CRRTにおける適切な電解質管理の重要性:イオン化Mg, イオン化Ca, 電解質をPoint-of-Careで測定(日本語ナレーション)


【概要 】
2022年3月に、米国サンディエゴで行われたAKI&CRRT 2022での発表の日本語抄訳ナレーション版です。
CRRT(持続的腎代替療法)およびクエン酸塩の使用と、それに伴うイオン化カルシウム(iCa)・イオン化マグネシウム(iMg)を中心とする電解質の挙動に関して、先行文献(主に2022~2020と最近のもの)を挙げつつ、腎臓専門医である演者が論理的に説明。14分間の簡潔なウェビナーです。

CRRTにおいては、iCaだけでなくiMgも低下すること、それらの経時的推移、「CRRT下でクエン酸塩による抗凝固を受ける患者では、tMgとiMgの間に相関関係は生じない」といったことが示されます。
興味深い報告ばかりですので、プレゼンで示される引用元の文献も、ぜひご参照下さい。
(本ウェビナーは日本語ナレーションでお届けいたします)

【2023年5月17日18時より配信開始】


演者 :Dr.チアゴ・レイス
ブラジリア大学 分子薬理学研究所
研究員 腎臓移植部 上級医師

Point-of-Care Testing in the Neonatal Population: Importance of Glucose Meter Accuracy

Point-of-care testing is an essential diagnostic tool in neonatal and pediatric patient settings because infants and children experience more rapid changes in clinical status than adults. Fast, accurate, interference-free POCT glucose testing in neonatal settings enables rapid detection or prevention of neonatal hypoglycemia.

In this webinar, Dr. Khosrow Adeli, Professor, Clinical Biochemistry, The Hospital for Sick Kids, Toronto, Ontario, Canada will describe the unique needs and benefits of point of care glucosetesting in the neonatal patient population. He will describe the positive impact that accurate,interference-free glucose testing accuracy has had on outcomes and quality of care at Sick Kids Hospital in Toronto, Canada.

Learning Objectives:

• Become aware of the benefits of point of care testing in the neonatal and pediatric patient population
• Understand the analytical measurement requirements for point-of-care glucose meters used in the neonatal setting
• Learn how point of care testing can affect quality of care, clinical outcome, and laboratory effectiveness

Presenters:

Khosrow Adeli, PhD, FCACB, NACB, DABCC
Head and Professor, Clinical Biochemistry
The Hospital for Sick Children, University of Toronto

Naveen Bangia, PhD
Director, Medical and Scientific Affairs
Nova Biomedical

Hipomagnesemia en Pacientes Críticos

Date: martes, 01 marzo
Time: 09:00 Hora de Europa Central, 10:00 Hora de Colombia

La hipomagnesemia es un trastorno electrolítico común en pacientes críticos y está asociado con un mayor riesgo de morbilidad y mortalidad. Muchas condiciones clínicas pueden contribuir a la hipomagnesemia a través de diferentes mecanismos patogénicos. En pacientes con lesión renal aguda (AKI), la necesidad de una terapia de reemplazo renal intermitente continua o prolongada (CKRT y PIKRT, respectivamente) puede sumarse a otras causas de hipomagnesemia, especialmente cuando se usa anticoagulación regional con citrato (RCA). La Dr. DiMario explorará estrategias destinadas a determinar con precisión cómo la adaptación precisa de las prescripciones de diálisis y la composición de los fluidos de la terapia de reemplazo renal (KRT), así como la administración temprana de suplementos de magnesio y la estrecha monitorización, podrían representar una piedra angular en la reducción de la hipomagnesemia relacionada con la KRT.

Francesca Di Mario, MD
Dipartimento Medicina Interna e Nefrologia
Az. Ospedaliero – Universitaria di Parma, Italia

Marcin Pacek, Ph.D., MBA
Scientific Director, Medical & Scientific Affairs (MASA), Europe
Nova Biomedical

Detection and Management of Acute Kidney Injury in the ICU

Date: Thursday, February 17, 2022 & Thursday, March 03, 2022

Time: 02:00 PM Eastern Standard Time

Duration: 1 hour

Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with high morbidity and mortality. AKI is often multifactorial, asymptomatic and difficult to predict. This webinar provides a review of the etiologies of AKI and a systematic approach toward its diagnosis and management with emphasis on fluid volume assessment and management. The use of point-of-care (POC) biomarkers have provided additional tools to detect patients at high risk of AKI and improve their outcomes. We will review protocols that integrate the use of POC biomarkers into a multidisciplinary clinical response team to potentially reduce AKI development, severity and the number of patients who need dialysis.

Whether in the ICU or other hospital wards, AKI represents a complex disorder that requires frequent monitoring and early detection to achieve optimal outcomes.  There are many testing modalities available for the clinician to aid in AKI clinical decision making and management.  These involve following trends in blood creatinine, plasma volume status, and electrolytes including ionized magnesium. This webinar will also investigate point-of-care testing options available to clinicians that care for these patients.

