard, MD (he/him/his) – Southlake Regional Healthcare Centre
Co-Chair: Sean Van Diepen, MD, MSc – University of Alberta
Panelist: Maude Peretz-Larochelle, MDCM, FRCPC – CANCARE
Presenter: Jeff Shaw, FRCPC, MSc – CANCARE
Discussant: Christopher B. Fordyce, MD, MHS, MSc – University of British Columbia
Presenter: Erin Rayner-Hartley, MD FRCPC – CANCARE
Discussant: Peter Lugomirski, MD, FRCPC – Southlake Regional Health Centre
Presenter: Rebecca Mathew, MD, FRCPC – University of Ottawa Heart Institute
Discussant: Lior Bibas, MD FRCPC – CANCARE
Presenter: Mia Bertic, MD FRCPC ABIM – Trillium Health Partners
Discussant: Adriana Luk, MD, MSc, FRCPC – University Health Network
Presenter: Thomas M. Roston, MD, PhD, FRCPC – UBC
Discussant: Janek Senaratne – University of Alberta