On-Demand Webinars   

Lactate monitoring for severe sepsis and septic shock: Are all lactate measurements the same?

July 18, 2017    2 PM EST

Lactate is a well-established biomarker for hypo-perfusion and is commonly used in numerous sepsis protocols. Current Surviving Sepsis Campaign guidelines suggest using a lactate cutoff of 4 mmol/L to identify patients with severe sepsis or septic shock. However, the recently updated 2017 Sepsis 3 guideline proposes a lactate cutoff of 2 mmol/L as an early indicator for septic shock. This webinar will review the Sepsis 3 guideline changes, specifically related to lactate as an early biomarker. Additionally, this webinar will review proper specimen handling to minimize pre-analytical errors for lactate testing and will present a UC Davis study that evaluated the performance of point-of-care (POC) lactate methods compared to a central laboratory definitive method.


  1. Learning Objectives:

    • Review 2017 Sepsis 3 guideline including changes to target lactate values.
    • Review proper specimen collection and handling to minimize pre-analytical errors. in hospital-based lactate testing, including POC testing
    • Discuss performance differences between commercially available laboratory and POC lactate testing methods.
    • Categorize the clinical performance of common POC lactate methods, compared to a definitive laboratory method.

    Who should attend?
    • POC coordinators • Laboratorians • Critical care nurses
  2. View this recording here

Featured Speaker:
Nam K. Tran,
PhD, MS, FACB Associate Clinical Professor, Director of Clinical Chemistry and Point-of-Care Testing, Department of Pathology and Laboratory Medicine University of California, Davis.
Nam K. Tran serves as an associate clinical professor in the department of medical pathology and laboratory medicine and as director of clinical chemistry and point-of-care testing at UC Davis Medical Center. He is a National Heart, Lung, and Blood Institute (NHLBI) emergency medicine K12 scholar. Tran has published over 40 peer-reviewed manuscripts and 34 abstracts, and has presented at national and international conferences. His areas of expertise include special applications of POC testing in critically ill patients.

Breakthrough in Cell Culture Analysis with BioProfile Flex2

 

Featured Speaker:
Matt McRae
Product Line Manager,
Biotechnology Products
Nova Biomedical

In this webinar, Nova’s biotechnology specialists will describe our just-released BioProfile FLEX2 analytical system. FLEX2 combines Nova’s groundbreaking MicroSensor Card technology with optical measurement and freezing point osmometry for a comprehensive cell culture analyzer that eliminates chemistry sensor maintenance and provides a full, 16-test panel analysis in under 4.5 minutes with a sample volume of 265uL.

  1. Discover how Nova’s innovative technology can improve your bioprocess

    1. Learn about Nova Biomedical and our automated chemistry and cell culture analyzers
    2. Review the advantages of BioProfile FLEX2’s unique modular design
    3. Understand how this comprehensive, high throughput analyzer benefits bioreactor analysis and process optimization
    4. Examine how reduced sample volume can improve cell line selection and early-phase screening.
    5. Gain insight into the advantages of maintenance-free MicroSensor Card technology.
    6. Understand the impact of culture osmolality and the benefits of accurately measured osmolality for improved process robustness.

    This webinar is not eligible for continuing education credit.
  2. View this recording here

 

Bedside Glucose Monitoring – Is it Safe for Critically Ill Patients?

 

Featured Speaker:
Andrei Malic,
PhD Director, Medical and Scientific Affairs
Nova Biomedical

Concern continues over the accuracy of glucose meters used in critically ill patients, as deaths and serious adverse events associated with certain meters are still being reported in the U.S. FDA MAUDE database and in peer-reviewed medical journals. Substances commonly found in the whole blood of critically ill patients often interfere with glucose measurement accuracy in these meters, which, though currently used in hospitalized critically ill patients, were originally designed for self-monitoring at home.

This webinar will present a new, regulatory-compliant risk evaluation protocol in critically ill patient care settings. It will detail the methodology, data analysis, and complex and extensive clinical risk analysis undertaken in an international, multi-site study to substantiate the performance of a glucose meter in critically ill patients.

