Summer School of Acid-Base and Homeostasis is a 4-day course focused on acid-base. We will take you from basics to advanced level in 4 days of lectures and practical workshops in small groups on real patients’ cases in the very heart of medieval Prague.
The target audience consists of interested medical students, trainees as well as specialists in intensive care medicine, emergency medicine, anaesthesiology, internal medicine and all other disciplines that use reading blood gases as diagnostic tool. Critical care nurses and paramedics are most welcome, too.
The overarching objective is to help the participants to learn, thoroughly understand and gain confidence in reading and interpreting the blood gas analysis in an acutely sick patient.
The partcipation fee is 3 250 CZK (aprox. 127 EUR) for medical doctors and 2 500 CZK (aprox. 98 EUR) for medical students and other participants. The fee will be paid in Czech Crowns online by a credit or debit card. We are currently working on launching the payment gateway.
DAY 1: The basics – Physiology of homeostasis
|12:30-13:00||Introduction: Course objectives, logistics, house rules. Introducing the faculty and the candidates (F. Duska + All)||F. Duska||L|
|13:00-13:40||Brief history of homeostasis, acids, bases and blood gases - introducing basic mathematics and terminology based on historical conceps||D. Lodahl||L|
|14:00-14:40||Body fluids and regulation of homeostasis||M. Bestle||L/WB|
|14:50-15:40||Blood gas exchange and transport (including the mechanisms of respiratory compensation and pCO2 gap interpretation)||T. Langer|
|16:20-17:00||The kidney – physiology with emphasis to acid-base regulation.||M. Matejovic||WB|
|17:10-17:40||How the blood gas analyze works: pre-analytical errors, pitfalls, meaning of measured/calculated variables||T. Langer||L|
|17:45-18:30||Guided tour through Karolinum Building (2 groups)|
|18:30-19:15||Lactate (physiology, regulation, L/D forms, diagnosis incl. lactate gap, types and mechanisms of lactic acidoses, handling exogenous lactate)||P. Waldauf||L|
|19:30||Welcome drink + hello||All|
DAY 2: Clinical acid base
|09:00-09:30||Respiratory acid-base derangements||S. Brusatori||L|
|09:35-10:10||Metabolic disorders: bicarbonate-centered approach||T. Itenov||L|
|10:30-11:00||Boston Rules||T. Langer||L|
|11:10-12:10||Introduction to Stewart electroneutrality-based approach||M.W. Langer||L|
|13:30-14:10||Making sense out of it: The use of simplified electroneutrality-based approach to solving complex acid base cases.||F. Duska||WB|
|14:15-14:30||Physiological consequences of acidaemia||M. Matejovic||L|
|14:30-15:00||Role of sodium bicarbonate in the management of metabolic acidosis||P. Caironi||L|
|15:30-18:30||Practical workshops on real clinical cases / candidates rotate among tables, 30 min each allowing for short rotation breaks – topics not disclosed to candidates:|
|Table 1: Case 1||S. Brusatori||C|
|Table 2: Case 2||D. Lodahl||C|
|Table 3: Case 3||M. Krbec||C|
|Table 4: Case 4||M.Matejovic||C|
|Table 5: Case 5||P. Waldauf||C|
|Table 6: Ask me what you did not get (No case, just an expert and a whiteboard)||T. Langer||WB|
|Table 7: SIMULATION Scenario A||M. Mlcek||Other||SIM|
DAY 3: Water and osmoles
|09:00-09:10||Kick-off case||M. Krbec||C|
|09:10-09:40||The magic of numbers: which calculation using plasma and urine concentrations and volumes do I find useful?||P. Caironi||WB|
|09:40-10:10||Hyponatraemia – practical approach||T. Langer||L|
|10:10-10:30||Hypernatramia – practical approach||T. Itenov||L|
|10:50-11:10||There are other ions, too||M.W. Langer||L|
|11:10-11:30||Life-threatening disorders of homeostasis (What to do when there is little time to think?)||M.W. Langer||L|
|13:00-13:30||Microcirculation and fluid homeostasis||M. Malbrain||L|
|13:30-14:00||Assessing volume status at the bedside - an overview||T. Itenov||L|
|14:20-15:00||Influence of fluids on acid-base status||M. Malbrain||L|
|15:10-18:00||Practical workshops on real clinical cases / candidates rotate among tables, 20 min each allowing for short rotation breaks – topics not disclosed to candidates:|
|Table 1: Case 6||S. Brusatori||C|
|Table 2: Case 7||M. Bestle||C|
|Table 3: Case 8||D. Lodahl||C|
|Table 4: Case 9||P. Waldauf||C|
|Table 5: Case 10||F. Duska||C|
|Table 6: Ask me what you did not get (No case, just an expert and a whiteboard)||M. Malbrain||WB|
|Table 7: SIMULATION Scenario B||M. Mlcek||SIM|
|18:00-18:10||Solution of the morning case + instructions for the evening||M. Krbec||C|
DAY 4: Geeks day
|09:00-09:10||Warm up case (extreme body temperature)||S . Brusatori||C|
|09:10-10:00||Influence of temperature on acid-base equilibria, interpretation of acid base in patients at both extremes of body temperature (cased based)||P. Elbers||L|
|10:20-11:00||Cerebrospinal fluid, blood-brain barrier and implications on acid-base equilibria||T. Langer||L|
|11:00-11:20||Comparative physiology of acid base homeostasis||P. Elbers||L|
|11:20-12:30||The most interesting case of my career (5 faculty members, one case each)||M Malbrain,
|12:30||Wrap up, course evaluation, group photo||All|
Morten’s research interests are in targeted temperature management and fluid regulations.
