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8thINDONESIAN PICU NICU Update

FINAL ANNOUNCEMENT

PRE SYMPOSIUM WORKSHOPS Tuesday, 19 April 2016• BasicMechanicalVentilationinNewbornInfants

Wednesday-Thursday, 20-21 April 2016• SepsisManagementinPediatric:Update&Integrated Approach• Fluid&HemodynamicManagementinSevereDengueInfection

Wednesday, 20 April 2016• TrilogyofChallengesinImprovingLongTermOutcomeofPretermInfants

• AdvancedModesofMechanicalVentilatorinChildren

Thursday, 21 April 2016• IntegratedCourseofNon-InvasiveVentilationinCriticallyillNeonatesandChildren

8th INDONESIAN PICU NICU UPDATE & EXHIBITIONFriday - Saturday, 22 – 23 April 2016

POST-SYMPOSIUM WORKSHOPSunday, 24 April 2016AnIntroductionCourseonGeneralMovementsMethod:EarlyDetectionofNewbornInfantsatHighRiskforDevelopmentalDisorder

INDONESIAN PEDIATRIC CRITICAL CARE FOUNDATION

CALL FOR PAPERABSTRACT SUBMISSION DEADLINE 15 FEBRUARY 2016

PEDIATRIC EMERGENCY AND INTENSIVE CARE WORKING GROUP – INDONESIAN PEDIATRIC SOCIETY (UKK ERIA – IDAI)

In Collaboration With

INDONESIAN PEDIATRIC SOCIETY – WEST JAVA BRANCH

Endorsed By

proudlypresentandorganized,

The Trans Luxury Hotel Bandung

19, 20-21, 22-23, 24 April 2016

“Fighting Infection in Early Life &

Optimizing Long Term Developmental

Outcome”

withthetheme

CABANG JAWA BARAT

UKK ERIA

WELCOME MESSAGEDear Colleagues,

Over the last few decades, the challenges faced by survivors at the early childhood are discussed and their treatments have a direct impact on the developing brain and on the quality of life of these children and their families. In the 8th Indonesian PICU NICU Update 22 – 23 April 2016 with the theme this year; “Fighting Infection in Early Life & Optimizing Long Term Developmental Outcomes”, we present an outline for understanding systemic interactions among the multiple factors that influence the child’s development over time and take into account contextual variables through the conceptual of trilogy: fighting infection, adequate nutrition and brain monitoring, linking the developmental challenges associated with each and strategies for optimizing cognitive available to meet these challenges. The 8th Indonesian PICU NICU Update will be packed with innovative workshops in pre-settings on 19, 20-21 April 2016 and post-setting on 24 April 2016 at The Trans Luxury Hotel Bandung.

Organized by Indonesian Pediatric Critical Care Foundation - in collaboration with Pediatric Emergency and Intensive Care (ERIA) Working Group/Indonesian Pediatric Society, and with the endorsement of Indonesian Pediatric Society – West Java Branch, the annually Indonesian PICU NICU Update has been continuously kept Its work force to share Its leading clinical and management practice innovations in the field of pediatric and neonates critical care to its growing members. In Bandung as the venue place, a melting pot of art-deco cultures and wide variety culinary, the combination of beauty of Paris van Java is something you should not missed. We have prepared an exciting two days schedule for you to fully load up on the latest information on neonatal and pediatric critical care with the expertise of leading national and international figures.

The 8th Indonesian PICU NICU Update is the perfect opportunity to promote the art and science of pediatric and neonatal intensive care, raising awareness amongst doctors and other allied healthcare professionals in the field. We aim to provide plenty of opportunities to interact and networking with each other.

We hope to see you again in “Paris van Java” this 2016!

Abdul Latief, dr, SpA K President of the Indonesian Pediatric Critical Care FoundationINDONESIAN PEDIATRIC CRITICAL CARE FOUNDATION

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MANAGEMENT COMMITTEETo achieve learning excellence, The Indonesian Pediatric Critical Care Foundation (Yayasan Pediatri Gawat Darurat Indonesia) resources and expertises are set to make comprehensive range of educational needs

FOUNDERAbdul Latief

Antonius H. PudjiadiDadang Hudaya Somasetia

Darlan DarwisDzulfikar Djalil Lukmanul Hakim

H. Munar Lubis Novik Budi Wardhana

Silvia TriratnaSusetyo Harry Purwanto

CO-CHAIRYani Akhyar Kasim

Darlan Darwis

TRUSTEESusetyo Harry Purwanto

Dadang Hudaya SomasetiaSilvia Triratna

PRESIDENTAbdul Latief

VICE-PRESIDENTAntonius H. Pudjiadi

TREASUREREva Miranda Marwali

MEMBERSChairul YoelDzulfikar Djalil Lukmanul HakimNovik Budi WardhanaRirie Fachrina MalisieIrene YuniarRismala DewiNurnaningsihRinawati RohsiswatmoRisma Kerina KabanLily RundjanRosalina Dewi Roeslani STRATEGIC TEAMAbdul LatiefAntonius H. PudjiadiRirie Fachrina MalisieRinawati RohsiswatmoLily Rundjan

GENERAL INFORMATION

Event

The 8th INDONESIAN PICU-NICU UPDATE

Theme

“Fighting Infection in Early Life & Optimizing Long Term Developmental Outcomes”

Place

The Trans Luxury Hotel - Bandung

Organized By

Indonesian Pediatric Critical Care Foundation

Audience

• Specialists in Neonates Intensivist • Pediatric Intensivist;

Pediatric Respiralogy; Pediatric Hematology; Pediatric

Infectious Diseases; Pediatric Neurology; Pediatric

Nutrition & Metabolism; Pediatric Gastroenterology;

Pediatric Immunology; Pediatric Cardiology • Pediatric

Surgery • Pediatric Anesthesiologists

• Trainee

• ICU and Emergency Doctors

• General Practitioners

• Critical Care Nurses

PRE SYMPOSIUM WORKSHOPS

Tuesday, 19 April 2016Basic Mechanical Ventilation in Newborn Infants

Wednesday-Thursday, 20-21 April 2016- Sepsis Management in Pediatric: Update & Integrated

Approach- Fluid & Hemodynamic Management in Severe Dengue

Infection

Wednesday, 20 April 2016- Trilogy of Challenges in Improving Long Term

Outcome of Preterm Infants- Advanced Modes of Mechanical Ventilator in Children

Thursday, 21 April 2016- Integrated Course of Non-Invasive Ventilation in Criti-

cally ill Neonates and Children

8th INDONESIAN PICU NICU UPDATE & EXHIBITIONFriday - Saturday, 22 – 23 April 2016

POST-SYMPOSIUM WORKSHOPSunday, 24 April 2016An Introduction Course on General Movements Method: Early Detection of Newborn Infants at High Risk for Devel-opmental Disorder

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Registration Secretariat & Mailing AddressIndonesian Pediatric Critical Care Foundation has cho-sen a cooperate organizer, who will ensure a smooth and efficient management of the scientific exhibition, hotel accommodation, registration management and other pro-grams linked to the 8th Indonesian PICU NICU Update.For any further information about these services, do not hesitate to contact the Secretariat & Mailing Address:

c/o. Global Echo Organizer convexEmail : [email protected] : www.geoconvex.comRegistration & Accommodation: Office Hours : 021.3149318 – 3149319 Mobile : 0811.882080 Fax : 021.3153392

ExhibitionThe 8th Indonesian PICU NICU Update will host a scientific exhibition on 22 – 23 April 2016 including the latest tech-nology, equipment for clinical management & research and literature.

Pre and Post Symposium WorkshopsTo emphasize the importance of this essential part of its 8th Indonesian PICU-NICU Update will organize intractable two full days, which consist of scientific lectures, case stud-ies and/or hands-on special design courses, as its pre-sym-posium workshop programs. The program will be held on Tuesday - Thursday, 19 – 21 April 2016 (for Physicians only). Also Post setting on 24 April 2016. See detail schedule.

Call For Papers Participants are invited to submit Free Paper not later than 15 February 2016. The eligible presenters must be regis-tered as Participant. Free Paper Committee will select the eligible Abstract to be presented as Poster Presentation on 22 & 23 April 2016.

Official LanguageThe official languages of the 8th Indonesian PICU NICU Update is in English & Indonesian. English will be used for all printed materials, presentation along with overseas speakers and discussions. Simultaneous translation will not be provided.

DisclaimerEvery attempt will be made to present the program as printed. However, Organizers and its agent reserve the right to alter or cancel, without prior notice, any of the arrangements, time tables, plans or other items relating di-rectly or indirectly to the Scientific Meeting, for any cause beyond its reasonable control. In the event of cancellation of the Scientific Meeting, all pre-paid fees will be refunded in full. The Organizers and its agent are not liable for any loss or inconvenience caused as a result of such alteration and cancellation.

PRE SYMPOSIUM WORKSHOPS Pre Symposium Workshops, conducted by experts of Pediatric and Neonates will update participants on the current state-of-art on developing participants’ skill and technique in management of Pediatric & Neonates critically ill patients.

Certificate with IDI & CPD IDAI Accreditations (for General Practitioners and Pediatricians) will be issued for all registrants.

Each workshop participants is limited to 60 upon payment made.In the case that payment made after full seats, the registration made will be returned to its payer bank account.

AGENDAPRE SYMPOSIUM WORKSHOPS SYMPOSIUM &

EXHIBITIONPOST

SYMPOSIUM WORKSHOPS

Tuesday 19 April’16

Wednesday 20 April’16

Thursday 21 April’16

Friday 22 April’16

Saturday 23 April’16 Sunday, 24 April 2016

Basic Mechanical Ventilation in

Newborn Infants

Trilogy of Challenges in Improving Long Term Outcome of Preterm

Infants*

Integrated Course of Non-Invasive

Ventilation in Critically ill Neonates

& Children***

The 8th Indonesian PICU NICU Update & Exhibition

An Introduction Course on General Movements Method: Early Detection of Newborn Infants at High Risk for

Developmental Disorder

Advanced Modes of Mechanical Ventilator in

Children**

Sepsis Management in Pediatric: Update & Integrated Approach

Day 1

Sepsis Management in Pediatric: Update & Integrated Approach

Day 2

Fluid & Hemodynamic Management in Severe Dengue Infection Day 1

Fluid & Hemodynamic Management in Severe Dengue Infection Day 2

* Priority Registrants of Regular Course March 2016 Edition** Compulsory Registrants after Basic Mechanical Ventilation in Critically ill Children Period 2011-2016*** Compulsory Registrants after Trilogy of Challenges in Improving Long Term Outcome of Preterm Infants & Advanced Modes of Mechanical Ventilator in Children

ALL WORKSHOP PARTICIPANTS ARE COMPULSORY REGISTRANTS FOR 8th INDONESIAN PICU NICU UPATE 22-23 APRIL 2016

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ONE DAY TUESDAY, 19 APRIL 2016

08.00 - 08.15 Opening

08.15 - 08.45 Basic Principles of Mechanical Ventilation

08.45 - 09.15 Ventilator Modes and Wave Forms

09.15 - 09.45 Initial Setting and Adjusting

09.45 - 10.15 Coffee Break

10.15 - 10.45 Monitoring of Babies on Ventilatory Support

10.45 - 11.15 Weaning Strategies

11.15 - 11.45 Volume Guarantee

11.45 - 13.00 Lunch

13.00 - 13.30 Blood Gas Analysis

13.30 - 14.00 Nursing Care of Ventilated Babies and Troubleshooting


14.30 - 16.45

Divided in to 3 groups @ 45 MinutesVolume GuaranteeInterpretation of Wave FormsInitial Setting and Adjusting

16.45 - 17.15 Summary

BASIC MECHANICAL VENTILATION IN NEWBORN INFANTS

Instructor TeamTeam Perinatology - Cipto Mangunkusumo National General Central Hospital

TUESDAY, 19 APRIL 2016Grand Ballroom 3, The Trans Luxury Hotel Bandung

Course DirectorLily Rundjan

PROGRAM

TRILOGY OF CHALLENGES IN IMPROVING LONG TERM OUTCOME OF PRETERM INFANTSWEDNESDAY, 20 APRIL 2016Grand Ballroom 3, The Trans Luxury Hotel Bandung

Compulsory RequirementThe participant of the Trilogy of Challenges in Improving Long Term Outcome of Sick Neonates Workshop is strongly recommended to pre-join the Regular Course March 2016 Edition (NICU Field Workshops). The participant names upon date base will be verified and prioritized accordingly. Participants, whose are interested in joining the Regular Course March 2016 Edition may visit http://picunicu.org/updated-regular-courses-schedule/ for the running schedule in PICNIC ACADEMIA Regular Course program.

