IFA Talks

🎤 Live from IFAD – Catching Up with Johnny Wilkinson

We're back again at IFAD, and I've got Johnny Wilkinson with me—who's been very busy this week.

🗣️ "Essentially, I'm doing a hell of a lot of podcasting. I've been wandering around like a bit of a roving lunatic with a microphone, catching people in the halls, at sessions, in workshops—basically anyone I can grab—to have short, sharp conversations about what's happening here at the meeting."

Johnny and his team are on a mission to give listeners a snapshot of the full IFAD experience—from hands-on workshops to major plenaries, from big-name speakers to rising stars you might not have heard of yet.

🎧 Where can you listen? "We're uploading and editing as we go. All the podcasts will be available on the IFAD website, most likely under a section labelled 'Podcasts', and we may also host them on CriticalCareNorthampton.com and other partner sites."

💡 Whether you missed a session, want to catch some behind-the-scenes insight, or just love a good bit of #FOAMed content, be sure to tune in!

Stay connected ➡️ #IFAD2017 #CriticalCare #Podcasting #FOAMed

🎥 Live from the International Fluid Academy Day 2017 Hi everyone, I'm Shagan Onasanya, and I'm here with Karen Browey, who just delivered a brilliant and succinct summary on the management of trauma-induced hyperglycemia and massive hemorrhage.

🩸 So, Karen, let's distill it down. Someone is exsanguinating on the floor—what's the one-word summary of what we should do?

Karim:

"Stop the bleeding. That's the first, second, third, and fourth priority. Press on the wound, apply a tourniquet, do something—get them to surgery. In the meantime, do as little as possible, and what you do should focus solely on keeping the patient alive:

• Maintain coronary perfusion

• Support the ability to clot

• Don't dilute them with unnecessary fluids

• Avoid exacerbating the inflammatory response

• And treat any existing coagulopathy"

✅ A clear, focused, and life-saving message. 🎙️ "Fantastic—thank you very much, Karen!"

📍 Stay tuned for more insights from #IFAD2017 #TraumaCare #MassiveHemorrhage #FluidTherapy #FOAMed #CriticalCare

🎙️ Live from IFAD – Friday Afternoon

We caught up with Dr. Jan just after his session on a crucial—yet often overlooked—topic: the dangers of de-resuscitation.

🗣️ "Yes, I spoke about de-resuscitation, or what's also called fluid de-escalation or fluid removal. The first thing we need to do is really understand what it is—and why it's important. It typically comes at the very end of resuscitation, which might be why it doesn't always get the attention it deserves."

While many clinicians rely on cumulative fluid balance numbers, biomarkers, and hemodynamic indices, Jan emphasizes a critical point:

👀 "Look at the patient. Don't just rely on numbers. Look for clinical signs of fluid overload and even fluid toxicity. Before you start removing fluid, make sure you have a clear clinical reason—such as unresolved respiratory failure or acute kidney injury that could be linked to fluid accumulation."

So how does Jan decide when to start de-resuscitation?

🤔 "It's difficult. There's no biomarker for it. You need to make a clinical judgment. Many people wait for the patient to become hemodynamically stable or to be off vasopressors—but actually, in my experience, fluid removal can often be tolerated even with low-dose vasopressors. That shouldn't be seen as an absolute barrier."

✅ Key takeaway: There's no one-size-fits-all solution. The decision to de-resuscitate should be based on the full clinical picture, not just fluid balance sheets.

👏 Thanks to Jan for sharing these important insights!

📍 Stay tuned for more from #IFAD2017 #FluidTherapy #DeResuscitation #CriticalCare #FOAMed

🎉 Good morning from IFAD! We're really excited as the first day of the conference kicks off—and the opening plenary session is starting in just one minute! We just wanted to say a quick hello 👋

🎤 Kean, what are you most excited about today?

🗣️ "I'm really looking forward to diving into the heart of the conference—meeting all the delegates and hearing the keynote presentations. I'm especially excited for the sepsis debate and the hot topics session this afternoon. There'll be plenty of lively back-and-forth on some of the most controversial issues we face in critical care. Definitely my highlight of the day!"

👏 Sounds like a packed and thought-provoking schedule ahead.

Don't miss a beat—follow us on Twitter (as we know you already are 😉) and stay tuned for more live updates throughout the day!

