Day 1 :
Keynote Forum
Khaled Alkattan
Alfaisal University, Saudi Arabia
Keynote: Role of Surgery in NSCLC
Time : 10:00-10:45
Biography:
Khaled Manae Al-Kattan, Dean College of Medicine, Alfaisal university and Consultant Thoracic Surgery and lung transplant at King Faisal Specialist Hospital & Research Centre. He was a co-founder of both the Saudi thoracic society and Pan Arab Chest Society. He is the Middle East regent for the European Society of Thoracic Surgery. Have extensive research and publication in his field, presented many abstracts in international symposiums. Was invited as an international speaker in many medical events. He is the Chairman of the National Lung Cancer Study Group and the national lung transplant program.
Abstract:
Management of lung cancer remains a challenge; recent advances in medicine had little impact on the outcome of lung cancer. Although surgery remains the best treatment modality for early NSCLC, but are results satisfactory? While advanced NSCLC stage is more common, but can surgery play a role. The best surgical approach depends on do I have a diagnosis, Is the Staging accurate, especially T status (3&4) and with N (2&3), M (1a), Is surgical Treatment curative or improve survival, Is the patient fit for the procedure (Assessment). The best management process should consist on the following: Tumor board approach, Better diagnosis, staging, Better patient assessment, Better anesthesia, Better techniques (VATS, Instruments), Better results (Less Morbidity and Mortality) and More Aggressive (Better Adjuvant therapy). To Improve results we need Screening, Sensitive investigation tools, Better staging of tumors. The role of Lymphadenectomy, Postoperative follow up and
metastasectomy is to be determined. Also Surgical techniques (Sleeve and Enblock resections) , Adjuvant therapy should be now part of the outcome based results. All that will help to definition of poor prognostic factors and achieving better results.
Keynote Forum
Mohammed AlAhmari
Prince Sultan Military College of Health Sciences, Saudi Arabia
Keynote: Noninvasive ventilation (NIV) in Acute Respiratory Failure
Biography:
Mohammed AlAhmari is a consultant and Assistant Professor of Respiratory Care. He is the Vice Dean of Post-graduate Studies & Scientific Research; Chairman in Respiratory Care department and Institutional Research Board at Prince Sultan College of Health Sciences, Saudi Arabia. He completed his PhD in Respiratory Medicine, UCL, UK. He is a registered Respiratory Therapist (RRT); certified Tobacco Treatment Specialist (CTTS); and fellow of American Association for Respiratory Care (FAARC). In 2008, he was appointed as a Saudi Governor of Respiratory Care at International Council of Respiratory Care. He won research awards from ATS in 2011 and 2012 for his research on “The NIV in OSA and inflammation related to this therapy”. He has Chaired and lectured at many national and international scientific meetings. He serves as an Editorial Board Member in scientific journals.
Abstract:
Noninvasive ventilation (NIV) is the delivery of positive pressure ventilation to the upper airway without the need for invasive artificial airway. NIV has been extensively used in clinical practice in the last two decades. NIV is well recognized therapy in selected patients with acute respiratory failure (ARF) related to exacerbation of chronic obstructive pulmonary disease (COPD), acute cardiogenic pulmonary edema and immuno compromised patients. Several studies have also shown that noninvasive therapy plays a substantial role in reducing the need for endotracheal intubation, hospital stay, morbidity and mortality. Despite the presence of evidence supporting the use of NIV, there are still wide variations in the actual initiation, usage and NIV utilization throughout the world. This presentation will discuss the rationale to treat acute respiratory failure (ARF) with NIV, considering timing of initiation for such therapy. In early stage of un-established ARF, NIV may prevent invasive ventilation while in established ARF, if predictors of success met, this therapy may help to avoid the endotracheal intubation. Role of NIV in different sittings will be discussed with providing up-to date evidence based medicine. This presentation will demonstrate some data for utilization of NIV.
- Heart and Lung Transplant | Diagnosis of Pulmonary Disorders
Location: Boardroom 350
Chair
Mohammed AlAhmari
Prince Sultan Military College of Health Sciences, Saudi Arabia
Session Introduction
Deborah Pierce
Amana Healthcare Long Term Medical and Rehabilitation Hospital, UAE
Title: Early mobilization of the ventilated patient: The when, how, why and impact
Time : 12:10-12:40
Biography:
Deborah Pierce has obtained a Bachelor of Health Science in Physiotherapy from Auckland University of Technology, New Zealand and has recently (2016) attained her Master’s in Business Administration (Health Management) from the University of Tasmania, Australia. She has spent over 8 years in tertiary acute care settings, specializing in Critical Care, Neurorehabilitation and General Medical Rehabilitation. She has joined Amana Healthcare as a Team Leader for Rehabilitation in 2013. She acts as a HAAD Examiner for the physiotherapy profession and is CPHQ certified for her commitment to quality service provision and the progression of rehabilitation in UAE.
Abstract:
Objective: This presentation aims to highlight the evidence based practice regarding early mobilization and implementation of this for greatest efficacy and efficiency across the continuum of care in a developing health system.
Content: Effects of immobility, notably for the cardiorespiratory system; Effective and efficient evidence based safe mobilization practices; and impacts for the patient, the healthcare facilities and healthcare system.
Conclusion: Conclusions will be drawn regarding the current challenges faced in implementation in practice and recommendations for implementation in a developing health system.