  1. Learning Objectives:
    1. Review the history of patient safety issues associated with glucose meter use in hospitals.
    2. Describe the risk that unevaluated and non-qualified glucose meters pose to critically ill patients.
    3. Examine whether a glucose meter can be equivalent to a central laboratory, definitive reference method.
    4. Demonstrate the advanced analytical and statistical risk models needed to establish glucose meter effectiveness.
    5. Determine whether improved glucose meter technology can improve patient outcomes.
    6. Establish that a glucose meter can meet the FDA’s 2016 final guidance.

    Who should attend?
    • POC coordinators • Laboratorians • Critical care nurses • PharmD • Hospitalists
  2. View this recording here

 

The importance of measuring ionized magnesium in critically ill patients

Featured Speaker:
Evan Ntrivalas, MD, PhD. Director,
Medical and Scientific Affairs Nova Biomedical

Hypomagnesemia (low levels of magnesium) is associated with several clinical conditions, ranging from cardiovascular disease to respiratory disorders and sepsis. Traditionally, total magnesium (tMg) measured in the laboratory is used to identify patients with hypomagnesemia. However, various studies have shown the clinical significance of using iMg, the functional form of tMg, to correctly identify patients with hypomagnesemia.

  1. Learning Objectives:
    1. Describe the pathophysiology and role of Mg in biological processes
    2. Describe the distribution of Mg fractions (total, protein-bound, ionized) in bodily fluids
    3. Describe the differences between tMg and iMg
    4. Identify the clinical conditions associated with hypomagnesemia 5. Identify the clinical utility of measuring ionized magnesium in various clinical settings

    Who should attend?
    • Critical care physicians • Critical care nurses • POC coordinators • Laboratorians
  2. View this recording here

 

New Regulatory and Accreditation Issues that Affect Hospital Glycemic Management Programs

Featured Speaker:
Jeffery A. DuBois, PhD, HCLD/CC (ABB), FACP
VP Medical and Scientific Affairs
Nova Biomedical

Glycemic management programs are the standard of care in every hospital in the world, and bedside glucose monitoring systems (BGMS) are central to program success. The industry became aware of significant patient safety concerns when hospital deaths directly attributed to BGMS use were reported to the FDA. Regulatory and accreditation bodies around the world have now reacted, and created new regulations and guidelines to improve patient safety and reduce risk. In October 2016, the FDA issued a new guideline requiring BGMSs to be virtually equivalent to central laboratory methods and, for the first time, separating BGMS from self-testing of blood glucose (SMBG) meters.

Learning Objectives:
• Review background leading to the new FDA guideline, including new labeling for glucose meters “Not evaluated with the critically ill”
• Examine regulatory and accreditation changes affecting hospital BGMS and their impact on inpatient glycemic manage programs.
• Discuss how hospitals have addressed recent changes and how they can maintain accreditation for their point of care glucose programs.

Who should attend?
• Critical care nurses • Diabetes specialist nurses • POC coordinators • Laboratorians

View this recording here

 

The Clinical Impact of Improved Glucose Monitoring in Neonatal Intensive Care Pediatric Setting

Featured Speaker:
Khosrow Adeli, Ph.D., FCACB, NACB, DABCC
Head and Professor, Clinical Biochemistry
The Hospital for Sick Children, University of Toronto

Tight glycemic control in critically ill adult patients has been associated with improved clinical outcomes such as reduction in length of hospital stay, risk of sepsis, renal failure and mortality. However to date; only a few clinical studies have evaluated the performance of blood glucose measuring systems (BGMSs) in neonates at risk for hypo and hyperglycemia. Hypoglycemia is one of the most common metabolic concerns for the neonatal population.

This webinar will discuss a new study that has evaluated the clinical results of bedside point-of-care-testing (POCT) BGMS use by non-laboratorian operators to reflect real life situations in the NICU. The presentation will discuss the accuracy of the POCT BGMS and show comparisons against laboratory results, the impact on detection of important glucose decision cutoffs, and the frequency of meter testing in the NICU.

View this recording here

 

The Confusing Conundrum of Collecting and Measuring Glucose in Neonates

Featured Speaker:
Martha Lyon, PhD, DABCC, FACB Clinical Biochemist/Clinical
Associate Professor
Royal University Hospital
Saskatoon Saskatchewan

Over the past decade, there have been significant advancements in our ability to measure glucose with greater accuracy and precision. In spite of these, the timely identification of hypoglycemia in neonates still represents a challenge for nurses, neonatologists, pathologists and clinical laboratorians. The incidence of hypoglycemia in the newborn has been estimated at 1-5 per 1000 live births. The controversy surrounding a universally accepted definition of neonatal hypoglycemia and why it is important to identify neonatal hypoglycemia in a timely manner will be presented in this webinar. Finally, numerous pre-analytical errors related to collection and handling of neonatal blood specimens will be presented and how these factors can/will influence the measurement of glucose will be discussed.