Rolando Claure-Del Granado, MD, FASN
Director, AKI/CRRT Program
Hospital Obrero, Cochabamba, Bolivia

Dr. Claure-Del Granado is also Professor of Medicine, Universidad Mayor de San Simon, School of Medicine, Bolivia and Member at Large, International Society of Nephrology Executive Committee

Dennis Begos, MD, FACS, FACRS
Medical Director, Medical and Scientific Affairs
Nova Biomedical

Estimated Plasma Volume (ePV) in Critical Care

Overview

Title: Estimated Plasma Volume (ePV) in Critical Care

Date: 
Thursday, April 28, 2022, 02:00 PM EDT
Thursday, May 12, 2022, 02:00 PM EDT

Time: 02:00 PM Eastern Daylight Time

Duration: 1 hour

Summary

Estimated Plasma Volume (ePV) in Critical Care
New studies have reinforced the clinical importance of ePV as a diagnostic and prognostic tool in many clinical settings, particularly critical care. The ePV can be calculated using several formulas, mostly based on hemoglobin and hematocrit and sometimes body weight. It has been shown to provide useful prognostic information in patients with heart failure, myocardial infarction, renal failure, and recently acute respiratory distress syndrome (ARDS). Additionally, it has been associated with all-cause mortality and mortality from cancer in large cohort studies. This webinar will review the epidemiology, predictive power and potential clinical uses of ePV, especially in critically ill patients. We will discuss the origin of PV measurement, other  techniques for PV measurement, and explore the pathophysiology of how PV can affect various disease processes, with special focus on ARDS and acute illnesses.

Measuring ePV in Critical Care
There is growing recognition that PV is an important parameter to determine in various disease processes. Nova Biomedical offers a blood gas analyzer that can calculate and trend ePV and ΔPV at the point-of-care as part of a comprehensive blood gas/critical care profile. Since ePV requires both measured hemoglobin and hematocrit, Nova’s blood gas analyzer is uniquely qualified to give an accurate calculation of ePV. This portion of the webinar will review this technology and reinforce the clinical importance of ePV as part of the blood gas critical care profile.Speakers

Thomas Metkus, MD

Thomas Metkus, MD
Divisions of Cardiology and Cardiac Surgery, Departments of Medicine and Surgery
Johns Hopkins University School of Medicine

Dennis Begos, MD, FACS, FACRS

Dennis Begos, MD, FACS, FACRS
Medical Director, Medical and Scientific Affairs
Nova Biomedical

Detection and Management of Acute Kidney Injury in the ICU


Date: February 17 and March 3, 2022
Time: 2:00 PM Eastern Daylight Time

Overview

Title: Detection and Management of Acute Kidney Injury in the ICU

Date: Thursday, February 17, 2022

Time: 02:00 PM Eastern Standard Time

Duration: 1 hour

Summary

Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with high morbidity and mortality. AKI is often multifactorial, asymptomatic and difficult to predict. This webinar provides a review of the etiologies of AKI and a systematic approach toward its diagnosis and management with emphasis on fluid volume assessment and management. The use of point-of-care (POC) biomarkers have provided additional tools to detect patients at high risk of AKI and improve their outcomes. We will review protocols that integrate the use of POC biomarkers into a multidisciplinary clinical response team to potentially reduce AKI development, severity and the number of patients who need dialysis.

Whether in the ICU or other hospital wards, AKI represents a complex disorder that requires frequent monitoring and early detection to achieve optimal outcomes.  There are many testing modalities available for the clinician to aid in AKI clinical decision making and management.  These involve following trends in blood creatinine, plasma volume status, and electrolytes including ionized magnesium. This webinar will also investigate point-of-care testing options available to clinicians that care for these patients.Speakers

Rolando Claure-Del Granado, MD, FASN

Rolando Claure-Del Granado, MD, FASN
Director, AKI/CRRT Program
Hospital Obrero, Cochabamba, Bolivia

Dr. Claure-Del Granado is also Professor of Medicine, Universidad Mayor de San Simon, School of Medicine, Bolivia and Member at Large, International Society of Nephrology Executive Committee

Dennis Begos, MD, FACS, FACRS

Dennis Begos, MD, FACS, FACRS
Medical Director, Medical and Scientific Affairs
Nova Biomedical

Estrategias de Control de Calidad y su Impacto en la Seguridad del Paciente de Cuidado Crítico

En la prestación de servicios de salud es fundamental garantizar excelencia en la calidad, por lo cual, se deben implementar herramientas que permitan entregar resultados clínicamente útiles a los pacientes parara mantener o mejorar su estado de salud.

El aseguramiento de la calidad enmarca una serie de actividades, procesos y procedimientos que contribuyen a la implementación de estrategias con impacto positivo en la seguridad del paciente y garantizan la toma de decisiones basadas en evidencia objetiva.

