© 2023 CRRT Inc. CRRT 2005 Conference Summary Program and Workshops Wednesday, March 9 6:00pm-8:00 pm Registration Thursday Morning, March 10 7:00am-7:30pm Registration 8:45am-4:45pm WORKSHOPS (open to all participants - applicable to physicians, nurses and allied personnel) (Codes: C= Core workshop, I = Intermediate, A = Advanced, N= Nurses, AP = of interest to nurses and allied personnel) Workshops designated by an asterisk (*) will be presented twice in different time slots. Workshops presented in a series are marked with a "1" for a primary workshop discussion in this area and "2" for a more complex or advanced discussion in this area. Please note that the series workshops 1 and 2 can be either taken subsequently (following each other) or they can each be taken independently (e.g. workshop 1 can be taken without taking workshop 2 and vice versa). WORKSHOP GROUP 1 8:45-10:15 8:45-10:15 A01 CRRT Systems I I. Fresenius Systems Christian Schlaeper, MS 8:45-10:15 A01 II. Baxter - Edwards Lifesciences Critical Care Nephrology Alliance Accura/Aquarius Bev Ryan, RN Lee C. Ware, RN Device demonstrations of features, setup, operation, monitoring and discontinuation 8:45-10:15 B02 Vascular Access /Membrane and Circuit 1 Ian Baldwin, RN, MN, ACCCN Reinhold Deppisch, PhD Michael A. Kraus, MD Principles of catheter choice, placement, maintenance, recognition and management of complications, selection and use of membranes for different applications, circuit design, setup and monitoring 8:45-10:15 C03 Dialysis Dose Prescription and Delivery 1 William R. Clark, MD Mark R. Marshall, MD, FRACP Claudio Ronco, MD Operational characteristics influencing solute removal in IHD, PD and CRRT 8:45-10:15 D04 Drug Management 1 Thomas A. Golper, MD Bruce A. Mueller, PharmD, FCCP Miet Schetz, MD, PhD Dosing principles for critically ill patients and adjustments in extracorporeal support techniques 8:45-10:15 E05 CRRT Around the World: Clinical Vignettes Emmanuel Burdmann, MD, PhD Rajasekara Chakravarthi, MD, DNB (Nephrology) Lei-shi Li, MD, FHKCP Fernando Liaño, MD, PhD Patrick T. Murray, MD Illustrative cases demonstrating applications of CRRT in various settings. Application of CRRT in developing countries 8:45-10:15 F06 Extracorporeal Techniques for Sepsis 1 Patrick M. Honoré, MD Stanislao Morgera, MD Ramesh Venkataraman, MD Rationale for use of extracorporeal support in treatment of sepsis. Experimental models for high permeability membranes, HVHF, VHVHF and hybrid therapies 8:45-10:15 G07 Advances in Technology Moderator: Ravindra Mehta, MD 1. Baxter/Edwards Critical Care Alliance 2. B. Braun Medical, Inc. 3. DSI-Dialysis Solutions, Inc. 4. Fresenius Medical Care 5. Gambro 6. Nephros Therapeutics 7. NxStage Medical, Inc. This workshop highlights the current and future advances in technology for extracorporeal support. Available equipment and products from different providers will be compared. This workshop provides a glimpse of all the key equipment and products available for CRRT in one session 10:15-10:30 Coffee Break WORKSHOP GROUP 2 10:30-12:00 10:30-12:00 A08 CRRT Systems II I. Nephros Therapeutics Nancy Bullard, RN, CNN Rick DaSilva, RN Device demonstrations of features, setup, operation, monitoring and discontinuation 10:30-12:00 A08 CRRT Systems II II. NxStage Therapy System Susan Dirkes, RN, MSA, CCRN Device demonstrations of