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The Pediatric Cardiology Department is organizing conference entitled “Perioperative Management of Congenital Heart Disease” at the Amrita Institute of Medical Sciences, Cochin, Kerala on June 7 -9, 2019.
Venue: Amrita Institute of Medical Sciences, Cochin, Kerala
Children’s Heart Link (NGO)
Children’s HeartLink (CH) is a non-governmental organization based in Minnesota, USA dedicated to developing sustainable programs to prevent and treat children’s heart disease globally in the underserved areas. It empowers volunteer medical personnel from leading institutions to change lives worldwide. Now in its 40th year, CH partners with hospitals in India, China, Ukraine, Vietnam, Malaysia, South Africa, Kenya and Brazil.
http://childrensheartlink.org/wp-content/uploads/2020/05/CHL.India-Fact-…
Pediatric Cardiac Society of India
The PCSI was among the first few societies of paediatric cardiology established in 1999. During the last two decades, they have grown into one of the prominent societies for paediatric cardiology leading academic activities across India and in running a world class journal ‘Annals of paediatric cardiology’. The Vision of the society is to be one of the ten best academic societies for Paediatric Cardiology in the world.
Their Mission is to facilitate the provision of equitable high quality healthcare to children with heart disease in India through world-class excellence in education, academic activities, research, and advocacy.
Pediatric Cardiac Intensive Care Society, USA
PCICS was formed to provide an international professional forum for promoting excellence in pediatric cardiac critical care. The founders of the society launched their inaugural membership campaign in 2003. By the end of 2005, they had held their first symposium. They have grown to more than 1100 members in 44 countries. Their members are healthcare professionals dedicated to promoting scientific inquiry, acquiring knowledge and improving practice for their critically ill pediatric patients with congenital and acquired heart disease.
National Health Mission, Kerala (Hridyam)
This is a web based solution for system management of care of children with Congenital Heart Disease (CHD). This can be used as web based registry for CHD cases across Kerala, monitoring the progress of program envisaged for management of children with CHD, identify the bottlenecks for implementing the protocols established at any point, understand the case status and response time for systems in place and ultimately the outcome of the program
It is increasingly apparent that pediatric heart conditions contribute substantially to Infant and childhood mortality In man~ tow and middle Income countries (LMICs). Perioperative Intensive care is critical to ensuring good outcomes in children with heart disease. This conference is especially designed for physician and nursing staff In LMICs recognizing the challenges they face in caring for babies with heart disease. The world’s leading experts from institutions that have established highest standards of care will interact with local and regional experts in a unique format that is carefully designed to maximize education and directly impact outcomes.
International Faculty
Regional Faculty
Host Faculty
Preconference Workshop (Friday June 7, 8.l0 AM – 5.3O PM)
Main Conference (Saturday, June 8 and Sunday, June 9; 9.00 AM – 5.30 PM)
Registration Closed
Day 1 – June – 7, 2019
Venue: Amrita Institute of Medical Sciences, Cochin
Time | Title of the Session | Contents | Title of Talk | Duration (Min) | Presentator (Name, Institution) | Session Moderator | Panelists |
---|---|---|---|---|---|---|---|
9.00 AM | Physiological Considerations | Illustrative talks for a general audience. | Single ventricle physiology | 12+3 | Rema Devi (MIMS Kozhikode) | R. Suresh Kumar | Venkat Shankar, Dr. Purushotaman |
Duct-dependent systemic circulation | 12+3 | Edwin Francis (Lissie) | |||||
Duct dependent pulmonary circulation | 12+3 | Navaneetha Sasikumar (MCH Kottayam) | |||||
Transposition | 12+3 | Arun Gopalakrishnan (SCT) | |||||
10.00 AM | Comprehensive preoperative evaluation | Introductory talks | Introductory talks | 12+3 | Renu Kurup (MIMS Kozhikode) | Mahesh K | Lara Shekerdemian, Dr. Febi, Suresh Kumar, Parvathi, Iyer |
Clues to underlying genetic syndromes in neonates with heart disease | 15+5 | Sheela Nampoothiri (AIMS, Cochin) | |||||
Ruling out sepsis | 15+5 | AIMS Neonatology | |||||
Comprehensive checklist | 5 min | Mahesh to summarize | |||||
11.00 – 11.30 AM | Tea Break | ||||||
11.30 – 1.00 PM | Preoperative stablization | Learning through Illustrative Cases | Left to right shunt with pneumonia: Simple (VSD) | 10+5 | Presentor from AIMS/other institutions | Mahesh K | Soo Kok Wai, Lara Shekerdemian, K.K Diwakar, Vishal Singh, Dr. Sheeja (SAT), Dr. Jayashree (AIMS) |
Left to right shunt with pneumonia: Complex (AVSD/multiple VSD) | 10+5 | Presentor from AIMS/other institutions | |||||
Duct dependent systemic circulation with end organ injury | 10+5 | Presentor from AIMS/other institutions | |||||
Preoperative sepsis in a newborn | 10+5 | Presentor from AIMS/other institutions | |||||
Obstructed TAPVC | 10+5 | Presentor from AIMS/other institutions | |||||
TGA: Septostomy? Prostaglandin? Direct ASO | 10+5 | AIMS data: Praveen Reddy | |||||
1.00 – 2.00 PM | Lunch | ||||||
2.00 PM | Key ICU Procedures | Lectures from experts | High-risk intubation; how to make it safer | 20+5 | Suchitra Ranjith (Appolo Chennai) | Jesin Jaishankar | |
2.25 PM | Peripheral, central and arterial lines, Tips and tricks | 20+5 | Suresh G Nair (Aster Cochin) | ||||
2.50 PM | Preoperative mechanical Ventilation: Key consideratons | Brief introduction | 10 | Rakhi B | Suresh G Nair | Parvathy Iyer, Suchithra Ranjit, Sheeja, Vijay Kumar (NICU-Kottayam), Leela Kamath (Kolenchery) |
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2. 10 PM | Interactive discussion with audience on 4-5 different condtions | 40 | |||||
3.40 PM | When do we say no to surgery? | Where do we draw a line and why? | Key considerations | 12+3 | Balu Vaidyanathan | Balu Vaidyanathan | Renu Kurup, Sivakumar Sivalingam, Charu Singh, Lara Shekerdemian |
3.55 PM | Illustrative case demonstrating specific challenges; parental perspectives | Illustrative case | 10+5 | Pragnatha | |||
4.10 PM | Session Closed |
Time | Title | Method | Description / Details | Length (min) | Facilitator | # groups |
---|---|---|---|---|---|---|
8:30-9:00 AM | Registration | Participant registration, seating | 30 | Local support | ||
9:00-9:10 AM | Introduction | Review learning objectives, course outline, introduce faculty | 10 | Aveek + MAM | 1 | |
9:10-9:30 AM | ECMO-a Primer | Mini-lecture | Brief review of indications, general principles, and circuit “anatomy” | 20 | TBD | 1 |
9:30-10:00 AM | ECMO in an Envelope | Tabletop | Participants “assemble” their 2D ECMO circuit and discuss components and set up with facilitator. | 30 | All | 10 |
10:00-10:15 AM | ECMO in a Bag | Tabletop facilitated exercise | Tables combine and assemble ECMO in a bag followed by labelling key circuit components with sticky notes | 15 | All | 5 |
10:15-10:30 AM | Check-In | Large group discussion | Participant questions and intro to rotating activity | 15 | 1 | |
10:30-10:45 AM | Break | Tea, refreshments | 15 | 1 | ||
10:45-12:15 PM | Around and around we go | 3 stations noted below, participants rotate amongst stations. Each station takes 30min | 90 | All | 3 | |
1-Uncanny cannulas | Interactive Demo | Show selection of cannulas, cannulae tables and brief overview of cannulation-based ECMO nomenclature | ||||
2-The Real Thing | Interactive Demo | Participants “tour” a fully assembled, wet circuit and label circuit components | ||||
3-Here we go | Interactive Demo and table top | Step-by step guide to cannulating and establishing flow. Participants are given individual steps and are expected to put them in order. | ||||
12:15 – 13:00 PM | Lunch | |||||
13:00-13:15 PM | Review | Large group | Large group sharing of lessons learned and preview of afternoon plans | 15 | MAM, Aveek | |
13:15-13:25 PM | ECMO in an Envelope | Sm group competition | Timed competition. Correctly reassemble 2D tabletop circuits with ECMO in an envelope. | 10 | All | 10 |
13:25-13:45 PM | Go With the Flow | Small group exercise | Participants label tabletop circuits with flows and pressure measurements. Once successfully completed, match ECMO terms to human physiologic measurements | 20 | All | 10 |
13:45-14:00 PM | ECMO as the Patient | Mini-lecture | Lecture introducing a physiologic framework for “diagnosing” ECMO problems and troubleshooting emergencies | 15 | TBD | 1 |
14:00-14:30 PM | Create the table | Tabletop | Small groups work together to create a table of physiologic changes seen with different ECLS problems | 30 | All | 10 |
Small group | ||||||
14:30-14:45 PM | Check-In | Large group | Questions re: framework, clarification as needed. | 15 | MAM | 1 |
14:45-15:00 PM | Break | Tea, refreshments | ||||
15:00-15:30 PM | Diagnose it! | Small group | Utilizing tabletop models, learners are given sets of physiologic changes and need to identify the underlying problem | 30 | All | 10 |
15:30-16:00 PM | Special Patients, Special Circuits, Special Problems | Interactive lecture | Tricks of the trade for ECLS cannulation and support strategies for children with altered circulations | 30 | TBD | 1 |
16:00-16:45 PM | The Who and the How | Expert panel | Facilitated expert panel and audience discussion regarding the logistics and challenges of establishing and maintaining an ECMO program in low | 45 | Aveek (facilitator) local+international experts | 1 |
16:45-17:00 PM | Wrap It Up | Large group | Recap of the day, final thoughts, course evaluation | 15 | All | 1 |
June 7, 2019 Meeting Followed by Faculty Dinner: Building Systems Towards a Sustainable Workforce for PCICUs in Low and Middle Income Countie
4:30 PM | Meeting; Building systems towards a sustainable workforce for PCICUs in low and Middle Income Counties | Defining the problem: Workforce and Training Data from LMICs | Defining the problem: Workforce and Training Data from LMICs: Physician and nursing Staff | 30 min | ICU representatives from Vietnam, Sri Lanka, Malaysia, Bangladesh and ; Indian data to be presented by Jigar Surti | Session Moderated by Bistra Zheleva | Sandy Staveski, Suresh G Rao, Snehal Kulkarni, Sunita Maheshwari, Jigar Surti, Aveek Jayant, Vishal Singh, Parvathy Iyer | Present and learn from examples of PCICU training that meets patient and/or population needs; present 1-2 innovative approaches for meeting the demand. |
5:00 PM | Learning from Examples | Existing models from established programs in high income nations | 10 min | Ravi Thiagarajan | ||||
The nurse residency program at AIMS | 10 min | Vaisak/Saibala | ||||||
IJN Nurse mentor program | 10 min | Karpagam | ||||||
The CHL fellowship | 10 min | Bistra/KK | ||||||
5.45 PM | Envisioning Future Education Opportunities for PCICU Professionals | Brainstorming on ideas for the future | 70 min | Objective: explore options for building the next generation of PCICU professionals and educators. Explore creative solutions, without compromising on quality of education and patient outcomes. | ||||
7.20 PM | Wrapping up | 10 min | Bistra | Questions to discuss:
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Day 2 – June 8, 2019
