COMPLETED PRojects: supported endorsed
Supported PROJECTS- ONGOING
COBATRICE-IT
Competency-based Training in Intensive Care Medicine in Europe – Innovation Transfer
Lead Investigator: Julian Bion
Project start date: November 2007 (24 months)
The CoBaTrICE project, funded by the Leonardo programme in 2003-6, successfully created an international competency-based programme for ICM and the objective of this second project is to ensure that this unique and innovative project is translated into more effective training and better patient care in member states, by supporting & harmonising national initiatives in vocational education & training.
More information can be found at www.cobatrice.org
GENOSEPT
Genetics of Sepsis in Europe
Lead Investigator: Frank Stueber
Project start date: January 2005 (48 months)
The fatal outcome following treatment for severe sepsis may be, in part, genetically determined.
GenOSept will test this hypothesis through three phases:
- A genetic epidemiologic study of genetic predisposition to sepsis related mortality and morbidity in European intensive care units.
- This unique European dataset on the effect of genetic variation on sepsis outcomes will help to explain variation in response to new treatments for sepsis and will deliver data on gender related mortality and morbidity.
- Harmonization of standards for European high throughput genotyping and quality control by co-ordinating three major European genotyping centres (Wellcome Trust Centre for Human Genetics - Oxford, Cochin Institute - