Insights from the NUHCS Cardiac Critical Care Masterclass
PULSE Issue 45 | July 2025
The inaugural National University Heart Centre, Singapore (NUHCS) Cardiac Critical Care Masterclass held on 4–5 April 2025 brought together over 240 healthcare professionals for two days of intensive learning, hands-on training, and interdisciplinary collaboration. Attendees included specialists, intensivists, critical care nurses, allied health professionals, and medical officers, all with a shared goal: to elevate the standard of care for critically ill cardiac patients.
Led by Course Director Dr Anand Ambhore, Director, Coronary Care Unit, NUHCS, and Scientific Programme Chairman, Dr Lin Weiqin, Clinical Director, Heart Failure and Cardiomyopathy Programme, Department of Cardiology, NUHCS, the two-day masterclass delivered an immersive and impactful learning experience. Each session skillfully integrated clinical theory with practical, hands-on training and vibrant interdisciplinary dialogue. Participants left not only with deeper knowledge, but also the confidence and tools to apply it in delivering life-saving care on the ground.
The masterclass started with an intensive exploration of the most critical cardiac emergencies. This session armed participants with the skills and strategies to tackle high-risk cases including percutaneous coronary interventions1, life-threatening arrhythmias, pulmonary embolism2, and mechanical complications following acute myocardial infarction3. Through real-world case scenarios and interactive discussions, participants honed their critical decision-making abilities required to act swiftly and effectively during cardiac emergencies — setting a strong foundation for the rest of the programme.
Following up on the knowledge of cardiac emergencies, Session 2 delved into cardiogenic shock: a serious condition where the heart fails to pump enough blood to the body, which can be fatal. This session focused on the classification, diagnosis, and management of this life-threatening condition. Participants gained insights into the latest treatment approaches, ranging from non-invasive tools to advanced haemodynamic monitoring techniques.
Their key takeaway? Early intervention is critical. With the tools shared in this session, participants are now better equipped to diagnose with precision and respond more swiftly in critical situations.
Imagine being at the bedside of a patient in severe shock, their heart struggling to keep up with the body’s demands.
How can you help? In this session, experts offered essential guidance on selecting the right medical device for patients with cardiogenic shock. This provided participants with valuable insights into navigating advanced technologies such as Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) and Catheter-based Ventricular Assist Devices (cVADs). Additionally, the session provided tips on using echocardiography to monitor and manage patients on MCS — a skill increasingly vital in today’s cardiac Intensive Care Units (ICUs).
Acute cardiac conditions often lead to multi-organ complications, which require a broader approach to care beyond sole attention to the heart. Hence, this session discussed the interconnectedness of the body and the challenges of managing these complex conditions, including the ethics of medical futility and the challenge of managing difficult airways. Attendees also got to explore critical care nephrology and the nutritional needs of cardiac patients, offering them a holistic view of care within the CCU. This session emphasised that in critical care, collaboration across multiple disciplines is the key to better patient outcomes.
The Hands-On Sessions at the NUHCS Cardiac Critical Care Masterclass equipped participants with the confidence to act swiftly during cardiac emergencies, bringing practical skills to the forefront. Attendees engaged in immersive, small-group training focused on cVAD troubleshooting and VA-ECMO priming. The sessions offered an in-depth showcase of the key equipment and techniques used in cardiac critical care, providing participants with valuable insight into their function and application.
A session that focused on one of the most catastrophic cardiac crises – cardiac arrest. Participants explored the realities of out-of-hospital cardiac arrests4 in Singapore, alongside current practices in post-resuscitation care encompassing targeted temperature management, neuromonitoring and neuroprognostication5. With the spotlight on the evolving role of Extracorporeal Cardiopulmonary Resuscitation (E-CPR), this session covered cutting-edge techniques that rapidly reshapes the future of cardiac arrest.
Building on the previous session, this follow-up session deepened the focus on the multi-disciplinary framework with a focus on coagulation and bleeding disorders6, antibiotic stewardship in the cardiothoracic ICU, and drug dosing in extracorporeal circuits - all critical elements in the recovery of critically ill patients. The session also addressed the role of early mobilisation in cardiac intensive care, highlighting how integrated care can support faster recovery and reduce complications, and reinforcing the need for strong interconnected coordination in the CCU.
This dedicated session allowed NUHCS nurses to come together to share on the vital contributions of nurses in the management of critically ill cardiac patients. This session offered an in-depth look into nurse-led spontaneous breathing trials and extubations, key nursing considerations in managing patients on VA-ECMO, and providing specialised care for those supported by cVAD. This session also addressed the compassionate removal of mechanical ventilation in cardiac intensive care, underscoring the central role of nurses in both life-sustaining interventions and dignified end-of-life care.
The final session addressed the vital aspects of end-of-life care and the profound decision-making dilemmas around organ donation. Key speakers across coronary care, palliative care, anaesthesia and medical social work specialties concluded this masterclass with discussions on end-of-life and bereavement services. Sharing valuable information on brain death assessments and the ethical complexities of organ procurement - alongside practical approaches to support families through these emotionally charged decisions - participants ultimately learnt tips on promoting dignity in death and saving lives through organ donation. Crucially, participants developed a deeper appreciation of the compassion needed when making these difficult decisions.
Through a blend of case discussions, evidence-based guidelines, and hands-on demonstrations, this masterclass was an exceptional avenue for medical professionals to enhance their capacity in delivering exemplary care in high stakes emergencies – all in making a significant impact to the lives of cardiac critical care patients. Stay tuned for upcoming masterclass sessions as we continue to shape the future of cardiac care!