features, setup, operation, monitoring and discontinuation 10:30-12:00 B09 Anticoagulation 1: Mechanisms and Techniques Andrew Davenport, MD, MA Ashita Tolwani, MD Anticoagulation regimens: Mechanisms, selection, prescription, monitoring and implementation 10:30-12:00 C10 Fluid Management 1 Ravindra L. Mehta, MBBS, MD, FACP Michael R. Pinsky, MD Principles of volume assessment, fluid removal and fluid regulation with different CRRT equipment 10:30-12:00 D11 Developing, Implementing and Maintaining a CRRT Program Jorge Cerda, MD, FACP, FASN Rhonda K. Martin, RN, MS, MLT(ASCP) Karen Schardin, RN Practical issues for organization and implementation of a CRRT program. Developing and implementing policies and protocols for CRRT 10:30-12:00 E12 Plasma Exchange Therapy and Hybrid Techniques 1 H. David Humes, MD Andre A. Kaplan, MD Shigeto Oda, MD Principles of plasma exchange, sorbent based and hybrid therapies for extracorporeal support. Results from experimental models and human studies 10:30-12:00 F13 Heart Failure and Cardio-Renal Syndrome 1 Richard Amerling, MD Alan Maisel, MD Emil P. Paganini, MD, FACP, FRCP James A. Tumlin, MD Pathophysiology, recognition and management strategies for cardiac and renal failure in the critically ill patient 10:30-12:00 G14 Pediatric CRRT: The Basics Steven R. Alexander, MD Patrick D. Brophy, MD, FAAP, FRCPC Timothy E. Bunchman, MD Stuart L. Goldstein, MD Jordan M. Symons, MD Technique requirement and application for use in children including neonates 12:00-1:30 Lunch on your own Thursday Afternoon, March 10 WORKSHOP GROUP 3 1:30-3:00 1:30-3:00 A15 CRRT Systems III I. Gambro Prisma Stacey L. Johnson Device demonstrations of features, setup, operation, monitoring and discontinuation 1:30-3:00 A15 CRRT Systems III II. B.Braun Diapact Tony Annone, CRRT Product Special Ken Click, CRRT Product Special Device demonstrations of features, setup, operation, monitoring and discontinuation 1:30-3:00 B16 Solutions for CRRT 1 Timothy E. Bunchman, MD Michael A. Kraus, MD Emil P. Paganini, MD, FACP, FRCP Amy M. Sprague, MD Sheldon W. Tobe, MD Basic concepts for formulation and application of various solutions for pre-dilution, replacement and dialysate in critically ill patients 1:30-3:00 C17 Therapy Comparisons I: SLED vs. CRRT vs. PD Richard Amerling, MD Ian Baldwin, RN, MN, ACCCN Mark R. Marshall, MD, FRACP Raymond C. Vanholder, MD PhD Comparisons of operational characteristics including anticoagulation, membranes, solutions and flows and approaches for ongoing and future research 1:30-3:00 D18 Nutritional Assessment and Support 1 Paul E. Marik, MD Miguel C. Riella, MD, PhD Pathophysiology of malnutrition in critically ill patients. Principles of nutritional assessment and support 1:30-3:00 E19 A Systems-based Approach to CRRT Geraldine Biddle, RN, CNN, CPHQ Ravindra L. Mehta, MBBS, MD, FACP Principles of systems based management strategies and their application to CRRT. Approaches to reduce errors in therapy prescription and delivery 1:30-3:00 F20 Hepatic Failure and Hepato-renal Syndrome 1 Tarek Hassanein, MD Kang H. Lee, MD Jan Stange, MD Pathophysiology of hepatic failure and rationale for use of different techniques for extracorporeal support techniques (Cell based systems, MARS, CRRT) for hepatic support 1:30-3:00 G21 Nursing Issues in Pediatric CRRT Helen Currier, BSN, RN, CNN John Gardner, RN Practical