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CME: New Trends in Hemodynamics: Dynamic Assessments

ACCREDITATION EXPIRED: December 31, 2022

Activity Description / Statement of Need:

Goal-directed therapy (GDT) has been taken as the gospel in critical care since the publication of Rivers et al.’s seminal paper on the topic demonstrating a mortality benefit in patients with severe sepsis and related shock back in late 2001, whose protocols were soon embraced and became ensconced in practice as standards of care, overlapping with other, high-acuity areas of medical specialty like surgery and emergency medicine. However, these initially results later became more mixed and equivocal on the whole when balanced in the context of more recent literature.

Fluid balance is paramount, and indiscriminate administration of fluids, either too conservatively or too liberally, is associated with mortality and significant morbidity in a diverse array of patient populations, and conventional, one-size-fits all approaches to fluid management do a disservice to both medical and surgical patients with dynamic needs.

In this learning activity, Dr. Paul Marik, MD, FCCP, FCCM, discusses present techniques for assessing fluid responsiveness.

Target Audience:

This program has been designed for a multidisciplinary physician and nurse audience including: ICU / Anesthesia / Peri-op / Intensivists / Trauma / Critical Care


This program is supported by Educational Grants from Cheetah Medical and Baxter Healthcare.


Release Date: December 09, 2019 -- Expiration Date: December 31, 2022

Faculty: Paul Marik, MD, FCCP, FCCM

Agenda

-Hemodynamic Goals
-Fluid Resuscitation
-Historical Perspective
-Fluid responsiveness and the 6 Guiding principles of fluid resuscitation
-Techniques for assessment of fluid responsiveness
-Static – CVP (PCWP)
-Dangers of a high CVP
-Dynamic
-Heart-lung interactions
-Passive leg raising
-Fluid Challenge
-Do I give fluid?
-The effects of a fluid bolus are short lived

 

 

Learning Objectives

By the end of the session the participant will be able to:

  • Describe the risks of over- and under-resuscitation
  • Describe the present methods of fluid assessment
  • Describe the present methods of hemodynamic monitoring
  • Given patient cases, reason your approach to fluid management under various clinical circumstances

Accreditation

ACCREDITATION FOR THIS COURSE HAS EXPIRED. YOU MAY VIEW THE PROGRAM, BUT CME / CE IS NO LONGER AVAILABLE AND NO CERTIFICATE WILL BE ISSUED.


Faculty Disclosure and Resolution of COI

 As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved through  content review ScientiaCME.

 

Faculty Disclosure: Dr.  Paul Marik, MD discloses that he is a consultant / speaker for Baxter, Boehringer-Ingelheim, and Abbott Nutrition.

Disclosures of Educational Planner: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Commercial Support Disclosure: This program is supported by an educational grant from Cheetah Medical and Baxter Healthcare.

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.


Additional Courses That Are Related To This Activity

Applications in Hemodynamics - Taking Us from Here to the Future: Clinical Applications

Hemodynamics - Where are We Now?