Pre-Conference Workshops
Planning for the CNW14 pre-conference courses is underway, and topics will be announced in late summer.
Content from the following CNW13 pre-conference courses is available for purchase through A.S.P.E.N.'s eLearning Center
Clinical Nutrition Week 2013 Pre-Conference Workshops:
DESCRIPTION
The research workshop will provide key knowledge and the conceptual framework with which to understand and study the emerging role of the human intestinal microbiome on human health and disease with a focus on nutritional issues. The goal of the workshop is to provide participants with new knowledge and emerging technology that demonstrates how food, environment, stress, antibiotics and Western lifestyle affect the intestinal microbiome, which then in turn causes major changes in host biochemistry and physiology. Exposure to xenobiotics, and stress affect both host and microbiome physiology which then interact to affect each other in a way that leads to multiple disorders of human progress such as autoimmune disease, autism, inflammatory bowel disease, chronic infection, and mood disorders. Speakers will provide examples whereby the interactome of host genes and their products and microbial genes and their products drive emergent properties in cells such that they respond to environmental stressors in highly distinctive ways. An introductory session will provide a working knowledge of the available tools and scientific methods used in metagenomic interrogation of the intestinal microflora to diagnose real clinical disorders.
LEARNING OBJECTIVES
- Describe available tools and methods used in metagenomic interrogation
- Integrate new knowledge regarding the relationship of the Western lifestyle to the intestinal microbiome, and subsequent physiological changes that lead to multiple human disorders
- Analyze specific research breakthroughs in this field that have important implications in clinical practice
- Identify potential future research directions
FACULTY AND TOPICS
Welcome and introductions
John Alverdy, MD, FACS, Professor of Surgery, Director, Center for the Surgical Treatment of Obesity, Director Minimally Invasive Surgery, Department of Surgery, University of Chicago, Chicago, IL
Modeling the microbiome: creating predictive models from deterministic patterns
Jack Gilbert, PhD, Assistant Professor, Department of Ecology & Evolution, University of Chicago; Environmental Microbiologist, Argonne National Laboratory, Chicago, IL
Decades of promiscuous antibiotic use and our disappearing microbiome
Ilseung Cho, MD, Instructor, Department of Medicine (GI), New York University; Principal Investigator, Blaser Lab Group, Department of Microbiology and Department of Medicine, NYU School of Medicine, New York, NY
Uncovering the power of the microbiota: fecal bacteriotherapy for recalcitrant and recurrent Clostridium Difficile-associated diarrhea
Michael Sadowsky, PhD, Professor, Department of Microbiology, University of Minnesota, Minneapolis, MN; Director, Biotech Institute, University of Minnesota, St. Paul, MN
The intestinal microbiome and inflammatory bowel disease
Eugene Chang, MD, Professor of Medicine and Associate Section Chief for Research, Biological Sciences Division, Department of Medicine, University of Chicago, Chicago, IL
Total parenteral nutrition alters immunity via its effect on the intestinal microbiome
Dan Teitelbaum, MD, Professor of Surgery, C.S. Mott Children's Hospital, Department of Surgery, University of Michigan, Ann Arbor, MI
Host-microbe interactions in babies at risk for neonatal necrotizing enterocolitis
Michael Morowitz, MD, Assistant Professor of Surgery, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA
Effects of the microbiome on behavior
Rob Knight, PhD, Associate Professor, Molecular Biophysics, Department of Chemistry and Biochemistry, University of Colorado at Boulder, Boulder, CO
Synthesis of Presentations / Discussions –The best is yet to come: The future of research on nutrition and the gut microbiome
John Alverdy, MD, FACS, Professor of Surgery, Director, Center for the Surgical Treatment of Obesity, Director Minimally Invasive Surgery, Department of Surgery, University of Chicago, Chicago, IL
MODERATOR
John Alverdy, MD, FACS, Professor of Surgery, Director, Center for the Surgical Treatment of Obesity, Director Minimally Invasive Surgery, Department of Surgery, University of Chicago, Chicago, IL
UAN: 0216-0000-13-001-L04-P
LEVEL: Advanced
DESCRIPTION
The Nutrition Support Review Course provides an overview of nutrition support therapy that can be used as a tool for helping you identify personal knowledge gaps. Whether you are preparing for a certification exam or are seeking additional professional growth, recognizing these knowledge gaps allows you to use your professional development time and energy more effectively. The Nutrition Support Review Course divides topics into core subjects, areas of major emphasis for practice and the certification exams and specialty subjects. This course will include a broad overview of the core subjects including GI physiology, nutrition assessment, parenteral nutrition and enteral nutrition (plus handouts and slides on statistics). The review of specialty areas, such as pediatric nutrition support, home care and drug nutrient interactions will cover the highlights of the subject. Don’t miss this invaluable review of nutrition support therapy!
