Level 2: Transition course in Intensive Care Nephrology

Pathway directors

• Bairbre MCNICHOLAS MD PhD Consultant Intensivist and Nephrologist at Galway University Hospitals; Senior lecturer, University of Galway, Galway, Ireland
• John PROWLE MD, FRCP, FFICM Senior Clinical Lecturer in ICM, Queen Mary University of London, Consultant in Renal and Intensive Care Medicine, Royal London Hospital, London, United Kingdom

Directors Level 2

• Yvelynne KELLY MD, Consultant Intensivist, Department of Critical Care, Tallaght University Hospital, Dublin, Ireland
• Melanie MEERSCH MD, Prof. Senior Physician and Head of Post ICU Care, Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Germany
• John PROWLE MD, FRCP, FFICM Senior Clinical Lecturer in ICM, Queen Mary University of London, Consultant in Renal and Intensive Care Medicine, Royal London Hospital, London, United Kingdom
• Ahmet Oğuzhan KÜÇÜK MD Consultant Intensivist, Karadeniz Technical University, Farabi Hospital, Trabzon, Turkey
• Thomas RIMMELÉ MD, PhD Anesthesiology and Intensive Care Medicine, Edouard Herriot Hospital, Lyon, France

Outcome 1: Epidemiology/Risk of AKI
Epidemiology/Risk of AKI
Recognise risk factors for Acute kidney injury
Distinguish between modifiable and non-modifiable risk factors
List parameters to be noted on clinical examination in AKI

Outcome 3: Describe pathophysiology of AKI
Recognise typical aetiology and settings for AKI

Outcome 4: Diagnosis of AKI
List staging system currently used to diagnose AKI
Understand differences in urine and creatinine in defining AKI
Explain the limitation of creatinine for diagnosis of AKI

Outcome 7A: CRRT/RRT- Component and mode
Identify components of a CRRT machine.
Recall key modes of CRRT.
Mechanisms of Solute and Fluid Removal
Define key terms: convection, diffusion, ultrafiltration.
Recall the mechanisms of fluid movement across a semipermeable membrane.
List anticoagulation options for CRRT.
Catheters and membranes

Outcome 7B: Vascular Access for CRRT
Recall common vascular access sites for CRRT.
List equipment needed for central venous catheter (CVC) insertion.
Describe anatomy and physiology relevant to vascular access.
Identify key complications associated with CVCs.
Indications, Contraindications, and Infection Prevention:
Explain indications and contraindications for specific vascular access sites.
Summarize strategies to prevent catheter-related bloodstream infections (CRBSIs).

Outcome 7C: Prolonged intermittent RRT (PIRRT) “Sustained Low-Efficiency Dialysis (SLED)”
Explain PIRRT introduction

Outcome 7D: Renal Replacement Therapy (RRT)
Indications and Complications
List absolute indications to start CRRT.
List potential indications to start RRT.
List potential complications of RRT.

Outcome 10: Extracorporeal Life Support (ECLS) and Renal Considerations
Understand basic concepts of ECLS and renal consideration.

• AKI diagnosis and staging and the role of biomarkers
• Prescribing in AKI and RRT
• CRRT Modalities, Membranes and Principles of Dosing
• CRRT prescriptions
• Clinical evaluation of AKI
• Alarms & trouble shooting on CRRT device
• Fluid assessment and management in AKI
• Perform the set-up of CRRT devices
• Management of hepatorenal syndrome
• Management Citrate of Anticoagulation on CRRT
• Tumour lysis syndrome cases
• CRRT integration with ECMO
• Kidney-organ interactions in critical illness and crosstalk
• The role of the kidney in acid-bas homeostasis during critical illness
• Prolonged intermittent RRT (PIRRT)
• Blood Purification Techniques in Sepsis and Hyperinflammation

An application will be made to the UEMS EACCME® for CME accreditation of each live event.