Dr Pietro Caironi is an associate professor at the faculty of medicine, department of anaesthesia and critical care, at the University of Milan, Italy. He graduated with honors from the university of Milan, Italy in 2000 and achieved the same highest level of distinction in his residency program in anaesthesia and critical care in 2004. He did his internship in medicine, anaesthesia and critical care at the University of Milan and was also a research fellow at the Massachusetts general hospital, Harvard medical school, Boston, USA. In particular he has been awarded as a finalist of the Cournand and Comroe Young Investigator Award within cardiopulmonary and critical care council of the American Heart Association in 2004 and in 2008 he has received the ECCRN Clinical research Award of the European Society of Intensive Care Medicine. He has more than 41 publications, 17 book chapters, 55 abstracts and 17 proceedings to his credit. He holds various teaching activities in the University of Milan and also sits in the Editorial Board of Minerva Anesthesiologica and as reviewer for Intensive Care Medicine, American Journal of Respiratory and Critical Care Medicine, Minerva Anesthesiologica and Blood Transfusion. Assoc. Prof Caironi’s main research interest is in the area of lung physiology and acute respiratory failure, sepsis, urinary electrolytes and renal function and fluid therapy.
Dr. František Duška, MD, PhD, EDIC, AFICM is Associate Professor of Anaesthesiology and Intensive Care. Apart from research interests in muscle metabolism and bioenergetic failure in the critically ill, Franki is a practicing intensivists with interest in medical education. He is a chair of Clinical Training Committee of European Society of Intensive Care Medicine and has been a director of European Diploma in Intensive Care (EDIC) exam centre in Prague. Franki loves teaching acid base.
Paul WG Elbers, MD, PhD (1975) is an intensivist at Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands. Special interests include medical data science, quantitative acid base analysis, fluid therapy, ultrasound, pharmacometrics and the human microcirculation. He is known for the www.autokinetics.eu project on personalizing antibiotic dosing and www.acidbase.org, for acid-base analysis and Stewart's Textbook of Acid-Base.
Thomas Langer is researcher at the University of Milano, Italy and works in the pediatric ICU. He graduated in 2008 in Medicine at the University of Milan and in 2014 he was board certified in Anesthesiology and Critical Care Medicine by the same University.
From 2011 to 2012, he was research fellow of the National Research Council at the United States Army Institute for Surgical Research in San Antonio, Texas. His main research interests are acid-base physiology, fluid therapy, respiratory physiology, control of breathing and extracorporeal gas exchange.
Research interest: Procalcitonin in infections diagnostics, Ventilator settings, volume resuscitation.
Fields of teaching: Respiratory and circulatory physiology.
Manu Malbrain (1965) qualified as MD from the Catholic University of Leuven, Belgium in 1991. He is married to Bieke Depré and they have 3 sons: Jacco, Milan and Luca. He is the manager and director of the Medical and Surgical ICU, the High Care Burn Unit and a hyperbaric oxygen chamber of the ZNA "Ziekenhuis Netwerk Antwerpen", Campus Stuivenberg/St-Erasmus in Antwerp, Belgium. As of May 1st this year he became the medical hospital director of the ZNA Stuivenberg and St-Erasmus hospi-tals. He is a critical care physician (1996) with a basic training in internal medicine (1991). He is actively involved in the European Society of Intensive Care Medicine (ESICM) where he chaired the Working group on abdominal problems (WGAP) within the POIC section (2009 --2013) and studied the effects of raised intra-abdominal pressure (IAP) in general ICU patients for the last 20 years. He finished the Patient Acute Care Training (PACT) module on abdominal problems together with Jan De Waele. He was the Scientific program Chair together with Michael Sugrue of the 2nd World Congress on Abdominal Compartment Syndrome, Noosa, Australia, Dec 6-8 in 2004. He was the chairman of the 3rd WCACS in Antwerp, Belgium, March 22-24 in 2007 (www.wcacs.org). He is the founding President and actually the Treasurer of the World Society on Abdominal Compartment Syndrome (WSACS at www.wsacs.org). Together with Niels Van Regenmortel, he is co-founder of the International Fluid Academy (www.fluid-academy.org) and co-chaired the first 2 iFAD meetings on November 19th in 2011 and November 17th 2012 in Antwerp. Besides IAP, his favourite topic is less invasive (hemodynamic) monitoring and he enjoys his active involvement in (bedside) teaching and education of medical trainees and students. In 2003 he was the first ESICM Chris Stoutenbeek Award winner in Amsterdam with a study protocol on different intra-abdominal pressure measurement methods and he successfully defended his PhD doctorate’s thesis in 2007 on the same topic (KU Leuven). He is author and co-author of several peer-reviewed articles, reviews, editorials, book chapters and even two whole books on ACS.
Martin qualified in internal medicine, nephrology and intensive care. He did part of his PhD in Ulm, Germany. In his free time he is a keen sportsman, running half marathons.
Mark W. Langer MD, Trainee in Anaesthesia and intensive care. Special interest in acid-base calculation and interventions according to Stewart's approach.
Petr is a practicing intensivist and data scientists. He loves computers, equations, statistics and of course acid base.
Mikulas is a teacher of physiology, who is a pioneer of simulation. His particular interest is the border between physiology as a science and intensive care.
Serena works on acid-base research with Thomas Langer.
He is a PhD student of Franki looking at Sources of error in acid-base calculation.