The registration for the PBLD sessions will be opened in March, 2020.
PBLD 1: REGIONAL ANAESTHESIASessions schedule: Saturday, September 5, 2020, 11:00–12:30
Session chairs: Gabriela Iohom (Ireland), Subramanian Balavenkat (India)
Capacity PBLD 1: 22 participants
Gabriela Iohom (Ireland)
90yo female with a pansystolic murmur scheduled for operative fixation of fractured neck of femur (30 minutes)
90yo female with a pansystolic murmur scheduled for operative fixation of fractured neck of femur
- List the advantages of early hip fracture surgery and the merits of an integrated care pathway.
- List indications for cardiac consultation as part of the preoperative assessment.
- Integrate peripheral nerve blocks into perioperative analgesia.
- Chose the appropriate surgical anaesthesia technique.
Subramanian Balavenkat (India)
Regional Anaesthesia for a 60 year old patient with Hypertension, Diabetes, Coronary artery disease coming for a Shoulder Arthroscopy surgery (30 minutes)
Regional Anaesthesia for a 60 year old patient with Hypertension, Diabetes, Coronary artery disease coming for a Shoulder Arthroscopy surgery.
- List the optional regional blocks for shoulder surgery and their complications.
- Identify ways to avoid complications.
- Propose surgical positioning for shoulder surgery and their consequences.
- Formulate postoperative treatment options for pain.
PBLD 2: RESPIRATORY, SLEEP MEDICINE, OBESITY, AND AIRWAY MANAGEMENTSessions schedule: Saturday, September 5, 2020, 14:00–15:30
Session chairs: Paolo Pelosi (Italy), Marcelo Gama de Abreu (Germany)
Capacity PBLD 2: 22 participants
Paolo Pelosi (Italy)
Case presentation: The patient is desaturating in OR: time is running (30 minutes)
"The patient is desaturating in the OR: time is running"
- Predict patients at higher risk of desaturation during surgery.
- Perform differential diagnosis of hypoxemia in OR, including hemodynamic management.
- Identify the algorithms for oxygenation improvement in OR.
- Improve terapeutic management in the postoperative period.
Marcelo Gama de Abreu (Germany)
Case study: It is just a 10 min' intervention the surgeon said; and the patient arrested in the OR (30 minutes)
"It is just a 10 minute Intervention" the Surgeon said, and the Patient Arrested in the OR
- Increase the awareness for early signs of cardiac arrest, even during minor surgery
- Perform differential diagnosis of shock
- Identify the need for extracorporeal life support during cardiac arrest (expanded algorithm)
- Improve communication skills within the team to optimize patient outcome
PBLD 3: GERIATRIC ANAESTHESIASessions schedule: Sunday, September 6, 2020, 09:00–10:30
Session chairs: Ioana Grigoras (Romania), Idit Matot (Israel)
Capacity PBLD 3: 22 participants
Ioana Grigoras (Romania)
Case study: an 82yo woman with colorectal carcinoma, scheduled for surgery (30 minutes)
An 82 yo woman with Colorectal Carcinoma.
- List preoperative prehabilitation measure.
- Justify intraoperative fluid therapy and hemodynamic targets.
- Sketch a plan for prevention and treatment of postoperative renal dysfunction.
Idit Matot (Israel)
Case study: a 79yo woman with history of stroke and CAD s/p stent placement coming for TKR (30 minutes)
A 79 yo woman with history of Stroke and CAD s/p stent placement coming for Total Knee Replacement.
- Discuss preoperative evaluation of the elderly.
- Justify the right timing for this operation.
- Select interventions/strategies that might improve the elderly patient's outcome.
- Propose scenarios in which surgical procedures should be reconsidered in the elderly patient.
PBLD 4: NEUROANAESTHESIASessions schedule: Sunday, September 6, 2020, 11:00–12:30
Session chairs: Carolina Haylock-Loor (Honduras), Dafna Vilner (Israel)
Capacity PBLD 4: 22 participants
Carolina Haylock-Loor (Honduras)
Case study: Perioperative Management of Vertebrobasilar Stroke with Severe Brain Edema in a LMIC (30 minutes)
Perioperative Management of Vertebrobasilar Stroke with Severe Brain Edema in a LMIC
Comprehend the implications of perioperative management in vertebrobasilar stroke with severe brain edema and Anaesthesiologists role for limited resource settings, with respect to:
- Pre-admission scenario
- OR: performing a ventricular drainage / decompressive craniectomy
- Discuss benefits and risks of an early decompressive craniectomy.
- Define prevention, detection and management of penumbra zones.
- List options for neuro-monitoring for vertebrobasilar stroke with severe brain Edema in limited resource settings.