issues for setting up and maintaining a pediatric CRRT program. Policies and procedures and protocol based management 3:00-3:15 Coffee Break WORKSHOP GROUP 4 3:15-4:45 3:15-4:45 A22 CRRT Systems I I. Fresenius Systems Christian Schlaeper, MS 3:15-4:45 A22 II. Baxter - Edwards Lifesciences Critical Care Nephrology Alliance Accura/Aquarius Bev Ryan, RN Lee C. Ware, RN Device demonstrations of features, setup, operation, monitoring and discontinuation 3:15-4:45 B23 Vascular Access/Membrane and Circuit 2 Ian Baldwin, RN, MN, ACCCN Reinhold Deppisch, PhD Michael A. Kraus, MD Case based discussion of various factors influencing circuit longevity, membrane function and troubleshooting for problems encountered 3:15-4:45 C24 Dialysis Dose Prescription and Delivery 2 William R. Clark, MD Mark R. Marshall, MD, FRACP Claudio Ronco, MD Case based discussions of prescription of dose, modality choice and optimal dose delivery to match the therapy to the patients need 3:15-4:45 D25 Drug Management 2 Thomas A. Golper, MD Bruce A. Mueller, PharmD, FCCP Miet Schetz, MD, PhD Case based discussion of practical aspects for drug prescription, delivery and management of drug interactions in CRRT 3:15-4:45 E26 CRRT Around the World Emmanuel Burdmann, MD, PhD Rajasekara Chakravarthi, MD, DNB (Nephrology) Lei-shi Li, MD, FHKCP Fernando Liaño, MD, PhD Patrick T. Murray, MD Illustrative cases demonstrating applications of CRRT in various settings. Application of CRRT in developing countries 3:15-4:45 F27 Extracorporeal Techniques for Sepsis 2 Patrick M. Honoré, MD Stanislao Morgera, MD Ramesh Venkataraman, MD Technical considerations and practical application of extracorporeal support techniques for sepsis. Results of human studies for use of high permeability membranes, HVHF, VHVHF and hybrid techniques for sepsis 3:15-4:45 G28 Advances in Technology Moderator: Ravindra Mehta, MD 1. Baxter/Edwards Critical Care Alliance 2. B. Braun Medical, Inc. 3. DSI-Dialysis Solutions, Inc. 4. Fresenius Medical Care 5. Gambro 6. Nephros Therapeutics 7. NxStage Medical, Inc. This workshop highlights the current and future advances in technology for extra corporeal support. Available equipment and components from different providers will be compared. This workshop provides a glimpse of all the key equipment and products available for CRRT in one session 4:45 Adjourn 5:00-6:30 Opening Ceremony - A Historical Perspective of CRRT An overview of the technology and how the therapeutic machinery has evolved; and a viewpoint of how the technology may be changing in the next few years. Moderator: Thomas Golper, MD Thomas A. Golper, MD Lee Henderson, MD Claudio Ronco, MD 5:15-5:45 pm The Beginning of Hemofiltration Lee Henderson, MD 5:45-6:00 pm Technological Advances in Continuous Therapies: The Past, the Present and the Future Claudio Ronco, MD 6:30-8:00 Welcome Reception Poster Viewing and Exhibits Open Friday Morning, March 11 6:30am-6:00pm Registration Session I: Patient Characteristics 7:20-7:30 Opening Remarks Ravindra L. Mehta, MBBS, MD, FACP MINI-SYMPOSIA Organ Dysfunction in the Critically Ill Patient: Emerging Concepts 7:30-9:45 Co-chair: William L. Macias, MD, PhD Co-chair: Michael R. Pinsky, MD 7:30- 7:50 Acute Kidney Injury: Mechanisms and Adaptations Joseph V. Bonventre, MD, PhD 7:50- 8:10 Stress Hyperglycemia, Insulin and Immunomodulation in Sepsis Paul E. Marik, MD 