6th CACU (Critical and Acute Care Ultrasound) Course during IFAD

REGISTER FOR IFAD + CACU COURSE (NOV 23-24-25): https://whova.com/portal/registration/ifad_202305/
REGISTER FOR CACU ONLY (NOV 23): https://www.eventbrite.be/e/6th-cacu-course-critical-and-acute-care-ultrasound-tickets-701660033047?aff=oddtdtcreator

EDUCATION IS YOUR MOST POWERFUL WEAPON TO CREATE THE CHANGE YOU DESERVE

6th CACU course, Critical and Acute Care Ultrasound (Limited places)

Date: Thursday, November 23, 2023

Duration: Full Day 8:00 – 18:00

Organization: iMERiT vzw

Contact: info@fluidacademy.org or manu.malbrain@telenet.be

Location: Hilton Old Town Congress and Conference Centre, Groenplaats 32, 2000 Antwerp, Belgium

Room: TBA

Registration (website):

Chairs

• IFAD Chairman: Prof Dr Manu Malbrain and Niels Van Regenmortel
• Course directors: Dr Adrian Wong, Dr Cosmin Balan

Faculty and Speakers (tentative):

• Cosmin Balan – cosmin13mara@yahoo.com
• Olusegun Olusanya – segs@doctors.org.uk
• Adrian Wong – avkwong@mac.com
• Laura Galarza - lauragalarzabarrachina@gmail.com
• Hatem Soliman - hatem.soliman@gmail.com
• Bianca Morosanu - biancamorosanu12@icloud.com
• Francesco Corradi – francescorradi@gmail.com
• Pieter Tuinman – p.tuinman@amsterdamumc.nl
• Jonny Wilkinson – wilkinson.jonny@gmail.com

Hands-on Instructors: All Faculty

Pax: limited to a max of 40

Price: exceptionally low @ 350 EUR early bird (meals and drinks included) up to 450 EUR for last tickets

Comment: This workshop can be booked either separately or in combination with attending the 13th International Fluid Academy Days (#IFAD2023, Nov 23-25)

Target Audience: This course is for you if you practice clinical medicine and if you frequently need to assess fluid status or hemodynamic status in critically ill patients at the ER, OR or ICU. This applies to consultants and residents in intensive care medicine, anesthesiology, emergency medicine and internal medicine. However, anyone with an interest in POCUS is welcome to attend.

Overview and objectives: The course will start by refreshing core topics in point of care ultrasound of the heart, lung and abdomen. Then we will quickly move towards hands-on sessions to put this in practice. The CACU programme is innovative to meet the needs of beginners and advanced practitioners. The CACU course offers a fantastic opportunity to meet and greet expert sonographers in a small interactive group. You will have a true VIP experience on the front seat where you will be able to improve your skills during the hands-on sessions and to test your knowledge during the interactive cases with voting. Places are limited and will be allocated on a first come first serve basis.

Social Media coverage: The official Symplur hashtag of the meeting is #IFAD2023. Chair of SoMe team is Adrian Wong (@avkwong). #IFAD2023: Healthcare Conferences. Congestive Heart Failure, Critical Care, POCUS, FOAMed, FOAMcc, ultrasound, Handson, heart, lung, abdomen, fluidoverload, congestion, vexus, systolic, diastolic, Intensive Care, Medical Education.

Hands-on ULTRASOUND equipment training Delegates will have the opportunity to have hands-on training in small break-out groups with POCUS equipment. Delegates will experience practicing different modes and different organs and functions.

Healthcare Topics

• Medical Education
• Critical Care
• Heart Disease
• Intensive Care

Programme:

COI: The Hands-on course is supported partially via Unrestricted Educational Grants from Mindray, Philips, GE,...

Background: Point-of-care ultrasound has become increasingly integrated into the practice of intensive care and indeed other acute medical specialties. Several accreditation programmes being developed by leading professional organisation and societies (ICS UK, CUSIC, SCCM, ESICM courses, Dutch ICS, ICARUS, WinFocus, HandsOnEcho and CACU in Belgium etc). This course incorporates aspects of all these programmes into a one-day innovative, interactive course covering all aspects of critical care ultrasound but with a particular emphasis on fluid management.

Overall Learning objectives:

• Gain a foundation in the ultrasound skills needed for Intensive Care
• Interact with expert colleagues in the spirit of collaboration and shared learning
• Lectures and practical experience in:
  • Transthoracic echocardiography and FATE
  • Lung US and BLU
  • Abdominal US and FAST
  • Vascular US

• Ultrasound in shock and as a guide to fluid resuscitation and deresuscitation
• Hands-on sessions
• Interactive cases and voting to highlight and consolidate learning

Timetable

Lectures

Ultrasound on ICU

Learning objectives:

• An overview on the use of ultrasound in the critically ill patient
• Introduction to the use of ultrasound for structured assessment in a step-wise ABC approach
• Highlight the various different accreditation processes for point-of-care ultrasound

Take Home messages:

• POCUS is a core competency for all intensivists
• A structured ABC approach augments the clinical examination (but does not replace it)

Focussed Transthoracic Echocardiography

Learning objectives:

• Appreciate the difference between focussed versus comprehensive ultrasound examination
• Introduce the standard views for transthoracic echocardiography
  • Parasternal long-axis
  • Parasternal short-axis
  • Apical
  • Subcostal