LEARNING OBJECTIVES
- Assess personal knowledge of nutrition support and identify areas requiring further study for the nutrition support specialty certification examination or other professional growth
- Review core nutrition support topics including GI physiology, nutrition assessment, parenteral nutrition, and enteral nutrition
- Highlight specialty areas of nutrition support such as pediatric nutrition support, home care, and drug-nutrient interactions
NSRC PLANNING COMMITTEE
Consuelo Brewer, RPH, BCNSP, Nutrition Support Pharmacist, Mount Carmel Medical Center, Columbus, OH
Todd W. Canada, PharmD, BCNSP, FASHP, Clinical Pharmacy Specialist, Division of Pharmacy, University of Texas MD Anderson Cancer Center, Houston, TX
John Fang, MD, Clinical Director and Professor of Medicine, Division of Gastroenterology, University of Utah Hospital, Huntsman Cancer Institute, Salt Lake City, UT
Brandy Fuller, RD, LD, CNSD, Clinical Dietitian, Clinical Nutrition Services Department, Arkansas Children’s Hospital, Little Rock, AR
Cassandra Kight, PhD, RD, CNSC, Senior Clinical Nutritionist Critical Care & Nutrition Support, Clinical Nutrition Services, University of Wisconsin Hospital & Clinics, Madison, WI
Antoinette Neal, RN, CRNI, CNSC, VA-BC, Senior Clinical Infusion Nurse, Cleveland Clinic Home Care Services, Independence, OH
Joyce Owens, RD, CD, CNSC, Clinical Dietitian Specialist, Pediatric Critical Care, Medical College of Wisconsin, Milwaukee, WI
Vihas Patel, MD, FACS, CNSC, Director, Metabolic Support Service and Surgical Nutrition Fellowship, Brigham and Women's Hospital, Boston, MA
Marsha Stieber, MSA, RD, CNSC, Independent Nutrition Education Consultant; Clinical Practice Consultant, A.S.P.E.N., Mesa, AZ
UAN: 0216-0000-13-003-L04-P
LEVEL: Basic
DESCRIPTION
The ability to safely compound a parenteral nutrition (PN) solution is a skill that many pharmacists feel they don’t have. Practitioners must balance the patient’s clinical needs with the basic tenants of aseptic technique, physical and chemical compatibility. Knowledge of the differences in vascular access and parenteral delivery systems must also be considered. This course will provide a basic overview necessary for the safe provision of PN solution. It is geared to the practitioner new to the field of PN and for non-pharmacists with a desire to understand the nuances of PN compounding.
LEARNING OBJECTIVES
- Calculate the composition of a parenteral nutrition solution based on the practitioner’s parenteral nutrition order
- Predict the suitability of a parenteral nutrition solution given patient specific parameters
- Describe the complications that can occur if an unstable parenteral nutrition is infused and identify ways to prevent the complications
FACULTY AND TOPICS
Setting the Stage: Environmental Considerations for Safe PN Compounding: USP 797
Mary Baker, PharmD, MBA, Medical Affairs Manager and Clinical Fellow, Hospira, Inc., Lake Forest, IL
From Prescription to Formulation: Doing the Math
Carol Rollins, MS, RD, PharmD, BCNSP, CNSD, Coordinator, Nutrition Support Team, University Medical Center; Clinical Associate Professor, College of Pharmacy, University of Arizona, Tucson, AZ
Compatibility Considerations: Calcium/Phosphorus and Beyond
Todd W. Canada, PharmD, BCNSP, FASHP, Clinical Pharmacy Specialist, Division of Pharmacy, University of Texas MD Anderson Cancer Center, Houston, TX
Total Nutrient Admixtures - How to Compound a Safe TNA
Mark Klang, MS, RPh, BCNSP, PhD, Core Facility Head, Research Pharmacy, Memorial Sloan-Kettering Cancer Center, New York, NY
Pediatric Considerations in PN compounding
Kathleen M. Gura, PharmD, BCNSP, FASHP, FPPAG, Clinical Pharmacy Specialist GI/Nutrition, Center for Advanced Intestinal Rehabilitation (CAIR), Boston Children’s Hospital, Boston, MA
Homecare Issues
Don Filibeck, PharmD, MBA, National Director, Pharmacy Services, Critical Care Systems, Bedford, NH
Supply Issues - Shortages and Outsourcing
Eric H. Frankel, MSE, PharmD, BCNSP, Metabolic Support Service & Neonatal Clinical Lead Pharmacist, Truman Medical Center, Kansas City, MO
MODERATOR
Mary Baker, PharmD, MBA, Medical Affairs Manager and Clinical Fellow, Hospira, Inc., Lake Forest, IL
UAN: 0216-0000-13-003-L04-P
LEVEL: Basic
DESCRIPTION
This course is designed for the practicing nutrition support specialist. It will focus on state-of- the-art evaluation, monitoring and delivery of nutrition therapy to high-risk ICU populations. The course will begin with an overview of the latest evidence for our understanding of ICU metabolism, nutritional risk and the optimal delivery of calories and protein. The latest data from new trials of enteral and parenteral feeding will be reviewed and perspectives given on how to apply these studies to your practice. The appropriate nutritional evaluation of the ICU patients will also be discussed and a rational approach to determining the quantity of calorie and protein requirements will be addressed. The faculty will then discuss some key challenging patient types including ICU patients with renal failure, burns, and the high-risk surgical patient. Key controversial topics of specific nutrient-delivery and the many new trials addressing these issues will be addressed including antioxidants and probiotics. The course will conclude with a panel discussion and case presentations, which will illustrate how to apply the wide range of new data to your critical care nutrition practice.