Course DirectorLily Rundjan

PROGRAM

ONE DAY WEDNESDAY, 20 APRIL 2016 INSTRUCTOR

08.00 - 08.15 Introduction

08.15 - 08.45 Nutritional Needs of Preterm Infants to Achieve Optimal Growth and Development Virgilio P. Carnielli (Italy)

08.45 - 09.15 Prevention of Brain Injury Frank Bel (Netherlands)

09.15 - 09.45 Strategies to Achieve Zero CRBSI Gomez Joseph Manuel (Singapore)


10.15 - 10.45 Feeding SGA Infants Virgilio P. Carnielli (Italy)

10.45 - 11.15 Brain Monitoring with NIRS and Amplitude EEG Frank Bel (Netherlands)

11.15 - 11.45 A Systematic Approach to Antibiotics Selection in Neonatal Unit Gomez Joseph Manuel (Singapore)

11.45 - 12.15 Therapeutic Hypothermia in HIE Infants: Is It Too Complicated Frank Bel (Netherlands)

12.15 - 12.45 Closed Vascular Access System Implementation in Reducing Bloodstream Infection Rate in Low Birth Weight Preterm Infants Lily Rundjan (Jakarta)

12.45 - 13.30LunchHands-on Workshop[Participants are divided into 4 Groups @ 60 minutes Rotation]

13.30 - 14.30 Workshop: Application of NIRS, Cooling in HIE Frank Bel (Netherlands) & Lily Rundjan (Jakarta)

14.30 - 15.30 Workshop: Nutritional Care Virgilio P. Carnielli (Italy) & Rina Rohsiswatmo (Jakarta)

16.00 - 17.00 Workshop: Infection Control (Management of Outbreak in Neonatal Unit)

Gomez Joseph Manuel (Singapore) & Adhi Teguh (Jakarta)

(15.30 - 16.00) Coffee Break

17.00 - 17.15 Course Wrap and Evaluation 6

WEDNESDAY, 20 APRIL 2016Grand Ballroom 2, The Trans Luxury Hotel Bandung

Compulsory RequirementThe participant of the Advances Modes of Mechanical Venti-lation in Children must have been passed the Basic Mechan-ical Ventilation in Pediatric Workshop during 2011-2016. The participant names upon date base 2011-2016 will be verified accordingly.

Participants, whose are interested in joining this Advances Modes of Mechanical Ventilation in Children Workshop may participate the Basic Mechanical Ventilation in Pediatric Workshop previously in PICNIC ACADEMIA Regular Course

program running. Please visit http://picunicu.org/basic-me-chanical-ventilation-in-pediatric-workshop/ for the running schedule.

Learning ObjectiveThis workshop is specially prepared for the practitioners of pediatric intensive care unit, who has the sufficient knowl-edge about the basic mechanical ventilation. This workshop will extend in advances understanding and learning about ventilator settings and modes to optimize the difficult cases in critically ill children.

Course DirectorRirie F. Malisie

ONE DAY WEDNESDAY, 20 APRIL 2016


08.15 - 08.45 Pre-Test

Overview

08.45 - 09.15 Close-loop Ventilation

09.15 - 10.00 AsynchronyW

10.00 - 10.15 Discussion

10.15 - 11.00 Coffee BreakNew Modes in Mechanical Ventilation

11.00 - 11.45 Dual Modes BIPAP & Pressure Regulated Volume Control

11.45 - 12.15 Pressure Support Ventilation & Proportional Assist Ventilation


12.30 - 13.30 Lunch

13.30 - 16.30

Hands-on Workshop [Participants are divided into 6 Groups @ 35 minutes Rotation]Proportional Pressure Support (PPS) & Volume Guaranteed (VG)Volume Target Pressure Control & Support (VTPC/VTPS)Adaptive Support Ventilation (ASV)Pressure Controlled Volume Regulated (PCV-VG)Pressure Regulated Volume Control (PRVC)Volume Ventilation Plus for Weaning (PAV+)


17.15 - 17.45 Post-Test

17.45 - 18.00 Course Wrap and Evaluation

Instructor TeamAbdul Latief (Jakarta)

Antonius H. Pudjiadi (Jakarta)G. Dharma Mulyo (Jakarta)

Irene Yuniar (Jakarta)Ririe Fachrina Malisie (Pekan-

baru)Sri Martuti (Solo)

Yusrina Istianti (Semarang)Saptadi Yuliarto (Malang)

ADVANCES MODES OF MECHANICAL VENTILATION IN CHILDREN

PROGRAM

Learning ObjectiveTo enhance the updated knowledge and practical guidelines in the integrated management of sepsis in children includ-ed the understanding sepsis pathophysiology in children, the International standard for pediatrics sepsis & Surviving Sepsis Campaign as well as the Early Goals Directed Therapy for pediatric sepsis implementations. After completing the workshop, registrants are expected to understand the difference between hemodynamic in chil-dren and adult, and the capability to manage hemodynamic in pediatric sepsis, to choose appropriate early antibiotics in pediatric sepsis, diagnosis and manage the coagulation in children with sepsis and giving the protective ventilation strategy in children with sepsis. Registrants are also expected to be able to give the nutritional and metabolic support in children with sepsis, sedation and analgesia in children with sepsis, assess the severity and mortality prediction in septic children and use the computerize system to do the register upon pediatric sepsis management guidelines

Course DirectorAbdul Latief

SEPSIS MANAGEMENT IN PEDIATRIC: UPDATE & INTEGRATED APPROACH WORKSHOP

DAY 2 THURSDAY, 21 APRIL 2016 GROUP DISCUSSION

[Participants are divided into 4 Groups @ 45 minutes Rotation]

08.00 - 08.45 Sedative and Analgesic

08.45 - 09.30 Coagulation Problems


10.10 - 10.55 Pediatric Logistic Organ Dysfunction Score

10.55 - 11.40 Nutritional Support

11.40 - 13.30 Lunch & Friday Pray

13.30 - 14.30 Program Based Sepsis Management

14.30 - 15.00 Post Test


15.40 - 15.55 Course Wrap & Evaluation

DAY 1 WEDNESDAY, 20 APRIL 2016


08.15 - 08.45 Pre-Test

08.45 - 09.30 The Surviving Sepsis Campaign

09.30 - 10.15 Pediatric Sepsis Definition


10.30 - 11.10 Coffee BreakGROUP DISCUSSION[Participants are divided into 4 Groups @ 50 minutes Rotation]

11.10 - 12.00 Early Goal Directed Therapy

12.00 - 13.00 Lunch

13.00 - 13.50 Fighting Infections

13.50 - 14.40 Protective Ventilation Strategy

14.40 - 15.30 Glucose Control


WEDNESDAY - THURSDAY, 20 - 21 APRIL 2016Grand Ballroom 3, The Trans Luxury Hotel Bandung

Instructor TeamAbdul Latief (Jakarta) ; Dadang Hudaya (Bandung) ; M. Supriatna (Semarang) ; Nurnaningsih (Jogjakarta)

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Earlier ScheduleParticipants, whose are interested in Fluid & Hemodynamic Monitoring in Shock Dengue in earlier schedule may join the Regular Course March 2016 Edition and visit http://picunicu.org/updated-regular-courses-schedule/ for the running schedule in PICNIC ACADEMIA Regular Course program.