📍 #IFAD2017 #FOAMed #CriticalCare #SepsisDebate

🎙️ Welcome back to the iFAD Live Vodcasts! It's Friday afternoon here at IFAD, and we're joined by Jade and Eve, two fantastic research nurses from Cardiff ICU.

🩺 So, what brought you to IFAD?

Jade: "One of our colleagues was presenting a poster, and we helped collect the data for it. But more than that, we really wanted to see how research is impacting clinical care across different centers."

Eve: "Yeah—it's a great opportunity to collaborate, to share what we're doing, and also learn what others are working on so we can take new ideas back to our own unit."

📍 Do you do a lot of research back in Cardiff?

Both: "We do! We're involved in a wide range of studies—both commercial and non-commercial—and we actually run 24/7 recruitment."

⏰ 24/7? That's quite rare, isn't it?

Eve: "It is! But we've found it's the most effective way to maximize recruitment. Most of our patients are recruited outside of standard hours—because that's when people are admitted, that's when their conditions deteriorate. ICU doesn't run on a 9-to-5 schedule, so neither can we."

Jade: "If you're only recruiting during office hours, you're missing a significant portion of your ICU population, and that can seriously bias your study outcomes. Running a full-time recruitment model allows us to serve all eligible patients and strengthens the validity of the research we're involved in."

🧪 A big thank you to Jade and Eve for joining us and for the incredible work you're doing in advancing intensive care research. 💬 This is what IFAD is all about—collaboration, real-world impact, and pushing the boundaries of critical care. 📍 #IFAD2017 #ICUResearch #FOAMed #NursingExcellence #CriticalCareResearch

🎤 Live from IFAD 2017 in Antwerp, Belgium!

We're joined now by two local attendees, Sim and Tom, who've come to the conference from nearby.

👋 "We're from Brussels," they tell us. "I work in Bruges," says Sim, "and Tom works at the University Hospital in Brussels."

🗣️ So why did they come to IFAD?

"We know about the conference because our new Head of the Intensive Care Department is Professor Malbrain," Tom explains. "He invited us, and even though I'm a trainee in internal medicine and Sim's more in nuclear medicine, it's a great opportunity to learn about fluid and critical care—areas we don't get exposed to much."

When asked about highlights from the day, Sim says:

🧠 "There's been a lot of really good information—I've picked up so many take-home points, I can't even choose one specific thing."

Tom adds:

💡 "One of the most interesting presentations for me was about the choice of maintenance fluids—both in pediatrics and stable adult patients. It really made me reflect on the importance of tailoring fluids to the individual patient, rather than just following routine practice."

And they both agree:

💬 "Fluids should be considered a medicine, not just an afterthought or a standard protocol. That perspective really stood out to us."

👏 Thank you to Tom and Sim for sharing your reflections! 🎥 This has been your live update from IFAD 2017—stay tuned for more conversations and insights from the floor. 📍 #IFAD2017 #FOAMed #FluidTherapy

🎥 Live from IFAD! I'm here with the ever-energetic David Lyness from Propofology.com and @gas_craic on Twitter. So, David—what are you up to at IFAD?

🗣️ "I'm herding cattle and cats—basically trying to rally the social media troops! I'm helping to run the social media campaign, getting content online, pushing Twitter hard, and broadcasting as much of the conference to the #FOAMed community as humanly possible. Also, I'm being very militant about hashtags."

We appreciate the dedication! And just to be clear—what's the official hashtag?

🟦 #IFAD2017 – for anyone following the action.

So aside from the tweeting frenzy, what else is going on?

🗣️ "I've teamed up with Johnny Wilkinson from CriticalCareNorthampton.com, and we've created a joint fluid protocol flowchart. You can download it on Propofology.com or Johnny's site. We're launching it during the conference to get feedback and promote safer, smarter fluid prescribing—it's a quality improvement tool and a fluid stewardship initiative all in one."

That's awesome. A big thank you for pushing the digital boundaries and bringing IFAD to a global audience!