LEARNING OBJECTIVES
- Describe the latest evidence for our understanding of ICU metabolism, nutritional risk, and the optimal delivery of calories and protein
- Determine caloric need and how to deliver protein and calories via parenteral or enteral nutrition in the high risk ICU patient populations
- Provide optimal nutrition therapy for high risk patient populations in the ICU, such as renal failure and high-risk surgical patients
- Understand the latest data for key pharmaconutrients, including when to prescribe antioxidants and probiotics
FACULTY AND TOPICS
- Metabolic Response to Critical Illness and How Should We Feed ICU Patients?
The Metabolic Response to Critical Illness: Are We Evolved to Get the Same Nutrition Across All Phases of Critical Illness?
Paul Wischmeyer, MD, Professor of Anesthesiology, Associate-Chairman for Clinical and Translational Research, Director of Nutrition Therapy Services, University of Colorado School of Medicine, Aurora, CO
How Much is Enough: Can We Predict Who Needs Nutrition Most?
Daren Heyland, MD, FRCPC, MSc, Full Professor of Medicine, Department of Medicine, Queen’s University; Director of Research for the Critical Care Program and Director of the Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada
What is the Role of PN in the Critical Care Patient? New Data
Gordon Doig MD, Associate Professor, Northern Clinical School Intensive Care Research Unit, Sydney Medical School, University of Sydney, Australia
How Much is Enough or Too Much? Can Indirect Calorimetry Answer the Question Best?
Stephen McClave, MD, Professor of Medicine, Division of Gastroenterology/Hepatology, University of Louisville School of Medicine, Louisville, KY
II. Special Nutrition Challenges
Renal Failure
Mary McCarthy, PhD, RN, Senior Nurse Scientist, Division of Nursing Research Sciences, Madigan Healthcare System, Tacoma, WA
Nutrition and Anti-Catabolic/Anabolic Therapy in Burn Injury
Marc Jeschke, MD, PhD, FACS, FRCSC, Director, Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre; Senior Scientist, Sunnybrook Research Institute; Associate Professor, University of Toronto, Toronto, ON, Canada
The High Risk Surgical Patient
Robert Martindale, MD, PhD, FACS, Chief, Division of General Surgery; Medical Director, Hospital Nutritional Services, Oregon Health and Science University, Portland, OR
III. Pharmaconutrient Updates
Update on Antioxidant Use in Critical Care
William Manzanares, MD, PhD, Assistant Professor, Department of Critical Care, Universidad de la República, Montevideo, Uruguay
Probiotics: Has the Time Come?
Gail Cresci, PhD, RD, LD, CNSC, Assistant Professor, Department of Gastroenterology and Pathobiology, Cleveland Clinic, Cleveland, OH
IV. Case Studies and Panel Discussion
MODERATOR
Stephen McClave, MD, Professor of Medicine, Division of Gastroenterology/Hepatology, University of Louisville School of Medicine, Louisville, KY
UAN: 0216-0000-13-004-L04-P
LEVEL: Intermediate
DESCRIPTION
New this year, the Nutrition for the Practicing Pediatric Clinician (NPPC) course will be divided into two individual courses. The first course will focus on metabolic support of the critically ill child who is in the pediatric intensive care unit (PICU). Participants will have the opportunity to learn more about the characteristics of acute metabolic stress response and the concept of using bedside metabolic monitoring, including indirect calorimetry to guide macronutrient intake for patients in the PICU. Attention will also be given to the impact of energy and protein imbalance on clinical outcomes of patients in the PICU and strategies to avoid overfeeding will be provided. Participants will have the opportunity to better understand the physiology and metabolism of the surgical infant as well as the evidence for providing nutrition support to the post operative cardiac infant. Lastly, a deeper look into the available evidence of using lactoferrin and probiotics to prevent necrotizing enterocolitis (NEC) will take place.