Learning Objective- To understand the shock dengue in Indonesia- Diagnose and general management of shock dengue

- Basic intravenous fluid therapy in children- Pato physiology and clinical shock dengue in children- Hemodynamic assessment with ultrasonography- Assessment and management of shock dengue in chil-

dren in the case of bleeding and transfusion- Diagnose and management electrolyte, acid base bal-

anced in shock dengue- Encephalopathy dengue

Course DirectorAntonius H. Pudjiadi

DAY 2 THURSDAY, 21 APRIL 2016 - INTERACTIVE DISCUSSION

08.00-08.35 Management of Bleeding

08.35-09.10 Diagnosis and Management of Electrolyte/Acid-base Imbalance

09.10-09.45 Dengue Encephalopathy

09.45-10.15 Coffee/Tea Break

10.15 - 12.15 COMPREHENSIVE SKILL STATION


12.15 - 13.00 Lunch

13.00 - 15.00 COMPREHENSIVE SKILL STATION - CONTINUED


15.00 - 15.30 Coffee/Tea Break

15.30-15.45 CASE DISCUSSION (with Keypads)

15.45-16.00 Course Wrap & Evaluation

DAY 1 WEDNESDAY, 20 APRIL 2016


08.15 - 08.35 Pre-Test -INTERACTIVE DISCUSSION

08.35 - 09.10 Current Situation of Dengue Infection in Indonesia

09.10 - 09.45 Diagnosis and Management of Dengue Hemorrhagic Fever

09.45 - 10.20 Intravenous Fluid Management in Children

10.20 - 10.50 Coffee/Tea Break - INTERACTIVE DISCUSSION

10.50 - 11.25 Pathophysiology of Shock in Children

11.25 - 12.00 Noninvasive in Hemodynamic Assessment

12.00 - 12.35 Management of Dengue Shock in Children

12.35 - 13.15 Lunch

13.15 - 16.00 SKILL STATION [Participants are divided into 3 Groups @ 60 minutes Rotation]1. Diagnosis of dengue infection2. Non-invasive hemodynamic assessment3. Dengue Shock Management

15.30-15.45 CASE DISCUSSION (with Keypads)

15.45-16.00 Course Wrap & Evaluation Instructor TeamAbdul Latief (Jakarta)Antonius H. Pudjiadi (Jakarta)Irene Yuniar (Jakarta)Mulya Rahma Karyanti (Jakarta)

FLUID & HEMODYNAMIC MANAGEMENT IN SEVERE DENGUE INFECTION

WEDNESDAY - THURSDAY, 20 - 21 APRIL 2016Board Room, The Trans Luxury Hotel Bandung

Compulsory RequirementThe participant of the Integrated Non-Invasive Ventilation in Critically ill Neonates and Children is compulsory to register for Trilogy of Challenges in Improving Long Term Outcome of Preterm Infants & Advanced Modes of Mechanical Ventila-tor in Children.

Course DirectorLily Rundjan and Ririe F. Malisie

ONE DAY THURSDAY, 21 APRIL 2016 INSTRUCTOR

08.00 - 08.15 Introduction Ririe Fachrina Malisie (Pekanbaru)

08.15 - 08.45 Optimizing Non-Invasive Respiratory Support in Neonate

Risma K. Kaban (Jakarta)

08.45 - 09.30 The Role of Non-Invasive Ventilation in Acute and Chronic Pediatric Disease

Marti Pons-Odena (Spain)



10.25 - 10.55 The Role of Bi-Level CPAP in the Management of Preterm Infants

Giovanni Vento (Italy)

10.55 - 11.25 Nasal High Flow versus NCPAP Peter Davis (Australia)

11.25 - 11.55 How To Begin and Synchronization During NIV in Children?



12.10 - 13.40 Lunch

13.40 - 16.10 Dry Workshop:

Nasal HFO as A New Modality Giovanni Vento (Italy)

Non-Invasive Positive Pressure Ventilation (NIPPV) Peter Davis (Australia)

Non-Invasive Ventilation - Neurally Adjusted Ventilatory Assist (NIV-NAVA)



16.50 - 17.20 Course Wrap and Evaluation Ririe Fachrina Malisie (Pekanbaru) & Lily Rundjan (Jakarta)

INTEGRATED COURSE OF NON-INVASIVE VENTILATION IN CRITICALLY ILL NEONATES AND CHILDRENTHURSDAY, 21 APRIL 2016Grand Ballroom 2, The Trans Luxury Hotel Bandung

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SCIENTIFIC PROGRAM TRANS CONVENTION CENTER 1

08.00 - 08.30 Grand Opening - KEYNOTE LECTURE - Chairperson: Abdul Latief (Jakarta)

08.30 - 09.00 Revisiting the Algoritm of Haemodynamic Management in Pediatric Septic Shock - Antonius H. Pudjiadi (Jakarta)

09.00 - 09.30 Advances and Controversies in Parenteral Nutrition of Preterm Infants - Virgilio P. Carnielli (Italy)

09.30 - 10.00 Asynchrony Management with Non-Invasive Ventilation - Marti Pons-Odena (Spain)


Trans Grand Ballroom 2-3PEDIATRIC ICU -FLUID THERAPY UPDATE - Chairperson: Hari Kushartono (Surabaya)

Trans Convention Center 1NEONATAL ICU - NEONATAL NUTRITION UPDATE - Chairperson: Sjarif Hidajat Effendi (Bandung)

10.40 - 11.00 Rehydration Therapy with Balanced Solution for Children with Diarrhea - Arina Setyaningtyas B.Pudjo (Surabaya) Optimal Nutritional Update in Limited Resources - Rinawati Rohsiswatmo (Jakarta)

11.00 - 11.20 Small Volume Resuscitation in Shock Dengue - Dadang Hudaya Somasetia (Bandung) Feeding the Small for Gestational Age Infant is a Challenge - Virgilio P. Carnielli (Italy)

11.20 - 11.30 Discussion Discussion

11.30 - 13.00 Lunch & Friday Pray PEDIATRIC INFECTION UPDATE - Chairperson: Munar Lubis (Medan)

NEONATAL BRAIN MONITORING - Chairperson: Rinawati Rohsiswatmo (Jakarta)

13.00 - 13.20 Invasive Fungal Infection in Critically ill Children - Ririe F. Malisie (Pekanbaru) Multimodal Brain Monitoring with NIRS and Amplitude EEG - Frank Bel (Netherlands)