• Introduction of a focussed examination commenting on:
  • LV size and function
  • RV size and function
  • Presence of pericardial or pleural fluid
  • IVC assessment

Take Home messages:

• Focussed echocardiography relies on qualitative assessment of cardiac function
• It is important to practise within competency and seek help appropriately

Fluid Responsiveness

Learning objectives:

• Understand the physiology underpinning the assessment of fluid responsiveness using ultrasound
• Appreciate the benefits and limitations of using ultrasound to assess fluid responsiveness
• Introduction to the various ultrasonographic techniques used to assess fluid responsiveness e.g. VTi, IVC

Take Home messages:

• Assessment of fluid responsiveness is complicated
• Ultrasonography is a useful tool in assessing fluid responsiveness but has its limitations

Fluid Congestion + VEXUS

Learning objectives:

• Understanding the physiology and importance of venous compartment
• Introduce the various modalities available to assess the venous compartment including for venous congestion

Take Home messages:

• Venous congestion is probably underappreciated in most haemodynamic management plans
• Ultrasonography is a useful tool in assessing venous congestion but further research is required

Lung Ultrasound – BLU protocol

Learning objectives:

• Understanding the logic of the progression of the BLU-protocol in order to elaborate probable diagnoses (mainly, why the veins before the posterior areas of the lung)
• Being able to use the BLU-protocol for making the cause of a dyspnoea when cardiac windows are lacking, or when cardiac information is in the grey zone

Take Home messages:

• Simple ultrasound is the most efficient for an efficient BLU-protocol
• The diagnosis of hemodynamic pulmonary edema should be done by looking at the lung first

Lung Pathology

Learning objectives:

• To consolidate and integrate the knowledge gained from lung ultrasound lecture
• Know the various diagnoses and pathologies that can be identified using lung ultrasound
• Compare lung ultrasound with other more established imaging modalities

Take Home messages:

• Compared to clinical examination, plain radiographs and CT imaging, lung ultrasound performs admirably with high sensitivity and specificity for a variety of conditions.

Abdominal Ultrasound

Learning objectives:

• Introduction to ultrasound examination using the FAST and eFAST protocol
  • Recognition of free fluid within the abdomen
  • Recognition of pericardial and pleural effusion

• Assessment of hydronephrosis
• Highlight other examinations which are currently being developed/researched e.g. Doppler techniques

Take Home messages:

• FAST/eFAST whilst useful in the context of trauma, does not replace CT imaging as the gold-standard

Putting it all togther

Learning objectives:

• Describe a holisitic, step-wise approach to whole body ultrasound in the critically ill

Take Home messages:

• Wholebody ultrasound provides a more cohesive evaluation of patient status rather than isolated examination and assessment

VA Coupling

Learning objectives:

• Introduction to concept of VA coupling
• Introduction to the various methods of assessing VA coupling

Take Home messages:

• VA coupling is a novel method of assessing haemodynamic status of patients

Hands-On sessions

Practical Session 1 (60 minutes)

• 6 cardiac ultrasound stations
• 20 minutes each rotation (3 rotations)

Practical Session 2 (60 minutes)

• 6 lung ultrasound stations
• 20 minutes each rotation (3 rotations)

Practical Session 3 (60 minutes)

• Learner specific – will have option to choose

Suggested reading:

1. Malbrain MLNG, De Tavernier B, Haverals S, Slama M, Vieillard-Baron A, Wong A, Poelaert J, Monnet X, Stockman W, Elbers P, Lichtenstein D. Executive summary on the use of ultrasound in the critically ill: consensus report from the 3rd Course on Acute Care Ultrasound (CACU). Anaesthesiol Intensive Ther. 2017;49(5):393-411. doi: 10.5603/AIT.a2017.0072. Epub 2017 Dec 1. PMID: 29192422.
2. Vermeiren GL, Malbrain ML, Walpot JM. Cardiac Ultrasonography in the critical care setting: a practical approach to asses cardiac function and preload for the "non-cardiologist". Anaesthesiol Intensive Ther. 2015;47 Spec No:s89-104. DOI:10.5603/AIT.a2015.0074. PMID: 26588484
3. Lichtenstein D, Malbrain ML. Critical care ultrasound in cardiac arrest. Technological requirements for performing the SESAME-protocol--a holistic approach. Anaesthesiol Intensive Ther. 2015;47(5):471-81. DOI:10.5603/AIT.a2015.0072. PMID: 26578398
4. Lichtenstein D, van Hooland S, Elbers P, Malbrain ML. Ten good reasons to practice ultrasound in critical care. Anaesthesiol Intensive Ther. 2014 Nov-Dec;46(5):323-35. doi: 10.5603/AIT.2014.0056. PMID: 25432552
5. International expert statement on training standards for critical care ultrasonography Expert Round Table on Ultrasound in ICU. Intensive Care Med. 2011 Jul;37(7):1077-83. DOI:10.1007/s00134-011-2246-9
6. International consensus statement on training standards for advanced critical care echocardiography - DOI:10.1007/s00134-014-3228-5
7. Bedside Ultrasound iBook by @ultrasoundpod - https://itunes.apple.com/us/book/introduction-to-bedside-ultrasound/id554196012