💻 Check out the protocol ➡️ Propofology.com 💬 Follow the conversation ➡️ #IFAD2017

🎬 Lunchtime update from IFAD! We've just wrapped up a fantastic morning of the Critical and Acute Care Ultrasound (CACU) course, and it's been really popular! I'm here in my classic white IFAD t-shirt, soaking up the atmosphere—and now, we're bringing you some top ultrasound tips straight from our amazing faculty. 🎉

🎤 Cian: "When I teach ultrasound, I always wear jeans—and here's why. On your right-hand side, there's that little jeans pocket. If you're struggling with rib shadows, line up your probe and twist it like you're sliding it into that pocket. Works every time!"

🎤 Segun: "Having trouble getting a good four-chamber view of the heart? Start with a parasternal short axis view and trace it down to where you see the twist at the apex—that shows you the heart's direction. Then switch to the left side and point the probe where the apex was. Boom! A beautiful four-chamber view, 99% of the time."

🎤 Adrian: "In a peri-arrest patient, the subcostal two-chamber view is often the only view you'll get. Just rotate the probe so the marker faces up and angle it toward the left ventricle. It gives you a view similar to the parasternal short axis—super useful in emergencies."

🎤 Justin: "When you're learning, and your mentor takes your hand to guide the probe—don't let go. Grip tighter. Feel how they move the probe, relate that to what you see on the screen, and you'll learn so much faster."

🎤 Aidan: "Movement is everything. Remember the three key probe motions: slide, rotate, and tilt/fan. And as for grip, think of it like holding a screwdriver—or applying lipstick (your choice!). #iFAD2017"

🎤 Johnny Wilkinson: "No talk about lipstick or grabbing probes from me. Just this: practice, practice, practice. Learn what's normal—then you'll recognize what's not. Especially if you're being mentored by me. 😉"

🎥 That's it from us (for now!)—some top tips from some of the best educators in ultrasound. Stay tuned, because there's more to come throughout the day. Thanks for tuning in! 💬 #iFAD2017 #POCUS #UltrasoundTips

🎙️ Hello from the Fluid Academy!

We're back again—and this time, I'm joined by Brendan Riardan, who might just be the furthest-traveled member of our faculty. Brendan, where have you come from?

🗺️ "I've come from Seattle in the US—but I did spend a bit of time traveling through the Netherlands before arriving here, so technically I've only just come from The Hague by train!"

So maybe not quite in the last 24 hours—but still impressive!

🚨 Don't forget—we've got an exciting Social Media Workshop happening this afternoon! 📍 Hope Room 🕓 4:10 PM (local time)

We'll be discussing how to:

• 📲 Use social media to support your research and education

• 🌍 Disseminate your work and ideas to a global audience

• 💡 Share what matters to you in medicine, in real time

Whether you're a social media pro or just getting started, come join us for a practical and engaging session!

When you walk into an ICU, you often see patients who look very much alike. Regardless of the original insult—be it trauma, infection, or another trigger—they're all receiving mechanical ventilation, hemodynamic support, renal replacement therapy, artificial feeding, and more. That's because any localized insult can trigger a systemic host response—transforming a regional issue into a body-wide disease.

I had the opportunity to give two lectures at this congress. One focused on cytokine removal in septic shock patients, and the other addressed fluid therapy—specifically, crystalloids versus colloids—and their impact on hemodynamics.

Let me bring the pathophysiology a little closer to home. Over the past few years, I've stumbled upon what I like to call an analogy between sepsis and love.

What is love, from a pathophysiological perspective? It's a systemic inflammatory response provoked by somebody.

Now, back to clinical practice: In patients with severe sepsis and high risk of death, we often see multiple organ dysfunction and a cytokine storm. My recommendation is to monitor this inflammatory surge using procalcitonin kinetics. If it's rising significantly, consider implementing cytokine removal therapies as part of the treatment plan.

Regarding fluid therapy, our data suggests that as long as hemodynamic stability is maintained using a multimodal, individualized approach, it doesn't matter much whether you use crystalloids or colloids in terms of microcirculatory outcomes.

That said, we still believe that in the early resuscitation phase, colloids may have an advantage—they tend to restore circulation faster than crystalloids.

And finally, a word on antioxidants: If you consume too many, you'll simply excrete most of them. The only antioxidant I confidently recommend?

Hungarian red wine.

This was my first time attending IFAD, and I must say, it's been one of the best conference experiences I've had. The environment is friendly and relaxed, the audience is highly motivated, and the speakers are truly world-class. It's been a fantastic experience, and I look forward to returning.