8:10-8:30 Hepatic Failure and Hepatorenal Syndrome Kang H. Lee, MD 8:30-8:50 Brain Injury Hoi Sang U, MD 8:50-9:10 Pathophysiology of Uremia Raymond C. Vanholder, MD PhD 9:10-9:30 Repair Mechanisms: The Role of Stem Cells Joseph V. Bonventre, MD, PhD 9:30-9:45 Panel Discussion Moderator: Noel Gibney, MD Noel Gibney, MD 9:45-10:00 Coffee Break MINI-SYMPOSIA Controversies in Management of the Critically Ill Patient: Can We Modulate 10:00-12:30 Co-chair: Lee Henderson, MD Co-chair: Miet Schetz, MD, PhD 10:00-10:20 Dysregulation of the Immune Response in Sepsis: Opportunities to Intervene? Michael R. Pinsky, MD 10:20-10:35 Re-establishing Organ Function in Severe Sepsis: Targeting the Microcirculation William L. Macias, MD, PhD 10:35-10:55 Immunomodulation with High Volume Hemofiltration Patrick M. Honoré, MD 10:55-11:15 Hemofiltration: Effect on Apoptosis Claudio Ronco, MD 11:15-11:35 High Permeability Membrane Hemofiltration and Dialysis: Effects on Inflammatory Mediators Stanislao Morgera, MD 11:35-11:55 Immunomodulation With Cell-based Systems James A. Tumlin, MD 11:55-12:15 Cytokine Removal with Sorbents Ramesh Venkataraman, MD 12:15-12:30 Panel Discussion Moderator: Emil Paganini, MD Emil P. Paganini, MD, FACP, FRCP 12:30-1:30 Lunch Hosted by Conference Friday Afternoon, March 11 Session II: Emerging Concepts in ARF and CRRT 1:30-3:00 Concurrent Workshops and Nursing and Allied Personnel Sessions Simultaneous Session for Nursing and Allied Personnel MINI-SYMPOSIA Contemporary Topics in Nursing Care: Interdisciplinary Interactions 1:30-3:00 Co-chair: Geraldine Biddle, RN, CNN, CPHQ Co-chair: Helen Currier, BSN, RN, CNN 1:30-1:50 Improving Patient Safety: Preventing Errors Bruce A. Mueller, PharmD, FCCP 1:50-2:10 Training and Retaining Nurses in the ICU: The ECCO Approach Deborah Ann Snyder, RN, MSN, CCRN 2:10-2:30 Nursing Standards and Competency Assessment for Extracorporeal Techniques Ian Baldwin, RN, MN, ACCCN 2:30-2:50 The Future of Nephrology Nursing Practice: Is the ICU Off Limits? Rhonda K. Martin, RN, MS, MLT(ASCP) 2:50-3:00 Panel Discussion Moderator: Patti Graham, RN Patti Graham, RN WORKSHOP GROUP 5 1:30-3:00 1:30-3:00 A29 CRRT Systems II I. Nephros Therapeutics Nancy Bullard, RN, CNN Rick DaSilva, RN Device demonstrations of features, setup, operation, monitoring and discontinuation 1:30-3:00 A29 CRRT Systems II II. NxStage Therapy System Susan Dirkes, RN, MSA, CCRN Device demonstrations of features, setup, operation, monitoring and discontinuation 1:30-3:00 B30 Anticoagulation 2: Special Techniques Citrate Timothy E. Bunchman, MD Andrew Davenport, MD, MA Noel Gibney, MD Thomas A. Golper, MD Ashita Tolwani, MD David M. Ward, MD, FRCP Comparison of various techniques for regional citrate anticoagulation including requirements, setup, monitoring and results 1:30-3:00 C31 Fluid Management 2 Ravindra L. Mehta, MBBS, MD, FACP Michael R. Pinsky, MD Case based discussion of application of techniques for fluid regulation in CRRT 1:30-3:00 D32 Developing, Implementing and Maintaining a CRRT Program Jorge Cerda, MD, FACP, FASN Rhonda K. Martin, RN, MS, MLT(ASCP) Karen Schardin, RN Practical issues for organization and implementation of a CRRT program. Developing and implementing policies and protocols for CRRT 1:30-3:00 E33 Plasma Exchange Therapy and Hybrid Techniques 2 H. David Humes, MD Andre A. Kaplan, MD Shigeto Oda, MD Case based discussion of practical application of plasma exchange, sorbent based and hybrid therapies for extracorporeal support. 