Antimicrobial Stewardship

• Understanding the pro and con of antimicrobial use
• Identification of likely infection and empiric antimicrobial selection (incl. initial PK/PD)
• Role of diagnostics in identifying the microorganisms involved & resistance patterns
• The modification of antimicrobial therapy (microbiology, clinical evolution, drug-interactions, TDM)
• Importance of source control in infection management & how this contributes to AMS
• The importance of multi-professional teams 
• The importance of infection prevention and control
• How individual patient data contributes to surveillance, and feeds into decision making

Hemodynamics Cardiogenic shock and Septic shock

• Understand the pathophysiology and aetiologies of cardiogenic and septic shock
• Recognize clinical phenotypes of CS
• Recognize the causes of deterioration in CS
• Have in depth knowledge of the haemodynamic consequences of shock
• Physiology pre and postcapillary PHT
• Have in depth knowledge of the implications of fluids and vasoactive drugs
• Early start of norepi in case of severe hypotension
• Have an in-depth knowledge of inotropic Rx in CS
• Early fluid infusion (no need for preload responsiveness assessment)
• Have in depth knowledge of haemodynamic monitoring options
• Understand different modes of haemodynamic monitoring incl. their advantages and disadvantages
• Escalation of haemodynamic monitoring. Resident asks if he should insert a PAC or PiCCO
• Apply and analyse different methods for testing fluid responsiveness
• Effect of PPV on myocardial wall tension (MC)
• Understand the role of echocardiography in diagnosis and monitoring, differentiating focused vs advanced CCE
• Recognize the importance of time 'time is muscle'
• Understand the dilemma of sedation and intubation at ED without cathlab at hand
• Understand how positive pressure ventilation affects myocardial wall tension and myocardial oxygen consumption
• Understand the indications for mechanical circulatory support

Mechanical Ventilation

• How to assess the severity of a patient with acute respiratory failure
• How to choose the oxygenation support and to prepare intubation
• How to monitor the lung mechanics in a ARDS patient
• How to decide when using neuromuscular blocking agents and proning
• How to monitor the transition toward spontaneous breathing
• How to do weaning

Renal Replacement Therapies

• Initiation of RRT
• Discuss the individual components of prescription of RRT
• Discuss how to select the appropriate catheter
• Evaluate RRT troubleshooting
• Complications of citrate anticoagulation
• Demonstrate the benefits of a multi-disciplinary and collaborative approach

VV-ECMO

• To understand the indications and rationale for VV-ECMO support
• To understand the (patho)physiology of oxygen uptake during VV-ECMO support
• To be able to troubleshoot inadequate oxygenation during VV-ECMO support
• To understand the (patho)physiology of carbon dioxide removal during VV-ECMO support
• To be able to troubleshoot inadequate carbon dioxide removal during VV-ECMO support
• To understand the interaction of VV-ECMO with hemodynamics