Level 1: Foundation Course in Haemodynamics (Part I)

Haemodynamics Pathway Directors:

Michelle CHEW MD, PhD Professor Anaesthesia and Intensive Care Medicine, Linköping University Hospital, Linköping, Sweden; Past Chair Cardiovascular Dynamics Section, ESICM

Antonio MESSINA MD, PhD ICU senior consultant, Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center – IRCCS, Rozzano (Milano), Italy; Chair Cardiovascular Dynamics Section, ESICM

Xavier MONNET MD, PhD, Professor of Intensive Care, Medical Intensive Care Unit, Bicêtre Hospital, Paris-Saclay University Hospitals, Paris, France; Past Chair Cardiovascular Dynamics Section, ESICM

Course Directors Level 1:

• Christopher LAI MD PhD Medical Intensive Care Unit, Bicêtre Hospital, Paris-Saclay University Hospitals, Paris, France
• Marco MAGGIORINI MD Professor emeritus University of Zurich, Switzerland

Endorsement: The course is endorsed by the Cardiovascular Dynamics Section, ESICM.

• Identify key structural and functional characteristics of cardiovascular dynamics (arteries, veins, and the systemic circulation).
• Describe determinants of cardiac output, stroke volume, arterial and venous pressure
• Describe pathophysiology of shock, recognize its types and key markers of tissue hypoperfusion such as lactate and ScvO₂.
• Describe the role of clinical examination and basic echocardiography in guiding therapy of shock.
• Describe the physiology of tissue fluid homeostasis, list principles of fluid therapy and assessment of fluid responsiveness by clinical examination and markers of tissue hypoperfusion.
• Describe the pharmacological properties of sympathomimetic andsympatholytic vasoactive medications and there use in shock.

1. Structure and Function of the Systemic Circulation
   • Anatomy and roles of arteries, capillaries, and veins.
   • Arterial and venous resistance, impedance, and determinants of the arterial pressure wave.
   • Cardiac pressure-volume relationships, afterload, and the Frank-Starling mechanism.
2. Cardiac Function and Monitoring
   • Determinants of cardiac output, stroke volume, and arterial pressure.
   • Arterial pressure and cardiac output measurement methods, including non-invasive approaches.
   • Indications for cardiac output monitoring.
3. Shock Pathophysiology and markers of tissue hypoperfusion
   • Types of shock: hypovolemic, cardiogenic, septic, anaphylactic, obstructive.
   • Physiological markers of perfusion: oxygen delivery, consumption, extraction, lactate, ScvO₂, SmvO₂.
   • Pathophysiology and bedside signs of tissue hypoperfusion.
4. Fluid and Vasoactive Therapy
   • Principles of fluid therapy, types of fluids, and management strategies in shock.
   • Capillary filtration, vessel permeability, and interstitial fluid dynamics.
   • Vasoactive medications and CVP monitoring, including limitations.
5. Clinical and Assessment and Echocardiography
   • Focused echocardiography techniques and use of probes at the bedside.
   • Clinical signs of shock, fluid status, cardiac output and tissue hypoperfusion indicators.
   • Integration of bedside findings with hemodynamic markers to guide therapy.

This Foundation course is particularly suitable for trainees before and in their first six months of training in intensive care medicine. However any practitioner who wishes to refresh the fundamentals of Haemodynamics is welcome.

ESICM members from the Emerging Nations and Eastern Europe (see list of countries here) benefit from a reduced registration fee. In order to benefit from it, participants need to have an active ESICM membership for the current year. To become a member, please see more information here.

An application has been made to the UEMS EACCME® for CME accreditation of this event.

The first edition of the Foundation Course provided an introduction to Haemodynamics to 97 participants from 47 countries. Here’s what they particularly enjoyed about it:

• Possibility to virtually attend the classes with high-profile specialists, the interaction between the panel and students.
• The emphasis on the clinical aspect of the haemodynamic evaluation as well as the clinical application and interpretation of the parameters measured during haemodynamic monitoring.
• Giving proper examples complete with data from various studies that support the information.
• Geat amount of information relevant to the clinical practice.
• The instructors were presenting evidence-based information, combining it with bits and pieces from their personal experience.

Social media: @ESICM #haemodynamics