1:30-3:00 F34 Heart Failure and Cardio-renal Syndrome 2 Richard Amerling, MD Alan Maisel, MD Emil P. Paganini, MD, FACP, FRCP James A. Tumlin, MD Technical considerations, practical application and results of different methods to treat heart failure and cardio-renal syndrome 1:30-3:00 G35 Non-renal Indications for Pediatric CRRT Patrick D. Brophy, MD, FAAP, FRCPC Joseph V. DiCarlo, MD Stuart L. Goldstein, MD Kevin McBryde, MD Case based discussion of non-renal indications for CRRT in pediatric patients including inborn errors of metabolism and poisonings 3:00-3:15 Coffee Break MINI-SYMPOSIA Surviving Acute Renal Failure in the ICU: Strategies for Success? 3:15-5:30 Co-chair: Patrick M. Honoré, MD Co-chair: Mark D. Okusa, MD 3:15-3:30 Ischemic Acute Renal Failure: An Inflammatory Disease? Hamid Rabb, MD, FACP 3:30-3:45 Predicting Outcomes in Critically Ill Patients: Which Markers? Miet Schetz, MD, PhD 3:45-4:00 Long-term Outcomes From ARF Fernando Liaño, MD, PhD 4:00-4:15 Sepsis and ARF: Prevalence and Consequences Raymond C. Vanholder, MD PhD 4:15-4:30 Organ Cross-Talk: Combined Lung & Renal Injury Hamid Rabb, MD, FACP 4:30-4:45 Timing is Everything: The Case for Early Intervention Ravindra L. Mehta, MBBS, MD, FACP 4:45-5:00 Interventions in ARF - What Has Been Tried? Patrick T. Murray, MD 5:00-5:30 Panel Discussion Moderator: Miguel Riella, MD PhD Miguel C. Riella, MD, PhD 5:30 Adjourn 6:30-10:00 Social Event on the Midway, San Diego Aircraft Carrier Museum Saturday Morning, March 12 7:00am-5:00pm Registration Session III: Technique Characteristics MINI-SYMPOSIA Challenges and Controversies in CRRT 7:45-10:15 Co-chair: Lei-shi Li, MD, FHKCP 7:45-8:05 Hemodynamic Instability During Different Forms of Dialysis Therapy: Do We Really Know Why? Lee Henderson, MD 8:05-8:20 Anticoagulation in CRRT: Is Citrate the Anticoagulant of Choice? Andrew Davenport, MD, MA 8:20-8:35 Bloodstream Infections: Does the Vascular Access Contribute? Reinhold Deppisch, PhD 8:35-8:50 Nutritional Support in the Critically Ill Patient: How Much is Enough? Paul E. Marik, MD 8:50-9:05 Bicarbonate-based Fluids for CRRT: The New Standard? Michael A. Kraus, MD 9:05-9:20 Fluid Balance in CRRT: A predictor of Outcome? Timothy E. Bunchman, MD 9:20-9:50 Debate: SLED is an Effective and More Desirable Therapy Than CRRT for Renal Replacement in the ICU Mark R. Marshall, MD, FRACP Emil P. Paganini, MD, FACP, FRCP 9:50-10:15 Panel Discussion Thomas Golper, MD Thomas A. Golper, MD 10:15-10:30 Coffee Break SPECIAL SESSION Applications for RRT: What's New? 10:30-12:30 Co-chair: Steven R. Alexander, MD Co-chair: Ashita Tolwani, MD 10:30-10:50 Coupled Plasma-Filtration Adsorption Claudio Ronco, MD 10:50-11:10 CRRT for Acute Respiratory Failure Following Bone Marrow Transplant in Pediatric Patients Joseph V. DiCarlo, MD 11:10-11:30 MARS Treatment for Hepatic Encephalopathy: Results of a Randomized Controlled Trial Tarek Hassanein, MD 11:30-11:50 Complications of CRRT: Lessons From Pediatric Patients Stuart L. Goldstein, MD 11:50-12:10 Minimizing Complications With Dialysis: Recommendations From the ADQI IV Conference Andrew Davenport, MD, MA 12:10-12:30 Panel Discussion Moderator: William Clark, MD William R. Clark, MD 12:30-1:30 Lunch