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CME: Tailored Volume Resuscitation in the Critically Ill is Achievable

Activity Description / Statement of Need:

In this online, self-learning activity: 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 in late 2001. Its 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. One challenge has been the conventional approach’s embrace a ‘recipe-book’ or one-size-fits all approach with directed by static parameters. The literature clearly demonstrates that indiscriminate administration of fluids is associated with a number of complications, increased length of stay, and mortality in a diverse array of patient populations, findings all the more important because only half of hemodynamically unstable patients respond to fluids. The benefits of dynamic monitoring strategies in a range of patient populations have been borne out not only by meta-analyses but also recent clinical trial evidence. 

Target Audience:

Physicians and nurses in the following areas of specialty: Anesthesiology, critical care, emergency medicine, and surgery.


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

Learners may participate in this activity free of charge.


Release Date: April 07, 2021 -- Expiration Date: April 07, 2023

Faculty: Heath Latham, MD

Agenda

  • Clinical Cases
  • Sepsis Core Measures
  • Surviving Sepsis
  • NYS Sepsis Initiative
  • Fluid Resuscitation
  • Determining Volume Response
  • Tailored Resuscitation
  • Passive Leg Raise
  • Pulse Contour Analysis
  • Stroke Volume
  • SV Guided Resuscitation
  • Conclusion

Learning Objectives

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

  • Describe the CMS goal of resuscitation in severe sepsis and septic shock.
  • Recognize potential adverse outcomes of under and over resuscitation of the critically ill.
  • Understand variability indices and changes in stroke volume to predict volume responsiveness.
  • Recognize applications and limitations of non-invasive hemodynamic monitoring.
  • Recognize potential benefits of guided volume resuscitation strategies.

Accreditation

ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this internet activity enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™  toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

ABA MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Anesthesia (ABA) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABA MOC credit.

CME-MOC_badge

ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Physicians: For maintenance of certification (MOC) credit, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC credit for this activity. Please note: Not all activities on this site provide MOC credit. If this activity does not specify that it provides MOC credit in this section, then it does NOT provide MOC credit.  

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.  ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.


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 thru content review ScientiaCME.

Faculty Disclosures: Heath E. Latham, MD, Associate Professor, Pulmonary and Critical Care Medicine, University of Kansas Medical Center, has no relevant conflicts of interest to disclose.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, CEO of ScientiaCME, has no relevant conflicts of interest to disclose.

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

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge 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.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

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

Hemodynamics - Where are We Now?

New Strategies for the Treatment and Management of Anticoagulant Bleeding - online enduring - NATF

New Trends in Hemodynamics: Dynamic Assessments

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