Dafna Wilner (Israel)
Case study: Anaesthetic Management of Brainstem Tumor in the Sitting Position (30 minutes)
Anaesthetic Management of Brainstem Tumor in the Sitting Position
- Evaluate the risks/benefits in performing a craniotomy in the sitting position and how these risks can be minimized.
- Define prevention strategies as well as detection and management of a venous air embolism in the sitting position.
- Justify use of neuro-monitoring for a brainstem tumor and its anaesthetic implications.
PBLD 5: PEDIATRIC ANAESTHESIASessions schedule: Sunday, September 6, 2020, 14:00–15:30
Session chairs: Kirk Lalwani (United States), Andrea Szekely (Hungary)
Capacity PBLD 5: 22 participants
Kirk Lalwani (United States)
Case study: A 5-Year Old with a History of "Feeling Walls" and Nocturia for Resection of a Suprasellar Tumour (30 minutes)
A 5-Year Old with a History of "Feeling Walls" and Nocturia for Resection of a Suprasellar Tumour
- Discuss the safe conduct of sedation for MRI in a pediatric patient with a brain tumour.
- Describe the pathophysiology and clinical presentation of suprasellar tumours.
- Outline the preoperative considerations for resection of a craniopharyngioma in a child.
- Review the differential diagnosis of delayed emergence following the resection of a craniopharyngioma.
- Differentiate between three known causes postoperative hyponatremia in neurosurgical patients.
Andrea Szekely (Hungary)
Case Study: A 3-year-old toddler with bidirectional Glenn anastomosis needs emergency laparotomy (30 minutes)
A 3-year-old toddler with bidirectional Glenn anastomosis needs emergency laparotomy
- Describe a structured approach about the child with cyanotic heart disease, stages of palliation, chronic medication, anticoagulation, possible organ dysfunctions.
- Review his anaesthetic management, preoperative assessment and possible risks for complications.
- Develop an anaesthesia plan for emergency laparotomy, and describe the effective postoperative analgesia plan, compare and contrast the multimodal, neuraxial and oral analgesia.
PBLD 6: THORACIC ANAESTHESIASessions schedule: Sunday, September 6, 2020, 16:00–17:30
Session chairs: Wanda Popescu (United States), Neskovic Vojislava (Serbia)
Capacity PBLD 6: 22 participants
Wanda M. Popescu (United States)
Case study: A patient presenting for ERAS Lobectomy Objectives (30 minutes)
A patient presenting for ERAS Lobectomy
- Discuss the preoperative optimization strategy for patient undergoing ERAS for lung resection surgery.
- Discuss intraoperative fluid management in the context of ERAS in lung surgery.
- Discuss strategies of protective lung ventilation.
- Understand multimodal pain management strategies in the context of ERAS in lung surgery.
- Discuss the post-operative goals of care lung resection surgery.
Vojislava Neskovic (Serbia)
Case study: young patient, presented for VATS thymectomy. After surgery, massive bleeding due to injured truncus brachiocephalicus. Emergency surgery. Resuscitation of hemorrhagic shock (30 minutes)
Hemorrhagic Shock During a VATS Thymectomy
- Plan preoperative assessment and intraoperative management for the patient with myasthenia gravis.
- Discuss perioperative risk for the myasthenia patient.
- Compare advantages and disadvantages between less invasive and open thoracic procedures.
- Recall vascular anatomy important for interventions in the thoracic cavity.
- Recognize possible postoperative complications after VATS surgery.
- Explain massive transfusion protocol.
- Describe viscoelastic coagulation tests (point of care monitoring).
PBLD 7: PAIN MANAGEMENTSessions schedule: Monday, September 7, 2020, 09:00–10:30
Session chairs: Esther Pogatzki-Zahn (Germany), Elizabeth Ogboli Nwasor (Nigeria)
Capacity PBLD 7: 22 participants
Esther Pogatzki-Zahn (Germany)
44 year old female patient, presented for surgery due to deep fibrous histiocytoma (25 x 12 x 12 cm) at the left leg (extremity-preserving surgery planned) (30 minutes)
Preoperative Opioids as a Risk Factor for Postoperative Complications
- Plan analgesic strategies for patients after extensive extremity surgery.
- Recall opioid conversion calculations.
- Discuss the role of preoperative opioids as a risk for perioperative complications.
- Illustrate how anxiety might complicate perioperative pain management.
- Debate different approaches to the management of patients with preoperative opioids / anxiety.
- Discuss a preoperative opioid taper down protocol.
- Evaluate different approaches for perioperative pain management in opioid-dependent patients.
Elizabeth Ogboli Nwasor (Nigeria)
Case study: Chronic pain management options where there are no opioids (30 minutes)
Chronic pain management options where there are no opioids
- Discuss the options available for chronic pain management in clinical scenarios where there is limited supply of opioids.
