Page 168 - Hospital Authority Convention 2018

Masterclasses
HOSPITAL AUTHORITY CONVENTION 2018

M13.1 Advances in Intensive Care 13:15 Convention Hall A

How Can Information Technology Improve Intensive Care Unit Service Provision?
Chan KKC
Department of Anaesthesia and Intensive Care, Tuen Mun Hospital, Hong Kong
Proper intensive care of patient requires managing a high volume of data, arriving at high velocity, from various sources
and with significant variability of noise in the data. Since the development of Intensive Care Unit (ICU) in the 1950s, various
techniques have been employed to manage mass information. With the advancement of medical and information technology,
sophisticated systems were developed to handle the increasing amount of information. The ICUs in Hong Kong are working
towards a unified information system for managing ICU data. Through this system, we hope to generate descriptive,
predictive and prescriptive intelligence for individual patient care and overall ICU management. This presentation will outline
these possibilities using local and overseas experience.

M13.2 Advances in Intensive Care 13:15 Convention Hall A

Modern Blood Purification in Intensive Care Unit
Shum HP
Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong

The concepts underlying the pathogenesis of septic acute kidney injury (AKI) are complex. Continuous renal replacement
Tuesday, 8 May 2018 in severe sepsis. Extracorporeal blood purification therapies have been proposed to improve outcomes for patients with
therapy (CRRT) is commonly performed for patients with septic AKI in critical care settings. However, the use of low or normal
volume continuous venovenous haemodialysis or haemofiltration failed to demonstrate any improvement of patient outcomes
severe sepsis with and without AKI. The underlying principle is to remove excessive inflammatory mediators and/or bacterial
toxins from the blood compartment in order to modulate inflammatory response. It involves various techniques including
haemoperfusion/haemoadsorption, high adsorption haemofiltration, high volume haemofiltration, high cut-off membrane
haemofiltration/haemodialysis, plasma exchange, and coupled plasma filtration adsorption. These techniques are gaining
popularity in Europe and Japan. They are effective in clearing endotoxin or inflammatory mediators and are well tolerated.
However, despite initial promising results, most blood purification techniques do not provide any sustainable mortality
benefits. In severe sepsis, source control, early appropriate antibiotics and haemodynamic support are three most important
treatment components. As a supportive treatment, blood purification techniques may not be able to significantly alter a
patient’s mortality. Since the outcome of septic patients has improved over time, much larger sample sizes will be needed to
detect the relatively small effects of these new therapies on sepsis.

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