El control de calidad hace parte del aseguramiento de la calidad y permite la identificación de errores, toma de acciones oportunas, así mismo, contribuye a incrementar la competencia técnica del personal.

Objetivos:

  1. Conceptualizar acerca de la importancia del aseguramiento de la calidad en pruebas de gasometría y su impacto en la seguridad del paciente.
  2. Proporcionar las herramientas para la implementación de estrategias de aseguramiento y control de calidad en pruebas de gasometría que contribuyan a la generación de resultados clínicamente útiles.

Dirigido a:

  • Laboratoristas Clinicos y todos su homo`logos
  • Médicos patólogos
  • Médicos internistas
  • Médicos intensivistas
  • Terapeutas respiratorios
  • Jefes de enfermería
  • Medicos Cardiologos
  • Medicos Cirujanos
  • Medicos Anestesiologos
  • Perfusionistas

Ipomagnesemia nei pazienti critici con Insufficienza Renale Acuta sottoposti a terapia sostitutiva della funzione renale

Data: Giovedì, 28 Ottobre 2021

Orario: 14:00

L’ipomagnesemia è un disturbo elettrolitico comune nei pazienti critici ed è associato ad un aumento della morbilità e del rischio di mortalità. Molte condizioni cliniche possono contribuire all’ipomagnesemia attraverso diversi meccanismi patogenetici. Nei pazienti con danno renale acuto (AKI) la necessità di una terapia sostitutiva renale intermittente continua o prolungata (rispettivamente CKRT e PIKRT,) può ulteriormente aggiungersi ad altre cause di ipomagnesiemia, specialmente quando viene utilizzata l’anticoagulazione regionale con citrato (RCA).

Questo webinar esplora le strategie mirate a personalizzare con precisione sia le prescrizioni di dialisi che la composizione dei fluidi KRT (kidney replacement terapy), nonché come l’integrazione precoce di magnesio e il monitoraggio attento del magnesio, incluso il magnesio ionizzato, potrebbero rappresentare una pietra miliare nella riduzione dell’ipomagnesemia correlata alla KRT.

Il Dr. Ferrari discuterà i limiti del magnesio sierico come test di laboratorio standard e i vantaggi del monitoraggio del magnesio ionizzato (iMg) per una gestione più efficace della dismagnesemia nei pazienti critici.

Francesca Di Mario, MD

Francesca Di Mario, MD
Dipartimento Medicina Interna e Nefrologia
Az. Ospedaliero-Universitaria di Parma, Italy

Germano Ferrari PhD, MBA
Direttore EU, Medical & Scientific Affairs (MASA)
Nova Biomedical

Recognition and Management of Community-Acquired Acute Kidney Injury in Low-Resource Settings

Date: Thursday, December 02, 2021

Time: 01:00 PM Eastern Standard Time

Dr. Ravindra Mehta, an internationally recognized nephrologist, will discuss a multi-country, International Society of Nephrology (ISN) sponsored study demonstrating that a comprehensive program of point-of-care creatinine/eGFR testing, urine dipstick testing, and protocolized care management can improve the recognition of AKI in low-resource settings, improve clinical outcomes, and reduce the overall costs of treating kidney disease. Dr. Mehta was the lead author and investigator of the study.

Dr. Begos will highlight the utility and accuracy of Nova StatSensor Creatinine/eGFR for kidney function screening in multiple settings.Speakers

Dr. Ravindra Mehta, MD

Dr. Ravindra Mehta, MD
Professor of Medicine, Division of Nephrology
UCSD Department of Medicine

Dennis Begos, MD, FACS, FACRS

Dennis Begos, MD, FACS, FACRS
Medical Director, Medical and Scientific Affairs
Nova Biomedical

Hypomagnesemia in Critically Ill patients on Kidney Replacement Therapy

Date: Thursday, October 28, 2021

Time: 02:00 PM Eastern Daylight Time

Hypomagnesemia is a common electrolyte disorder in critically ill patients and is associated with increased morbidity and mortality risk. Many clinical conditions may contribute to hypomagnesemia through different pathogenetic mechanisms. In patients with acute kidney injury (AKI) the need for continuous or prolonged intermittent kidney replacement therapy (CKRT and PIKRT, respectively) may further add to other causes of hypomagnesemia, especially when regional citrate anticoagulation (RCA) is used. Dr. DiMario will explore strategies aimed at how precisely tailoring both dialysis prescriptions and the composition of KRT fluids, as well as early magnesium supplementation and close monitoring, could represent a cornerstone in reducing KRT-related hypomagnesemia.

Dr. Ferrari will discuss the limitations of serum magnesium as a standard lab test and the advantages of ionized magnesium (iMg) testing for more effective management of dysmagnesemia in critically ill patients.

Francesca Di Mario, MD

Francesca Di Mario, MD
Internal Medicine and Nephrology Department
Parma University Medical School, Parma, Italy

Germano Ferrari PhD, MBA
EU Director, Medical & Scientific Affairs (MASA)
Nova Biomedical