13.20 - 13.40 Blood Level IL-6 Indicate the Post-operative Infection in Mayor Surgery in Children - Albert Daniel Solang (Manado) The Role of Head Ultrasound for Neonatologists - Evita B. Irfan (Jakarta)

13.40 - 14.00 How to Minimize the Central-Line-Association Blood Stream Infection in PICU? - Rismala Dewi (Jakarta) Therapeutic Hypothermia in HIE Infants : Is It Too Complicated ? - Frank Bel (Netherlands)

14.00 - 14.20 Combating the Antibiotic Resistance in PICU - Irene Yuniar (Jakarta) An Affordable and Accurate Point of Care to Prevent Acute Bilirubin Encephalopathy and Kernicterus in Indonesia - Lily Rundjan (Jkt)


14.40 - 15.10 Coffee/Tea BreakCOMPREHENSIVE MANAGEMENT APPROACH IN PICU - Chairperson: Ari Lukas Runtunuwu (Manado) NEONATAL INFECTION UPDATE - Chairperson: Rulina Suradi (Jakarta)

15.10 - 15.30 Inadequate Enteral Protein Intake is Associated with Mortality in Critically ill Children - Yusrina Istanti (Semarang) Strategies for the Prevention of Healthcare - Associated Infection - Lily Rundjan (Jakarta)

15.30 - 15.50 Early Detection in Acute Kidney Injury in Critically Ill Children - Partini Pudjiastuti Trihono (Jakarta) Newborn Skin Care to Prevent Infection - Triana Agustin (Jakarta)

15.50 - 16.10 Patient-Centered Care in Pediatric Intensive Care Unit Setting - Johnny Nurman (Jakarta) Management of Outbreak in Neonatal Unit - Gomez Joseph Manuel (Singapore)


YOUNG INVESTIGATOR - Chairperson: M. Supriatna TS (Semarang) YOUNG INVESTIGATOR - Chairperson: Aris Primadi (Bandung) FREE PAPER - POSTER SESSION - Chairpersons:

16.25 - 16.40 Early Goals Directed Therapy is Associated with Increase Respiratory Morbidity and Mortality Desy Rusmawatiningtyas (Jogjakarta)

Changes of Bronchopulmonal Dysplasia Incidence, Biomarkers of Oxidative Stress, Permeability and Microbiota of the Intestines Due To the Role of Oxygen in Resuscitation of Premature Babies Risma K. Kaban (Jakarta)

Rismala Dewi (Jakarta) Sri Martuti (Solo) Rosalina Roeslani (Jakarta) Tetty Yuniati (Bandung)16.40 - 16.55 Increasing of the Red blood cell Distribution Width (RDW) is Correlated With the Severity of Pediatric Sepsis

Gemma Nazri Yanni (Medan)Correlation of Hand Hygiene Compliance to Blood Stream Infection Rate in Neonatal Unit Cipto Mangunkusumo HospitalMustarim (Jakarta)

16.55 - 17.10 Validity of Stroke Volume Variation by Using Non-Invasive Cardiac Out put Monitoring in Hypovolemic Chidren I Nyoman Budi Hartawan (Denpasar)

Effectiveness of Continuous Positive Airway Pressure vs Nasal Intermittent Positive Pressure in Respiratory Distress of Newborn Babies Thomas Harry Adoe (Bekasi)


DAY 1 FRIDAY, 22 APRIL 2016

TRANS CONVENTION CENTER 1

KEYNOTE LECTURE - Chairperson: Abdul Rachman Sukadi (Bandung)

08.00 - 08.30 What Matters in the Long Term of NICU Graduates? - Bernie Endyarni (Jakarta)

08.30 - 09.00 Minimally Invasive Surfactant Therapy (MIST) - Peter Davis (Australia)

09.00 - 09.30 The Role of Driving Pressure in Non-Injured Lung: How Low Should We Go?Ririe F. Malisie (Pekanbaru)

09.30 - 10.00 Longterm Cognitive Development After Sepsis in Early AgeAhmad Suryawan (Surabaya)


Trans Grand Ballroom 2-3 PEDIATRIC ICU - NEW ISSUES IN PEDIATRIC SEPSISChairperson: Antonius H. Pudjiadi (Jakarta)

Trans Convention Center 1NEONATAL ICU -NEONATAL ENTERAL & PARENTERAL NUTRITION UPDATE Chairperson: Risma K. Kaban (Jakarta)

10.40 - 11.00 Serial Blood Lactate Level as a Prognostic Factor of Sepsis MortalityNurnaningsih (Yogyakarta)

Human Milk Fortified for ELBWRinawati Rohsiswatmo (Jakarta)

11.00 - 11.20 Inotropes and Other Vasoactive Agents in Pediatric Septic Shock: What is New?Saptadi Yuliarto (Malang)

Probiotics of Very Preterm InfantsVirgilio P. Carnielli (Italy)

11.20 - 11.40 National Guideline and Clinical Practice: Sepsis Diagnostic & Management in Pediatric - Abdul Latief (Jakarta)

Facilitating Breastfeeding and Kangaroo Mother Care in the NICU : Identifying Barriers - Rosalina Roeslani (Jakarta)


11.55 - 13.00 Lunch

PEDIATRIC VENTILATION UPDATE - Chairperson: Ririe F Malisie (Pekanbaru)

NEONATAL RESPIRATORY UPDATEChairperson: Lily Rundjan (Jakarta)

13.00 - 13.20 Non-Invasive Home Ventilation in Children, Are They Useful?Marti Pons-Odena (Spain)

Optimizing Non-Invasive Respiratory Support in NICURisma Kerina Kaban (Jakarta)

13.20 - 13.40 Ethical Aspect of Withdarawal Ventilatory SupportedChairul Yoel (Medan)

Nasal HFOV as a New Modality Giovanni Vento (Italy)

13.40 - 14.00 Probiotics Prevents Ventilator-Associated PneumoniaDzulfikar Djalil (Bandung)

High Flow Nasal Cannulae vs Nasal CPAP vs NIPPV : Which One Is Superior? - Peter Davis (Australia)


PRO-CON - Chairpersons: G.Dharma Mulyo & Rina Rohsiswatmo (Jakarta)Invasive versus Non-Invasive Mechanical Ventilator

14.15 - 14.30 Invasive: Antonius H. Pudjiadi (Jakarta)

14.30 - 15.00 Non-Invasive: Marti Pons-Odena (Spain)

15.00 - 15.20 Pro and Con - HFOV As A Primary Or Secondary Mode

15.20 - 15.35 Primary Mode: Giovanni Vento (Italy)

15.35 - 15.50 Secondary Mode: Peter Davis (Australia)

15.50 - 16.20 Pro and Con

16.20 - 16.40 Closing Remark


SCIENTIFIC PROGRAMDAY 2 SATURDAY, 23 APRIL 2016

SUNDAY, 24 APRIL 2016Grand Ballroom 2, The Trans Luxury Hotel Bandung

Learning ObjectiveDetection of children with a developmental disorder at an early age is notoriously difficult. Recently, a form of assess-ment in newborn infants was developed based on the quality of general movements (GMs). The quality of GMs at 2 to 4 months post-term has been found to have the highest predictive value for developmental disorders implies an indication for early intervention. During the course participants will learn how to assess general movements ofpreterm and term infants. The Training Course will consist of lectures and self-practice sessions during which video recordings of general movements of preterm and term infants will be analyzed.