LEARNING OBJECTIVES
1. Determine the nutrient needs of the critically ill and post-operative child
2. Describe the metabolic response to injury and the role of nutrition in the critically ill child
3. Evaluate the evidence available for the prevention of NEC
FACULTY AND TOPICS
Metabolic Monitoring and the New Paradigm of Individualized Nutrition Therapy in Pediatric Critical Care
Nilesh Mehta, MD, Associate Medical Director, Critical Care Medicine, Boston Children's Hospital; Assistant Professor of Anesthesia, Harvard Medical School, Boston, MA
The Acute Metabolic Response to Injury and Nutritional Resuscitation in Critically Ill Children
Walter J. Chwals, MD, Professor of Surgery and Pediatrics, Tufts University School of Medicine; Surgeon-in-Chief, Floating Hospital for Children, Boston, MA
Low Energy Caloric Repletion in the Post Operative Cardiac Surgical Baby
Bodil Larsen, PhD, RD, Child Health Nutrition Research Specialist, Pediatric Clinical Dietitian, NICU and PICU, Stollery Children’s Hospital, University Hospital, Edmonton, AB, Canada
Prevention of Necrotizing Enterocolitis (NEC) with Probiotics and Lactoferrin and “Other Controversies”: What is the Evidence?
David H. Adamkin, MD, Professor of Pediatrics, Director of Division of Neonatology, Rounsaval Endowed Chair of Neonatal Medicine, University of Louisville, Louisville, KY
MODERATOR
Walter J. Chwals, MD, FACS, FCCM, FAAP, Professor of Surgery and Pediatrics, Tufts University School of Medicine; Surgeon-in-Chief, Floating Hospital for Children; Director of Trauma, Division of Pediatric Surgery, Kiwanis Pediatric Trauma Institute, Boston, MA
Christina J. Valentine, MD, MS, RD, Assistant Professor and Neonatologist, Division of Neonatology, University of Cincinnati; Perinatal and Pulmonary Biology, Principal Investigator, The Center for Interdisciplinary Research in Human Milk and Lactation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
UAN: 0216-0000-13-005-L04-P
LEVEL: Basic/Intermediate
DESCRIPTION
This course will emphasize nutrition for the high risk infant in the neonatal intensive care unit (NICU) and provide attendees with strategies for targeting and optimizing growth in these infants.
LEARNING OBJECTIVES
- Prescribe adequate nutrients for the high risk preterm or intestinal-injured infant to improve growth
- Improve techniques to increase breastfeeding rates to improve health
- Understand how to document growth
FACULTY AND TOPICS
Enteral and Parenteral Nutrition of the Preterm Infant
Jackie Wessel, MEd, RD, CNSD, CSP, CLE, Neonatal Nutritionist, Department of Nutrition, Regional Center for Newborn Intensive Care, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
Breast is Best: Using Human Milk to Improve Outcomes for the Premature Infant
Amy Gates, RD, CSP, LD, Dietitian, Pediatric Neonatology, Medical College of Georgia, Augusta, GA
Update on the Nutritional Management of Infants with Injured Gut
Conrad Cole, MD, MPH, MSc, Associate Professor, Division of Gastroenterology, Hepatology and Nutrition; Medical Director, Intestinal Rehabilitation Program, Intestinal Care Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
The High Growth Velocity of Preterm Infants
Tanis Fenton, MHSc, PhD, RD, Epidemiologist, Faculty of Medicine, University of Calgary; Nutrition Research Lead, Nutrition Services, Alberta Health Services, Calgary, AB, Canada
MODERATOR
Walter J. Chwals, MD, FACS, FCCM, FAAP, Professor of Surgery and Pediatrics, Tufts University School of Medicine; Surgeon-in-Chief, Floating Hospital for Children; Director of Trauma, Division of Pediatric Surgery, Kiwanis Pediatric Trauma Institute, Boston, MA
Christina J. Valentine, MD, MS, RD, Assistant Professor and Neonatologist, Division of Neonatology, University of Cincinnati; Perinatal and Pulmonary Biology, Principal Investigator, The Center for Interdisciplinary Research in Human Milk and Lactation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
UAN: 0216-0000-13-006-L04-P
LEVEL: Basic/Intermediate