View this recording here

 

Can Point-of-Care Creatinine Testing Reduce Contrast-Induced Acute Kidney Injury (CI-AKI) in STEMI Patients Treated with PPCI?

Featured Speaker:
Dr. Thomas Keeble
Consultant Cardiologist – Southend Hospital / Essex Cardiothoracic Centre
Senior Clinical Fellow – Anglia Ruskin University

CI-AKI and related nephropathy occur in approximately 15-20% of patients who are treated for acute ST elevation myocardial infarction (STEMI) with primary percutaneous coronary intervention (PPCI). CI-AKI is multi-factorial including contrast load, dehydration, existing renal dysfunction and diabetes. Thomas Keeble, MD, and his team are conducting a trial in a STEMI population undergoing PPCI, part of which involves assessing whether simple, point-of-care (POC) creatinine and eGFR measurement, which determines renal status, impacts CI-AKI and nephropathy. The study gives early indication that patients found to have renal impairment prior to PPCI can receive less contrast medium during treatment, leading to decreased incidence of CI-AKI and nephropathy.

View this recording here

 

The Sepsis Epidemic: New sepsis definitions and evidence-based treatment

Featured Speaker:
Ron Daniels, BEM
NHS Consultant in Critical Care and Anaesthesia
Co-Founder and Chief Executive, UK Sepsis Trust
CEO, Global Sepsis Alliance

Sepsis is responsible for at least 44,000 deaths in the UK annually, and accounts for 30-50% of episodes of inpatient deterioration. Despite endorsement by relevant professional agencies, the internationally recognized sepsis standards of care are achieved in fewer than 20% of cases. Evidence in support of basic care elements—antibiotics and fluid challenges—suggests that they are more effective and their delivery more time-critical than interventions in acute coronary syndrome.

View this recording here

 

Clinical Impact of Blood Glucose Monitoring System Accuracy in Critical Care

Featured Speaker 1:
Nam K. Tran, PhD, MS, FACB
Assistant Clinical Professor
Director of Clinical Chemistry and Point-of-Care Testing
Department of Pathology and Laboratory Medicine
University of California, Davis
   

This webinar will review the consequences of BGMS error on hospitalized patients. Focusing on newer generation hospital BGMS, Dr. Tran will discuss the impact of BGMS accuracy on glycemic control efficacy in general and in two case studies of adult and pediatric burn patients. He will demonstrate how reducing BGMS error positively impacts glycemic control outcomes.

View this recording here

 

Point-of-Care Glucose in Critically Ill Patients– The Importance of glucose meter accuracy

Featured Speaker 1:
Arthur H. Combs, MD, FCCP, FCCM
President, FutureTech Strategies, Inc.
Featured Speaker 2:
Evan Ntrivalas, MD, PhD.
Director, Medical and Scientific Affairs
Nova Biomedical

This webinar will provide two perspectives of hospital POC glucose testing. Evan Ntrivalas, MD, PhD, will cover clinical cases and studies showing the significance of confounding factors that affect glucose meter performance on hospitalized patients, including critically ill, and the regulatory requirements for glucose meter use in hospitals. Arthur Combs, MD, will provide a critical care physician’s perspective on POC glucose testing, including special considerations when performing glycemic .management with critically ill patients.

View this recording here

 

Glucose meters and glycemic control: Does meter error impact glycemic control outcomes?

Featured Speaker 1:
Brad S. Karon, M.D., Ph.D.
Associate Professor of Laboratory Medicine and Pathology
Department of Laboratory Medicine and Pathology
Mayo Clinic
Rochester, MN
   

This webinar will review the consequences of glucose meter error on hospitalized patients. Dr. Karon will discuss the impact of meter accuracy on glycemic control efficacy, focusing on newer generation hospital glucose meters, and will demonstrate how reducing meter error positively impacts glycemic control outcomes.

View this recording here