Hosted by Conference Saturday Afternoon, March 12 Session IV: Future Trends in CRRT 1:30-3:00 Concurrent Workshops and Nursing and Allied Personnel Sessions Simultaneous Session for Nursing and Allied Personnel MINI SYMPOSIA The Year in Review: What You Should Know and Care About 1:30-3:00 Co-chair: Karen Schardin, RN Co-chair: Deborah Ann Snyder, RN, MSN, CCRN 1:30-1:50 Critical Care Nephrology Jorge Cerda, MD, FACP, FASN 1:50-2:10 Nursing Geraldine Biddle, RN, CNN, CPHQ 2:10-2:30 Pharmacotherapeutics Bruce A. Mueller, PharmD, FCCP 2:30-2:50 Clinical Information Systems Noel Gibney, MD 2:50-3:00 Panel Discussion Moderator: Rhonda Martin, RN Rhonda K. Martin, RN, MS, MLT(ASCP) WORKSHOP GROUP 6 1:30-3:00 1:30-3:00 A36 CRRT Systems III I. Gambro Prisma Stacey L. Johnson Device demonstrations of features, setup, operation, monitoring and discontinuation 1:30-3:00 A36 CRRT Systems III II. B.Braun Diapact Tony Annone, CRRT Product Special Ken Click, CRRT Product Special Device demonstrations of features, setup, operation, monitoring and discontinuation 1:30-3:00 B37 Solutions for CRRT 2 Neill Adhikari, MD, CM Linda Awdishu, BSc Pharm Adriana Berbece, MD Timothy E. Bunchman, MD Leasa A Knechtel, RN, BScN, MN, CNCC(c Michael A. Kraus, MD Emil P. Paganini, MD, FACP, FRCP Amy M. Sprague, MD Ashita Tolwani, MD Case based discussions of applications of solutions for acid-base and metabolic control, electrolyte and divalent ion homeostasis 1:30-3:00 C38 Therapy Comparisons I: SLED vs. CRRT vs. PD Richard Amerling, MD Ian Baldwin, RN, MN, ACCCN Mark R. Marshall, MD, FRACP Raymond C. Vanholder, MD PhD Comparisons of operational characteristics including anticoagulation, membranes, solutions and flows and approaches for ongoing and future research 1:30-3:00 D39 Nutritional Assessment and Support 2 Paul E. Marik, MD Miguel C. Riella, MD, PhD Case based discussion of technical and practical considerations for nutritional support with CRRT 1:30-3:00 E40 A Systems-based Approach to CRRT Geraldine Biddle, RN, CNN, CPHQ Ravindra L. Mehta, MBBS, MD, FACP Principles of systems based management strategies and their application to CRRT. Approaches to reduce errors in therapy prescription and delivery 1:30-3:00 F41 Hepatic Failure and Hepato-renal Syndrome 2 Barbra Alan, RN, CNN Tarek Hassanein, MD Kang H. Lee, MD Jan Stange, MD Technical considerations, practical application and results of different methods of hepatic support for patients with hepatic failure and hepatorenal syndrome 1:30-3:00 G42 Controversies in Pediatric CRRT Steven R. Alexander, MD Patrick D. Brophy, MD, FAAP, FRCPC Stuart L. Goldstein, MD Jordan M. Symons, MD Pro-con discussions of key areas of controversy in pediatric CRRT including citrate vs heparin; pharmacy-made vs commercial solutions, choice of modality 3:00-3:15 Coffee Break MINI-SYMPOSIA Looking to the Future: What Can We Expect? 3:15-5:00 3:15- 3:35 Therapeutic Targets and Interventions for ARF Mark D. Okusa, MD 3:35-3:55 The Future of CRRT in Developing Countries: Lessons from China Lei-shi Li, MD, FHKCP 3:55- 4:15 Enhancements in Technology: What's Needed? Ian Baldwin, RN, MN, ACCCN 4:15- 4:35 Communications Standards for CRRT Machines: The ADQI/IEEE Initiative Todd Cooper 4:35-5:00 Panel Discussion Moderator: Andre Kaplan, MD Andre A. Kaplan, MD 5:00 Closing Remarks Ravindra L. Mehta, MBBS, MD, FACP 5:05 Adjourn