Best Abstract Competition 2018

Best Abstract Competition 2018

As in previous years, the standard of entries in this year’s Best Abstract Competition was high, with a mixture of prospective and observation clinical studies, along with one basic science study.

This year’s judging panel was led by Chair Professor Marc Samama, Cochin University Hospital, Paris, France, and his fellow judges were Professor Frédéric Mercier of Hôpital Antoine Béclère and Univerisité Paris-Sud, Clamart, France, and Professor Alexander Zarbock of University Hospital Műnster, Germany.

The winning abstract was 1123: Expiratory Ventilation Assistance during mandatory ventilation in porcine ARDS improves arterial oxygenation – a randomised controlled animal study, by Dr Johannes Schmidt, Department of Anesthesiology and Critical Care Medical Center, University of Freiburg, Germany. He receives a prize of 3,000 Euros.

In second place (2,000 Euros) was Rasmus Åhman, a medical student of Linköping University, Faculty of Medicine, Sweden, who presented abstract 923: Postoperative outcome after hip fracture surgery. The third prize (1,000 Euros) went to Izabella Orzechowska, London School of Hygiene and Tropical Medicine, UK, for abstract 1466: Critical care after lung resection – Influence of anaesthetic and analgesic technique.

Following the presentations, Professor Samama said: “We really enjoyed this year’s presentations which were of a very high standard. However, Dr Schmidt’s presentation was exceptional and he is a worthy winner. On behalf of the panel I congratulate all our finalists, and we hope that the prize money will help the winners further their research.”

1st Prize

Abstract 1123: Expiratory Ventilation Assistance during mandatory ventilation in porcine ARDS improves arterial oxygenation – a randomized controlled animal study

Dr Johannes Schmidt, Dept. of Anesthesiology and Critical Care Medical Center – University of Freiburg, Germany

What gave you the idea to do this study?

For many years our group has tried to develop new ventilation strategies with lung protective effects. A particular control of the expiration showed promising results. Since this time, a main focus of our work lies on a specific influence of the expiratory part and its potential benefits.

Were the results what you expected?

Well, more or less. As always in scientific work, there are results that fit perfectly in the big picture and there are other results that raise new questions.

What are the next steps in your research?

We will try to reproduce our results in patients. This always is an exciting step in clinical science.

2nd Prize

Abstract 923: Postoperative outcome after hip fracture surgery

Rasmus Åhman, Medical student, Linköping University, Faculty of Medicine, Sweden, and colleagues.

What gave you the idea to do this study?

A newly developed national quality register in Sweden named SPOR (Swedish PeriOperative Register) presented preliminary data suggesting that the mortality after hip fracture surgery in Sweden differed depending on where a patient underwent surgery. We therefore wanted to look into this in more detail to, if possible, confirm this and also secondly evaluate which patients suffered the most from this discrepancy. The study we will present at the ESA congress is a minor study including patients from one County Council in Sweden, which we thought was a reasonable sample size to begin with.

Were the results what you expected?

Both yes and no; the difference depending on university hospital status was in fact statistically significant. However, this variable had a clearly higher impact than we expected beforehand. Another aim we had was investigating the impact of after-hours surgery, which in our cohort had no impact on mortality whatsoever. This contradicts some previous studies suggesting poorer outcomes during weekends and overnight.

What are the next steps in your research?

We are currently working on a nation-wide study to confirm our results from this study we present at the ESA congress. This new, larger-scale study include almost 15 000 patients undergoing acute hip fracture surgery in Sweden and we aim to investigate both surgical-, anaesthesia-, patient- and process-related variables to minimise potential confounding. Preliminary results indicate a similar strong independent impact for university hospital status as was the case for our minor study, among other interesting findings.

3rd Prize

Abstract 1466: Critical care after lung resection – Influence of anaesthetic and analgesic technique

Izabella Orzechowska, London School of Hygiene and Tropical Medicine, UK, and colleagues.

What gave you the idea to do this study?

The project is a follow-up on the single-centre pilot study CALoR-1 which investigates the effect of anaesthetic technique and analgesic technique on patient outcomes in – including the need for critical care admission – in patients undergoing lung resections. Unplanned critical care admission is a devastating complication of lung resection, often associated with increased morbidity, mortality, and additional burden on healthcare services. Our study was selected as the subject of the 2015 UK Association of Cardiothoracic Anaesthesia and Critical care collaborative audit into critical care following lung resection, to address the fundamental question of what we can do as a community of thoracic anaesthetists in order to improve patient outcomes.