Course DirectorAhmad Suryawan (Surabaya)

ONE DAY SUNDAY, 24 APRIL 2016 INSTRUCTOR08.00 - 08.10 Introduction

LECTURE SESSIONAbdul Latief (Jakarta)

08.10 - 08.40 Overview of General Movements (Pre-Test) Ahmad Suryawan (Surabaya)

08.40 - 09.00 Newborn Infants - Who Are at Risk for Developmental Disorders? Setya Wandita (Yogyakarta)

09.00 - 09.20 Developmental Assessment Tools for Preterm Infants Eddy Fadlyana (Bandung)

09.20 - 10.00 GMs Method - An Introduction and Practical Issues Ahmad Suryawan (Surabaya)



PRACTICAL SESSION Ahmad Suryawan (Surabaya)

10.35 - 11.05 Practical 1: GMs - Preterm

11.05 - 11.35 Practical 2: GMs - Writhing

11.35 - 12.05 Practical 3: GMs - Fidgety

12.05 - 13.00 Lunch

LECTURE SESSION

13.00 - 13.30 GMs Method - Clinical Significances and Validity Ahmad Suryawan (Surabaya)

PRACTICAL SESSION

13.30 - 14.00 Practical 4: Compilation Exercise (Post-Test) Ahmad Suryawan (Surabaya)

14.00 - 15.00 Practical 5: Analyzing the Test (Panel Discussion) Ahmad Suryawan (Surabaya)Setya Wandita (Yogyakarta)Eddy Fadlyana (Bandung)

15.00 - 15.15 Course Wrap and Evaluation

15.15 - 15.30 Afternoon Coffee Break

POST SYMPOSIUM WORKSHOPAN INTRODUCTION COURSE ON GENERAL MOVEMENTS METHOD : EARLY DETECTION OF NEWBORN INFANTS AT HIGH RISK FOR DEVELOPMENTAL DISORDER

PROGRAM

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CALL FOR PAPERTo emphasize the scientific value of 8th Indonesian PICU NICU Update which will be held on 22-23 April 2016 at Trans Luxury Hotel Bandung, the Organizing herewith cordially invites the pediatricians and physicians the Call for Paper.

Participants are invited to submit Abstracts for Poster Pre-sentations not later than 15 February 2016. The presenta-tions of research studies related to Neonatal and Pediatric Emergency & Intensive Care.

SUBMISSION CLOSING DEADLINE: 15 FEBRUARY 2016FORMALITY

Free Paper Presenters need to complete the Registration formalities before submitting Free Paper Abstract. Abstracts will not be processed until the registration fee have been received and acknowledged. Abstract submis-sion via email to [email protected]

GENERAL REGULATION No abstracts will be considered after the closing dead-

line. Abstracts must be typed in English Abstracts are submitted by online with file attachment.

Fax or mail will not be accepted or acknowledged. Presenting author of abstract must be registered

as participant. Registration payment must be firstly completed through web on-line registration before you proceeded for abstract submission on-line. Registration must be received by the Secretariat before the an-nounced deadline to ensure inclusion of the abstract in the meeting publications and in order to be scheduled for presentation.

Abstract must be original and must not be or have been published or presented at any other meeting prior to this meeting.

As condition of submission, Organizing Committee requires you to agree to such publication and to sur-render any copyright over the abstract s submitted to Secretariat

Other special request other than above procedures shall be submitted in written through email: [email protected]

ABSTRACT PREPARATIONPlease prepare the following information:

Abstract Title – limited 20 words in UPPER CASE Author and co-author names – with the first mentioned

and underline for presenting author Full name shall be written by first name and followed

by family name Authors’ names must be in upper and lower case (J.J.C.

Londa) Affiliation details: department, institution/hospital, city,

state (if relevant), country Abstract text – limited to 250 words, including ac-

knowledgements It should consist of five paragraphs, clearly stated/la-

beled in UPPER CASE:o Backgroundo Objectiveo Methodso Resultso Conclusions.

They should briefly describe, respectively, the problem and aim being addressed in the study, how the study was performed, the salient result, and what the authors conclude from the results.

Avoid using non standard abbreviations, unfamiliar terms, symbols, or acronyms not easily understood by the general readers

Use generic names of drugs. Express numbers as nu-merals.

Tables – A Maximum of 3 Tables of up to 10 rows x 10 columns can be included per abstract

Graph and images – It is important to note that each image included in the abstract is worth 30 words. A maximum of 3 images can be included per abstract. The maximum pixel size of the graph/image is 600(w) x 800(h) pixel.

You may upload the file using word-processing soft-ware (e.g. Word) for editing your abstract and counting the number of words. The words count is affected as graphs/tables/images are included.

FREE PAPERWITHDRAWAL / CHANGES

Revised abstract is allowed for one time only and should be clearly stated as the subject of email and received by 15 February 2016 to be final review by the Free Paper Committee.

Withdrawal/changes will not be possible after the above mentioned date.

ABSTRACT ACKNOWLEDGEMENT Submission of abstract will be acknowledged by email

reply to each nominated email address at the latest before closing deadline.

Submitted abstracts will be reviewed by the Free Paper Committee after 15 February 2016. The coordinator will review the abstracts to be allocated in poster upon cat-egory, quality, clarity, and relevance for the audience, as well as the significances of the paper.

Notification will be emailed to nominated email ad-dress at the latest 2 weeks working days after closing deadline along with the detail, including Poster View-ing Session schedule, and instructions.

The Poster Panel provided for later Poster Presentation is in the vertical size 90 X 150 cm (Portrait)

PUBLICATION Abstracts accepted Poster Presentations will appear

in the official Program Book with ISSN. In order for abstract to be published, the presenter must fulfill appropriate Registration Fee in term of administrative purpose.

The Organizing Committee has a right reserve to edit the format of abstract due to the printing task for publi-cation in terms of uniformity purpose.