Biography:
Fadi Hamed is a Staff Physician in the Respiratory and Critical Care Institute at Cleveland Clinic, Abu Dhabi. Prior to joining Cleveland Clinic Abu Dhabi, he has worked as an Associate Staff in the Department of Pulmonary and Critical Care Medicine at Cleveland Clinic. He has earned his Medical degree from the University of Jordan in Amman. He completed his residency in Internal Medicine from Albert Einstein Medical Center in Philadelphia, US, where he has also served as a Chief Medical Resident for a year on completion of his Residency training. He completed his Fellowship in Pulmonary and Critical Care Medicine at Cleveland Clinic in Cleveland, Ohio, US.
Abstract:
Since the first human lung transplant in 1963, more than 40,000 lung transplant procedures have been performed worldwide. Although lung transplant is usually the last resort for patients and physicians when medical care has been exhausted, lung transplantation is now an accepted therapy for the management of a wide range of severe lung disorders, with evidence supporting quality of life and survival benefit for lung transplant recipients. Indications include diverse spectrum of pulmonary diseases affecting the airway, parenchyma and vasculature. In 2014, the International Society for Heart and Lung Transplantation (ISHLT) released an updated consensus document for the selection of lung transplant candidates, following 2 previous editions published in 1998 and 2006. This consensus includes indications for referral and listing according to disease and highlights absolute and relative contraindications. Despite all the advances in medical management post lung transplant, acute rejection and infection remain the major complications affecting survival in the first year post lung transplant. On the other hand, chronic lung allograft dysfunction in form of bronchiolitis obliterans syndrome (BOS) or restrictive allograft dysfunction (RAD) remains major cause of morbidity and mortality resulting in graft dysfunction, making 5 years survival of post-transplant patients around 50% in average.
Mouhamad Ghyath Jamil
King Faisal Specialist Hospital& Research Center, Saudi Arabia
Title: Heart rate variability and outcomes prediction in critical illness
Biography:
Mouhamad Ghyath Jamil completed his Graduation at Aleppo University. After completing his Residency in Internal Medicine at University of North Dakota, he joined the university as an Associate Professor. He completed his fellowship in Pulmonary, Critical Care and sleep Medicine at George Washington University. He is Board Certified in Internal medicine, Pulmonary, Critical Care and Sleep medicine. He is currently a Consultant in Pulmonary, Critical Care and Sleep Medicine at King Faisal Hospital and Research Center. He is the Medical Director; Medical ICU and Sleep Medicine Unit. He is an active member of many societies including ACCP, SCCM, ASSM, SCCS, STC, and MCCA. He has a major interest in E-health and Simulation; he established the first Tele-ICU program in Middle East.
Abstract:
Introduction: Heart rate variability (HRV) is an indicator of the dynamic equilibrium between the sympathetic and parasympathetic divisions of the autonomic nervous system. We hypothesized that baseline HRV variables and changes during resuscitation may predict outcomes from critical illness.
Methods: A prospective, observational study was performed on inpatients that required a rapid response team (RRT)consultation. 24-hour holter monitoring and serial measurements of physiological and biochemical data were made. Heart rate variability was measured as time domains measured over 24 hours (SDNN, ASDNN, rMSSD, pNN50%, SDANN, mean NN) and frequency domains measured hourly (very low frequency- VLF, low frequency- LF, high frequency- HF, low/high ratio). The research ethics committee approved the study protocol (RAC no. 2151069).
Results: 53 patients were enrolled, mean APACHE II score was 23.5±6.3, age 52±24.3 years. Day one SOFA score was 8.9 (range 1, 23). 40 patients (75.5%) required ICU admission; ICU mortality rate was 27.5%. HRV was significantly higher in RRT consultations who stabilized and did not require ICU admission; time domains; ASDNN [33(IQR21) vs. 18(IQR21), p=0.024], rMSDD [23(IQR19) vs. 15(IQR18), p=0.036] and frequency domains; mean VLF [16.6(IQR7.3) vs. 9.3(IQR10), p=0.018],
mean LF [12.4(IQR11) vs. 5.4(IQR7), p=0.009], mean HF [9.3(IQR12) vs. 4.8(IQR7), p=0.011]. Baseline HRV was significantly higher in survivors; ASDNN [31.5(IQR24) vs. 12(IQR9),p=0.002], rMSDD [25(IQR19) vs. 11.5(IQR10), p=0.012], pNN50% [6(IQR9.5) vs. 0.75(IQR2.5), p=0.002], mean NN [732.5(IQR291) vs. 570(IQR87), p=0.006], mean VLF [12.1(IQR11.8) vs. 5.3(IQR4), p=0.002], mean LF [8.5(IQR10.2) vs. 3.4(IQR4.6), p=0.009], mean HF [7.5(IQR6) vs. 3.3(IQR3.9), p=0.005]. Survivors also demonstrated a significantly larger increase in HRV over 24 hours of resuscitation; delta VLF [3(IQR8.1) vs. -0.6(IQR8), p=0.015], delta LF [3.2(IQR5.9) vs. -0.3(IQR7.6), p=0.017].
Conclusion: HRV analysis appears to be a powerful identifier of outcomes in critical illness. Baseline values and changes over the first 24 hours of resuscitation accurately predicted both the need for ICU admission and survival
- Cardiac Diseases |Pulmonary Disorders
Location: Boardroom 350
Chair
Hatem H. AlMasri
King Abdulaziz Medical City, Saudi Arabia