Were the results what you expected?

The results in favour of both total intravenous anaesthesia and epidural analgesia might be considered to conflict with recent studies, however, the same trend was observed in the pilot study.

What are the next steps in your research?

This is the largest study to date examining unplanned critical cared admission. Future work should allow for long-term impact analysis of critical care, ideally in large scale prospective studies tailored towards this challenging group of patients. This would allow development of risk prediction models for both admission and mortality.

Finalist

Abstract 1417: Submental ultrasound in the assessment of difficult mask ventilation

Dr Eric Lin, Department of Anesthesiology, Taipei Tzu Chi Hospital, New Taipei City, Taiwan Buddhist Tzu Chi Medical Foundation, and colleagues.

What gave you the idea to do this study?

Difficult airway management can lead to severe complications. Unanticipated difficult airway problems still occur despite the use of current clinical predictors. A reliable method to identify patients at risk for difficult airway may reduce morbidity and mortality. Recently, ultrasound has emerged as a simple, portable, non-invasive, and radiation-free POINT-OF-CARE device for rapid airway assessment.

Were the results what you expected?

Unexpectedly, the sonographic parameters we measured, i.e. tongue base thickness (TBT), hyomental distance (HMD), and the distance between lingual arteries (DLA) did not show significant differences between easy and difficult laryngoscopy groups. Fortunately, there were higher TBT, HMD, and DLA of difficult mask ventilation group compared to the easy one.

What are the next steps in your research?

We are going to keep collecting more case numbers for better statistical significance and power. We’ll perform receiver operating characteristic (ROC) curve analysis to compare the diagnostic discriminatory ability of each parameters and try to find out the cut-off value of each parameter to distinguish difficult and easy mask ventilation.

Finalist

Abstract 1866: Gold nanorods-based thermosensitive hydrogel produces selective long-lasting regional anaesthesia triggered by photothermal activation of TRPV1 channel

Dr. Peng Liang, West China Hospital of Sichuan University, Chengdu (China), and colleagues

Previous studies have demonstrated that activation of TRPV1 channels facilitated the potency of a selective long-lasting regional anaesthetic drug QX-314 in vivo. Hydrogel is a solid jelly-like material. Gold nanorods are nanoparticles, which can be used for hyperthermia by exposure to near-infrared radiation.

This study in rats showed that, with exposure to near-infrared irradiation, the gold nanorods-QX-314/hydrogel nanocomposite can activate TRPV1 channels through photothermal conversion and release QX-314 at the same time. The gold nanorods and QX-314 loaded hydrogel exhibits a long-lasing regional anaesthetic effect with selective sensory function block. Sensory block duration of nanocomposite was significantly longer than 1% lidocaine (90.0±3.5 vs. 37.5±3.5 min, P<0.001).

The authors concluded: “This nanocomposites can produce selective long-lasting regional anaesthesia triggered by photothermal activation of TRPV1 channels.”

Finalist

Abstract 1989: The effect of buffered lidocaine in local anaesthesia during subcutaneous implantable venous access devices insertion: a prospective, randomized, double-blind study

Dr. Hosni Khouadja, Hôpital Farhat Hached, Sousse, Tunisia, and colleagues

This randomised, double-blind study of 120 patients evaluated the effectiveness of sodium bicarbonate buffered lidocaine on reducing pain during subcutaneous implantable venous access devices. Patient satisfaction was evaluated immediately after the procedure.

Patients reported significantly lower pain scores with the buffered versus non-buffered lidocaine 15.70 ± 7.58 mm vs.46.90 ± 12.27 mm (p<0.001). The time of anaesthesia onset was shorter with buffered lidocaine 3.25±1.33 minute vs. 5.46±1.28 (p=0.01). Mean procedure pain scores were similar between the two groups. Overall patient satisfaction is high for implantation of venous access devices under local anaesthesia. There was no difference between the two groups regarding satisfaction.

The authors concluded that, during vein cannulation under local anaesthesia, pain is mainly due to acidity of the lidocaine solution. In our study, we showed that buffering lidocaine with sodium bicarbonate significantly reduces pain during intraparenchymal injections.