WONDER OF BANDUNG CITY AND THE TRANS LUXURY HOTEL

Bandung, capital of West Java, is a great place to visit any time of the year as it’s not only renowned for its pictur-esque open vista, but the town also offers many attrac-tions well worth a visit.

Surrounded by green fertile mountains, Bandung today is Indonesia’s center for learning and creativity. Here is the wellknown, Institut Tekonologi Bandung (ITB) estab-lished since 1920, the university that has produced many of Indonesia’s top scientists from engineers, geologists to leaders in business management. Today Bandung is one of Indonesia’s most prestigeous university towns. Bandung is also the center of Indonesia’s burgeoning ICT technolo-gy, at the same time it is a center of arts and artists. Every weekend and long holidays the city is filled with young people from Jakarta who flock to Bandung to enjoy its youthful creative atmosphere in music, painting, fashion, and the culinary arts.

While along the present Jalan Juanda, then known as Dago Boulevard, were the houses of the elite with their green lawns and flower gardens fronting opulent homes. In those colonial heydays in the early 20th century, Bandung became known as “Parijs van Java”, or the Paris of Java, where Dutch planters and ladies paraded and flaunted their wealth and beauty along the boulevards and Braga-weg, then the Champs Elysees of the East.

Standing some 768 m above sea level, Bandung is today the country’s third largest city after Jakarta and Surabaya. Since the opening of the Cipularang Toll road, which cuts down travel from Jakarta to two hours from the previous four hours over the tortuous Puncak Pass, Bandung has become the favorite weekend getaway to relax and escape from the hectic pace of metropolitan Jakarta.

For Bandung offers trendy fashion wear at reasonable pric-es at its myriad factory outlets, a wide range of delicious local and international cuisines, and a distinct colonial European-style atmosphere combined with captivating traditional arts.

FREE PAPER WELCOME TO PARIS VAN JAVA

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HOW TO GET THE REGISTRATION FORM1. From our website:

Download the PDF file of the updated “Announcement” by logged into http://www.geoconvex.com/upcom-ing-event/ and click further to mentioned related event.

Find the last pages of Announcement to print the Registration Form for fax purpose. You may also save the soft copy in your personal PC for your perusal and further use.

2. From our secretariat address:You may get the soft/hard copy of Announcement to be delivered to your nominated email/ home address by sending the request to [email protected] or SMS to +62811882080

HOW TO REGISTER

REGISTRATION ON-LINEIt’s easy as 1-2-3-4:1. Log into http://geoconvex.biz2. You have to create your User ID and password when you Log-In3. Complete the required fields to next proceed.4. Keep your Registration ID for your further reference (e.g. Free Paper Submission).

GROUP REGISTRATIONFor company or institution who would like to make Group Registration and Accommodation Bookings may commu-nicate directly to our registration department at [email protected] for further collective group handling.

REGISTRATION OFF-LINE(Recommended for Domestic Participants Only)1. Fax the Registration Form to +62213153392 or Email to

[email protected] along with proof of payment (e.g. copy of bank transfer slip).

2. Payment Proof is strongly recommended to be done along with your Registration Form submission. Photo-copied forms are acceptable.

3. You may bring your payment proof as foreseen at the Re-Registration counter. Essentially, the name tag issued is an initial confirmation of registrants.

REGISTRATION CONFIRMATION- On-Line Registered Participant will receive Registration

Notification, followed by Registration Receipt after the payment has been effectively cashed in to our Event Bank Account.

- Off-Line Registered Participants are strongly suggested to make Re-Confirmation due to incoming facsimiles/Email and/or payment made to our Registration De-partment, hotline numbers at office hours.

CANCELLATION AND REFUND POLICYREGISTRATIONNotification of Registration cancellation for scientific sym-posium must be made in writing or emailed to the Sec-retariat. Registration Fee is refundable with the following cancellation policy:

One month before event – 50% refund of Fee paid On and After the date – No refund No Show registration cannot be refunded.

ACCOMMODATION Hotel room rate is net for room only. Please note that official check-in time is 14.00 local

time and check-out time is 12.00 local time. Approval of early check-in and late check-out is at discretion of the hotel.

No reservation will be made without full deposit of nights booking due to room availability.

v Any changes and cancellations regarding to room reservation in pre-registration period must be done in writing to the Secretariat at least 168 hours prior to arrival. After the date, guaranteed payment for 1 night will be charged.

No Show will be applied on the first night for delayed or postpone staying that causes the loss of 1 night room deposit made.

In the event of materialization, the hotel will charge the full amount duration of stay upon check-out that causes the loss of mentioned deposit made.

Refund may only be made after the event by bank transfer. Official letter should be submitted to Secretari-at address mentioning its payer’s Bank Account.

REGISTRATION & ACCOMMODATION

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PAYMENT METHOD

A. BANK TRANFERBank transfer is strongly recommended rather than any other payment method. Bank Transfer should be paid to this Event Bank Account:

Bank Name : CIMB NiagaBranch : Kemang BranchAddress : Jalan Kemang Raya No. 4, Jakarta SelatanNo. Account : 253-0100.219005Acc.Holder : GEO convex

Bank remittance must be paid by registrant, otherwise the registration receipt or badge will not be issued due to the less payment.

B. CASH TO SECRETARIAT ADDRESSCash can be paid directly to the Secretariat Address. Cash payment is ONLY valid for domestic participant.

C. ON SITE PAYMENT Please indicate your “On Site Payment” remark on the

Registration Form. On site payment is only valid for conference registration, not eligible for workshops or room bookings.

On site payment with Bank Notes IDR, shall be brought upon arrival.

The Bank Draft is to be made payable to “GEO convex” and to be drawn on Indonesia Bank.

Payment by Credit Card with EDC Machine will only be provided at the venue hotel by signing your personal authorization and the Credit Card transaction charges will be applied based on venue hotel’s regulation. The Organizing Committee holds no responsibility for any exchange rates applied by the Credit Card vendor when the statement converted into local currency.

Please acknowledge that Organizing Committee reserve the right not to guarantee any on-site registrant obtain its complete Symposium Kits that therefore we strongly encourage to make an urge early Registration.

Payment by Credit Card with EDC Machine will only be pro-vided at the venue hotel by signing your authorization and the Credit Card transaction charges will be applied based on venue hotel’s regulation. The Organizing Committee holds no responsibility for any exchange rates applied by the Credit Card vendor when the statement converted into local currency.

REGISTRATION FEE INCLUDE Name Badge & Symposium Kit.

Name Badge MUST BE worn entering to all scientific sessions and lunch/break programmed by the Organiz-ing Committee.

