Gordon Drummond FRCA,
Scientific Programme Chairman,
ESA, University Department of Anaesthesia,
Critical Care, and Pain Medicine Edinburgh, UK
Dr Drummond reviews the extremely successful annual meeting of the European Society ofAnaesthesiologists, held in Vienna this year.
A record number of delegates attended this meeting (see figure 1). About 80% of them were qualified anaesthetists, and most had come to listen, rather than present new data. The largest number came from Germany and the UK, but smaller countries such as Austria Holland and Switzerland were well represented. Generally the opinion was that the meeting was very well organised, and that the presentations were of a high standard.
What was drawing these people? Most had planned to come for some time, and it was the quality of the scientific programme first and foremost which attracted attendance.
What were the fields of interest? The most popular field was intensive care, followed closely by regional anaesthesia. This was even more evident for those who came from Eastern European countries. Thus, intensive care is an important interest for many specialist anaesthetists, reflecting the pattern of work of many countries. The refresher courses were considered the most instructive, followed by the symposia.
What was on offer? It’s hard to pick out the gems from about 55 refresher courses, and an equal number of symposia, workshops, and 700 or so abstracts. However, for me, the refresher courses that not only summarised, but also questioned our current practice were the most memorable, such as perioperative hyperglycaemia, or hyperchloraemia caused by sodium chloride infusions. Some problems continue to tax us: the criteria for blood administration for surgical and intensive care patients, and how to improve patient safety in our intrinsically hazardous and harmful environment. Some help with such problems comes from the use of studies using high-level simulation.
A topical session was organised, at relatively short notice, to consider the recent withdrawal of Cox 2 inhibitors from the market: a remarkable story of optimism and market forces, followed by re-assessment of clinical data, and a realisation that the biology was more complex than had first been realised. All of these matters were brought out in an interesting session, with a final re-assessment of the place these agents may now have. Unfortunately the evidence base for short-term use of these agents is limited to a few specific circumstances. A startlingly clear example of what is perhaps a frequent feature of “new treatments”: the pendulum of opinion.
We had two large symposia, combining inputs from different groups: one on hypothermia in a number of clinical circumstances, and a second on the new European Guidelines for Cardiopulmonary Resuscitation, held jointly with the European Resuscitation Council. Such extended inputs exemplify the wide ranges of interest and diverse talents of anaesthetists in Europe. A more traditional field of interest is management of the airway, and we welcomed the European Airway Management Society into the meeting, with a whole day of discussion and additional workshops.
Finally of course, the cutting edge: the new material presented in the abstracts. Again, hard to choose: but some of the choice is made in the prize-winner session. Here, some superb presentations were made, including a very practical application of protective ventilation during surgery, and a series of impressive images of brain activity during visual stimulation during anaesthesia. The first prize went to an intriguing observational study that suggests that omega-3 fatty acid supplements improve survival in critically ill patients. This was a large study (661 patients) and shows what can be done by effective pooling of data from many centres (see the article by Dr Heller and colleagues on page 28 in this issue).
With this number of delegates, and the spread of sessions and topics, most people couldn’t get to all the sessions they wanted to attend; most would have wanted to attend several more. We are probably at the “design limit” for a meeting such as this: we are now trying to think of more effective ways of presenting “something for everyone”, perhaps along the fault line of education and research: but perhaps not too far apart since many would want to jump from one to the other!