- Diagnose and treat simple cases of Chronic pain.
- Define different techniques for low back pain management.
- Describe Evidence-based Guidelines and Interventions and analgesic drug delivery systems.
- Conduct plexus blocks, Epidural steroid injections, insert Intrathecal drug delivery systems and other options for treatment of LBP.
PBLD 8: OBSTETRIC ANAESTHESIASessions schedule: Monday, September 7, 2020, 11:00–12:30
Session chairs: Ruth Landau (United States), Carolyn Weiniger (Israel)
Capacity PBLD 8: 22 participants
Ruth Landau (United States)
Case study: Post-Caesarean Analgesia (30 minutes)
- Discuss the various elements contributing to enhanced recovery after caesarean delivery.
- Recognize factors associated with increased pain and analgesic use after caesarean delivery and appraise the importance of tailored approaches.
- Setup strategies promoting stepwise multimodal analgesia while reducing opioid intake after caesarean delivery, within the participants’ clinical setting.
Carolyn Weiniger (Israel)
Case study: Labor Analgesia Options (30 minutes)
Labor Analgesia Options
- Discuss the options available for neuraxial labor analgesia, (epidural, combined-spinal, dural-puncture epidural) and to apply the options to clinical scenarios in their labor ward.
- Identify functioning neuraxial labor analgesia and to devise strategies within the participant's available setting to manage failed neuraxial labor analgesia.
- Manage labor pain for women unable to receive neuraxial labor analgesia using available and suitable alternative pharmacologic strategies such as remifentanil, fentanyl, nitrous oxide, subcutaneous saline.
PBLD 9: AMBULATORY ANAESTHESIASessions schedule: Monday, September 7, 2020, 14:00–15:30
Session chairs: Daniela Ionescu (Romania), Simurina Tatjana (Croatia)
Capacity PBLD 9: 22 participants
Daniela Ionescu (Romania)
Case study: A 72 years old lady is scheduled for colonoscopy and 5 polys (0.5-1 cm diameter) removal. She is known with atrial fibrillation and she is on beta-blockers, statins and DOACs. She wants to sleep during colonoscopy (30 minutes)
A 72 year old for Colonoscopy and Polypectomy with Atrial Fibrillation Who Wants General Anaesthesia
- Decide on the patient's management before procedure with a focus on her medication
- Discuss different options (drugs and techniques) for deep sedation during procedure
- Discuss monitoring during procedure according to guidelines
- Decide patient's post procedural management and resumption of DOAC
Tatjana Simurina (Croatia)
Case study: Adult and paediatric patients with obstructive sleep apnoea for ambulatory surgery (30 minutes)
Adult and Paediatric Patients with Obstructive Sleep Apnea for Ambulatory Surgery
- Describe the pathophysiology of OSA and comorbidities caused by OSA in adults and children
- Update on the selection of patients with suspected/documented OSA undergoing ambulatory anaesthesia
- Discuss the intraoperative, early postoperative and post discharge concerns in OSA patients in ambulatory settings
- Define peri-operative considerations of pain management of patients with OSA for ambulatory surgery
- Argue the use of neuromuscular blockers in patients with OSA for ambulatory surgery
- Discuss perioperative risk reduction strategies to adult and paediatric patients with OSA
- Post-operative discharge strategies in adult and paediatric patients with OSA
PBLD 10: INTENSIVE CARE AND RESUSCITATIONSessions schedule: Monday, September 7, 2020, 16:00–17:30
Session chairs: Thea Koch (Germany), Sharon Einav (Israel)
Capacity PBLD 10: 22 participants
Thea Koch (Germany)
Case study: Recurrent pulmonary embolism in severe ARDS (30 minutes)
Recurrent pulmonary embolism in severe ARDS
- List the indication and contraindication of thrombolysis in pulmonary embolism.
- Discuss the use of ECPR in refractory shock due to severe pulmonary embolism.
- Define the use of VA and VV ECMO dependent on the severity of cardio circulatory and/ or respiratory failure.
- Follow principles of therapy of ARDS adapted to its severity.
- Comprehend the principles of antimicrobial therapy in severe community acquired pneumonia.