Symposium documents (Proceeding Book with ISSN) and materials

Admission to the function room, lunch programmed and scientific exposure from Pharmaceutical and Health-Care Companies.

Certificate of Attendance with IDI Accreditation & CPD IDAI will be issued for eligible participants at the last day of the Symposium.

RE-REGISTRATION SERVICEThe Re-Registration will be handed out to the participants from registration counters during the opening hours at 07.00 – 12.00 during the event dates.

ON SITE REGISTRATIONApplicants that not registered in event Registration List will be treated as New Registrants and will have to register on-site, for which only payment by Cash or Credit Card are accepted.

REGISTRATION & ACCOMMODATION

19

PARTICIPANT (Kindly completed)Full Name & Title :____________________________________________________________________________________Institution :____________________________________________________________________________________Home Address :____________________________________________________________________________________City / Post Code :____________________________________________________________________________________Phone (Mobile) :_______________________ Fax : __________________________________________________________Email :____________________________________________________________________________________

SPONSOR (Kindly completed if any)Full Name & Position :____________________________________________________________________________________Company / City :____________________________________________________________________________________Phone (Mobile) :________________________Fax : _________________________________________________________Email :____________________________________________________________________________________

PRE & POST SYMPOSIUM WORKSHOP REGISTRATION &PACKAGE (kindly √ appropriate circle/box)

PHYSICIANS WORKSHOPS APRIL 2016WORK-

SHOP ONLYPRIORITY PARTICIPANT

WITH SYMPOSIUMOTHER PARTICIPANTS WITH

SYMPOSIUM Basic Mechanical Ventilation in Newborn Infants 19 2.000.000

Trilogy of Challenges in Improving Long Term Outcome of Preterm Infants 20, 22-23 - SPECIALISTS 4.000.000 SPECIALISTS 4.500.000

GP / FELLOW 3.750.000 GP / FELLOW 4.250.000

Trilogy of Challenges in Improving Long Term Outcome of Preterm Infants & Integrated Non-Invasive Ventilation in Critically ill Neonates and Children

20-21,22-23 - SPECIALISTS 6.000.000 SPECIALISTS 6.500.000


Advanced Modes of Mechanical Ventilator in Children 20, 22-23 - SPECIALISTS 4.000.000 SPECIALISTS 4.500.000


Advanced Modes of Mechanical Ventilator in Children & Integrated Non-Inva-sive Ventilation in Critically ill Neonates and Children

20-21,22-23 - SPECIALISTS 6.000.000 SPECIALISTS 6.500.000


Sepsis Management in Pediatric: Updated & Integrated Approach 20-21, 22-23 - - - SPECIALISTS 5.500.000

GP / FELLOW 5.250.000

Fluid & Hemodynamic Management in Severe Dengue Infection 20-21, 22-23 - - - SPECIALISTS 5.250.000

GP / FELLOW 5.000.000

An Introduction Course on General Movements Method: Early Detection of Newborn Infants at High Risk for Developmental Disorder

24 2.000.000

Please note that this regulation will be applied accordingly: 1. Priority Participants are Registrants of Regular Course March 2016 Edition2. Advances Modes of MV on Children must have certified/passed the Basic MV

in Pediatrics Workshop (2011-2016)3. Integrated Non-Invasive Ventilation in Critically ill Neonates and Children

must have registered for Trilogy of Challenges in Improving Long Term Out-come of Preterm Infants & Advanced Modes of Mechanical Ventilator in

Children4. Certain Workshop Participants are compulsory as Registrants of 8th Indone-

sian PICU NICU Update 22-23 April 20165. Member of Indonesian Pediatric Critical Care Foundation entitles for 10% discount

PAYMENT BY (Kindly √ appropriate circle) BANK TRANSFER IN FULL AMOUNT TO

OFFICIAL BANK ACCOUNT Account Holder (Beneficiary) : GEO convexNo. Account : 253-01-00-219005Bank Name : CIMB NiagaBranch : Kemang BranchAddress : Jl. Kemang Raya No. 4, Jaksel

CASH TO SECRETARIAT ADDRESS ON SITE

Confirmation to:EX-OFFICIO SECRETARIATThe Indonesian Pediatric Critical Care FoundationC/O. Global Echo Organizer ConvexJl. Kebon Sirih Timur No. 4, Jakarta Pusat 10340Registration Hot Line : 021- 3149318/3149319/2305835Fax : 021- 3153392Mobile Hotline : 0811882080Email : [email protected]

REGISTRATION PACKAGE FORM

PARTICIPANT (Kindly completed)Full Name & Title :____________________________________________________________________________________Institution :____________________________________________________________________________________Home Address :____________________________________________________________________________________City / Post Code :____________________________________________________________________________________Phone (Mobile) :_______________________ Fax : __________________________________________________________Email :____________________________________________________________________________________

SPONSOR (Kindly completed if any)Full Name & Position :____________________________________________________________________________________Company / City :____________________________________________________________________________________Phone (Mobile) :________________________Fax : _________________________________________________________Email :____________________________________________________________________________________

SYMPOSIUM ONLY REGISTRATION (kindly √ appropriate circle/box)

8th INDONESIAN PICU NICU UPDATE 22-23 APRIL’16 BEFORE 01 MAR’16-IDR AFTER 01 MAR’16-IDR

Specialists 2.500.000 2.750.000

General Practitioners/Fellow 2.250.000 2.500.000

HOTEL RESERVATION THE TRANS LUXURY HOTEL BANDUNG RATE/ROOM ONLY/NIGHT-IDR

PremiereRate in Net/Room/Night– Single Basis, Include Max 2 Breakfast

2.125.000,- NET

Check In Date : ____ Total Night(s) : ___

Check Out Date : ___ Total Accommodation Payment : IDR ____

PAYMENT BY (Kindly √ appropriate circle)

BANK TRANSFER IN FULL AMOUNT TO

OFFICIAL BANK ACCOUNT Account Holder (Beneficiary) : GEO convexNo. Account : 253-01-00-219005Bank Name : CIMB NiagaBranch : Kemang BranchAddress : Jalan Kemang Raya No. 4, Jakarta Selatan

CASH TO SECRETARIAT ADDRESS

ON SITE

Confirmation to:

EX-OFFICIO SECRETARIATThe Indonesian Pediatric Critical Care FoundationC/O. Global Echo Organizer Convex

Jl. Kebon Sirih Timur No. 4, Jakarta Pusat 10340Registration Hot Line : 021- 3149318/3149319/2305835Fax : 021- 3153392Mobile Hotline : 0811882080Email : [email protected]

REGISTRATION & ACCOMMODATION FORM

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