Time | Title of the Session | Contents | Title of Talk | Duration (Min) | Presentator (Name; Institution) | Session Moderator | Panelists | Other Related Specifics |
---|---|---|---|---|---|---|---|---|
9.00 AM | Welcome and Lamp lighting | |||||||
9.15 AM | Ventilatory management after congenital heart surgery | Two talks and 2-3 cases | Core Principles of Post operative ventilatory management | 20 | Venkat Shankar; CHOP | Aveek Jayant | Lara Shekerdemian, Shankar Kadam, Sujatha (MIMS) Sunil PR (Chitra); Ritujyoti RTIICS); Vaisakh G (AIMS) | Lecture; discussion will be integrated with cases |
9.35 AM | Non invasive ventilation: Who needs it, who does not, how is it practiced? | 15 | Suchitra Ranjith, Appolo Chennai | Lecture; discussion will be integrated with cases | ||||
9.50 AM | Case presentations | 40 | Participating Institutions | 2-3 cases from regional institutes illustrating specific challenges in post operative ventilation of CHD patients; one case should include non-invasive ventilation. What was the challenge? How did we manage? What could be done diffrerently? | ||||
10.30-11.00 AM | Tea Break | |||||||
11.00 AM | Post -operative arrhythmias | One introductory talk and 2-3 cases | Sytematic approach to post-operative rhythm disturbances | 15 | Maniram, AIMS Cochin | KK | KU Natarajan, Ravi Thiagarajan | Lecture outlining core principles of post operatrive arrhythmia management |
11.15 AM | Case presentations | 45 | Balaganesh / Farooq | 2-3 illustrative cases from regional institutes; JET, Re-entrant arrhythmia, AV disociation, Others | ||||
12.00 Noon | Sepsis, infection control and antibiotic stewardship | Talks , Panels, Data from centers | Real life challenges: Three perspectives- Bedside nurse, Charge Nurse and infection control nurse | 25 | Ashely, Reshma and Athira KS (AIMS, Cochin) | Dr. Sanjeev Singh | Parvathy Iyer, Shobha (GKNM); HMD Hawegeegana; Saibala (AIMS) | Brief presentations from each of the identified nurses |
12.15 PM | Innovative approaches to infection control in PCICU setting | 15 | Justine Fortkiewicz/Sandy Staveski | |||||
12.40 PM | Infection control experiences from selected ICU environments in LMICs | 30 | IJN, RTIICS, KDA, Other institutions, AIMS | Serial data from the last 3-4 years, specific challenges how they were overcome. AIMS to serve as back up in the event one centre drops out. 7 min presentations and remaining time (9 min) for discussion. | ||||
1.00 PM | Antibiotic stewardship: How to make it work? | 20 | Ramasubramanian, Appolo Chennai | 15+ 5 for discussion | ||||
1.30-2.015 PM | LUNCH | |||||||
2.15-3.15 PM | Challenging case Scenarios- Part 1 | Cases from various institutions | OR surprises | 20 | ICU staff AIMS/Other programs | Shivaprakasha | Soo Kok Wai, Sivakumar Sivalingam, Kamlesh Tailor, Jeril, Kanagarajan, Nagarajan | Illustrative case where an unexpected challenge in the OR changes the course of operation |
Airway challenges | 20 | ICU staff from AIMS/Other programs | Illustrative case of a significant airway related problem in association with congenital heart surgery | |||||
Miscellaneous | 20 | ICU staff from AIMS/Other programs | Any other unexpected challenge not ususally encountered | |||||
3.15-4.15 PM | Critical thinking by the bedside nurse | Case vignettes from various institutions | Illustrative Case Scenarios in Situations Identified by Nurses | 60 | Nursing staff AIMS/Other programs | Parvathy Iyer | Justine Fortkeiwickz, Saibala, Shyla Suratkal, Karpagam, Lara Shekerdemian, Ravi Thiagarajan, Sudhatmaja | |
4.15 PM | Tea Break | |||||||
4.40 PM | ECMO Roundtable | Panel Discussion | A perspective on ECMO use in low resource settings: is the world really flat? | 50 min | Program will include one or two illustrative cases if available | Aveek Jayanth | Suresh G Rao, K Shivaprakasha, Brijesh Kotayil, Sandeep Chauhan, Micheal-Alice Moga | Panel discussion on contentious issues in relation to use of ECMO in low resource settings |