Sharon Einav (Israel)
A post partum woman with abdominal pain and tachycardia (leading to cardiomyopathy of pregnancy and ECMO with discussion of diagnosis and delivery and ICU management) (30 minutes)
A Post-Partum Woman with Abdominal Pain, Cardiomyopathy of Pregnancy, and ECMO
- Cite the differential diagnosis of peripartum shock
- Evaluate severity of clinical condition in pregnant and peripartum women
- Apply the correct principles of hemodynamic management in cardiogenic and vasoplegic shock
PBLD 11: PATIENT SAFETYSessions schedule: Tuesday, September 8, 2020, 09:00–10:30
Session chairs: Daniel Arnal (Spain), Maytinee Lilaonitkul (United States)
Capacity PBLD 11: 22 participants
Daniel Arnal (Spain)
Case study: Medication error leading to epidural opioid overdose. An ICU PO patient receives epidural morphine instead of 0,125% bupivacaine due to a concatenation of system failures, a nurse error and lack of supervision (30 minutes)
Medication Error Leading to Epidural Opioid Overdose
- Describe the different tools to learn and avoid repetition of an adverse event.
- Recogniz\e the value of transparency with patients and relatives and care for the second victim after a serious adverse event.
- Analyse the main contributory factors intervening in the case.
- Devise the corrective actions to tackle the identified contributory factors.
Maytinee Lilaonitkul (United States)
Case study: Difficult intubation following a cervical haematoma Following a cervical spine surgery a patient developed rapidly neck haematoma that compromises his life. A team of 3 anaesthetists struggles to coordinate (30 minutes)
Difficult Intubation Following a Cervical Hematoma
- Recognize the importance of human factor vs technical skills when facing a crisis.
- Describe the team organization options to improve the outcome of a crisis.
- Formulate the communication strategies to achieve a common mental model to face the crisis.
- Assess the need of situation awareness, continuous revaluation and changing priorities to adapt to the situation.
PBLD 12: CARDIAC AND VASCULAR ANAESTHESIASessions schedule: Tuesday, September 8, 2020, 11:00–12:30
Session chairs: Wolfgang Buhre (the Netherlands), Daniela Filipescu (Romania)
Capacity PBLD 12: 22 participants
Wolfgang Buhre (the Netherlands)
Case study: Challenging cardiac complications in high-risk cardio-vascular surgery. The relevance of perioperative optimization and myocardial ischaemia (30 minutes)
Challenging cardiac complications in high-risk cardio-vascular surgery: The relevance of perioperative optimization and myocardial ischaemia
- Identify preoperatively the patients with high risk of perioperative myocardial ischaemia.
- Interpret the results bio-marker monitoring in the perioperative period.
- Figure anaesthesia related risk factors in patients with potential unstable hemodynmaic parameters.
- Adequately use actual guidelines in the pre-, intra and postoperative treatment of patient with increased cardiovascular risk.
Daniela Filipescu (Romania)
Case study: Challenging bleeding scenarios in high-risk cardiac surgery The patient is a 64-year-old female who presents for urgent re-operative cardiac surgery secondary to prosthetic aortic valve endocarditis and aortic root abscess. She is 3 months post aortic valve replacement for aortic stenosis (30 minutes)
Challenging bleeding scenarios in high-risk cardiac surgery
- Identify preoperatively the patients with high risk of bleeding after cardiac surgery.
- Interpret the results of point-of-care coagulation tests and distinguish different bleeding scenarios upon separation from cardiopulmonary bypass.
- Formulate treatment options for bleeding after high-risk cardiac surgery.
- Justify the use of diagnosis and treatment algorithms for bleeding after high-risk cardiac surgery.
PBLD 13: TRAUMA ANAESTHESIASessions schedule: Tuesday, September 8, 2020, 14:00–15:30
Session chairs: Kurt Ruetzler (Austria), Tania Ralha (Portugal)
Capacity PBLD 13: 22 participants
Kurt Ruetzler (Austria)
Case study: massive hemorrhage after major trauma (30 minutes)
Massive Hemorrhage after Major Trauma
- Understand the necessity of adequate out-of-hospital emergency medicine.
- Be aware of pathophysiology of hemorrhage coagulopathy and basics of damage control surgery.
- Know the basics of massive transfusion strategies.
Tania Ralha (Portugal)
Case study: Traumatic Brain Injury (TBI) (30 minutes)
Traumatic Brain Injury (TBI)
- Discuss the key components of primary survey in a major trauma.
- Classify the acute TBI and explain the epidemiology of specific injuries.
- Enunciate and understand the main targets and thresholds of TBI management.
- Recognize indications for major emergent decompressive craniotomy.
- Recall the main effects of anaesthesia in neurophysiology and discuss the best anaesthetic/analgesic approach.
- Discuss monitoring recommendations and advantages of advanced cerebral monitoring in the OR and in the ICU.
- Explain how to prevent and treat intracranial hypertension.
- Discuss the incidence, pathogenesis and treatment options of coagulopathy after TBI.
- Describe the main goals of TBI management in the ICU.
- Enunciate the differences in the approach of raised intracranial pressure in children with TBI.