Live Blog: ANZCP Down Under [1]

Media Journalism by…

Martin Gill: Perfusionist

(Children’s Hospital at Westmead, Sydney Australia)

Editor’s Note:  This opportunity is provided by the efforts of, Mr. Martin Gill, perfusionist, who is attending this meeting in Sydney.

The intention here @ CircuitSurfers is to offer up a library of these types of objective POV’s (Points of View) to highlight conferences as well as “personalize” what a potential attendee can expect if deciding to participate.

Pre-Conference: T minus 1

The Eve Before…

Just got home from a very long day in theatre- one Truncus Arteriosus,  and a very shaky Double Outlet Right Ventricle all done and safely tucked up in PICU.

Now just got to pick the kids up from the dry cleaners, drop my suit off at the baby sitters, get a good nights sleep- then its off to the conference.

Cheers for now

Conference Start:  Thursday eve.

What an enjoyable first day of the conference. Today was a half day with the emphasis on relaxed open forum chats. This consisted of three sessions- paediatric, ECMO and general discussion.

The paediatric session got underway with a fascinating discussion piece, by Neil Casey from BC kids, relating to the management of ionized magnesium and calcium for neonatal perfusion practice. As I am sure everyone is aware the monitoring of ionized magnesium is an event in itself. It would appear that if one is fortunate enough to be able to monitor this electrolyte then one could find ones self in a very favorable position. I myself am a paediatric Perfusionist so understand the benefit of attention to detail in a prime, but must admit that I still have a long way to go.

The second discussion piece was relating to the use of Near Infrared Spectroscopy in paediatric perfusion. This discussion was led by Dr Skowno from the Heart Centre for Kids, Sydney. Here in Oz we have 4 devices available for sale. It would appear that this technology is becoming increasingly viewed as a valuable tool in the OR, yet it still has a tremendous scope for improvement. Directly related to perfusion this device can be of use for assessing cannulae position, picking up subtle variances in the regional perfusion, an aid to commencing bypass with a clear prime etc etc etc. Unfortunately until a gold standard exists for comparison of the generated number this device may not be viewed as a gold standard of care.

The final talk was by Killian O Shaughnessy also from the heart centre for kids. This discussion was about the possible compromise in safety if a surgeon desires to use an ECMO machine for CPB.  We do all have guidelines for the safe practice of CPB and the general consensus would be that the use of an ECMO machine is an unacceptable compromise- even though the reduced surface area is always desirable. Perhaps a purpose built MECC system is the way to go?????

The ECMO discussion started with a talk about the use of ECMO with palliative shunts. Again attention to detail is the key. This is a potentially tricky population to place on ECMO- up to twice full flow may be needed with extreme caution to blood gas management with a patient group who’s PVR may dictate where blood flows.

Discussion then led into a case presentation about ECMO for airway surgery and then the presentation of the Better Bladder- a novel device not yet available in Australia but with many potential safety implications for ECMO practice.

The final general discussion session was a fascinating experience- relaxed chat over canapés, champagne and even Halloween treats for interesting points raised. What a hoot. Some very animated discussion re designing the perfect CPB circuit/ pump. As you can imagine everyone’s circuit is the best. as I am sure you can also imagine as the alcohol flowed the discussion became more animated….. brilliant.

Well off to the dinner event. Cheers and catch you in the morning.


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