5.30 PM | Sessions Close |
Day 3 – June 9, 2019
Time | Title of the Session | Contents | Title of Talk | Duration (Min) | Presentator (Name; Institution) | Session Moderator | Panelists | Other Related Specifics |
---|---|---|---|---|---|---|---|---|
9.00 AM | Perioperative cardiac pharmacology-a review of the evidence | Brief summary of evidence on commonly used medications in the ICU | Introduction | 10 | Micheal Alice Moga | Aveek Jayant: Asha, Sree lakshmi, Sreeja, Balaganesh, (AIMS) Two chithra PGs | Meena Trehan, Vilson, Kishore, Snigdha, Unni KP, Sandeep Chauhan | Succinct summary of available evidence about useful and harmfiul effects with recommendations |
9.10 AM | Dobutamine | 8+2 | ||||||
9.20 AM | Levosimendan | 8+2 | ||||||
9.30 AM | Milrinone | 8+2 | ||||||
9.40 AM | Phenoxybenzamine | 8+2 | ||||||
9.50 AM | Nitric oxide and sildenafil | 8+2 | Shine Kumar | |||||
10.00 AM | Thyroxine | 8+2 | ||||||
10.10 AM | Vasopressin | 8+2 | ||||||
10.20 AM | Summing up _Discussion | 10 |
Micheal Alice Moga |
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10.30 AM | Challenging Scenarios #2 | Case presentations on challenging scenarios | Cardiac cathterization early after cardiac surgery | 15 min | AIMS/ (Balaganesh to present) | Mahesh | Ravi Thiagarajan, Edwin, Jigar | Illustrative cases |
“Lung issues” | 15 min | AIMS/Other institutions | ||||||
11.00-11.30 AM | Tea Break | |||||||
11.30-12.45 PM | Nutrition | Lectures and cases | Overview of principles | 15 min | Rakhi Balachandran | Parvathy Iyer | Sandy Staveski, Vinay Joshi, Vishal Singh, Julie Chauhan (AIIMS Delhi); Nivedita (AIMS) | |
Results of the prospective study from AIMS | 7+3 | Nayan Banerjee | ||||||
Parenteral nutrition in the LMIC setting | 15+5 min | Invited expert | ||||||
Three Illustrative cases | 30 min | Nurses from AIMS/Other institutions | Illustrative cases | |||||
12.45-1.30 PM | Blood Product Management during and after cardiac surgery | Talks | Standard of care for blood product usage and it’s rationale | 15+ 5 min | Ravi Thiagarajan | Brijesh PK | Vijay Raju, Raja Joshi, Thomas Koshy, Sandy Staveski | |
Personal experience from a low resource environment | 10 min | Benedict Raj | ||||||
1.30-2.15 PM | Lunch | |||||||
2.15-3.20 PM | Managing long ICU stays | Talks and cases | PCICU staff physician Perspective | 15 min | Suchitra Ranjith | Lara Shekerdemian, Satish, Rayan Shetty, Nand Kishore; Suja (SCTIMST) | Lecture | |
PCICU nurse perspective | 15 min | Justine Fortkiewicz | Lecture | |||||
2 Case studies | 30 min | AIMS/Other institutions | two cases | |||||
Summing up -Discussion | 10 min | Session Moderator | ||||||
3.20-3.40 PM | Tea Break | |||||||
3.40 PM | Fast tracking in cardiac post operative intensive care: Who get’s it and What is needed | Talks and institutional experience | The North American Experience | 15+5 min | Lara Shekerdemian | Aveek Jayant | Sandy Staveski, Ravi Thiagarajan, Soo Kok Wai, Vipul Sharma, Prassanna Salvi, Nitya; | Lecture |
LMIC Perspective | 15+5 min | Keshavamurthy | ||||||
4.15 PM | Data from LMIC institutions (two or three programs to present their strategies) three brief presentations | 30 min | Three presentations from LMIC centers | Presentation of institutional data | ||||
4.45 PM | Closing Remarks and Announcement on the Kochi Declaration |
Department of Pediatric Cardiology
Amrita Institute of Medical Science and Research Center
Ponnekkara P.O, Cochin, Kerala
pin :- 682041
Fax : 91-484-2802020
reseachpeds@aims.amrita.edu
Amritapuri campus Clappana P. O.
For any queries, contact:
+91 9447702096 (Rinku)
+91 7994999610 (Neethu)
+91 7994999810 (Vaisakh)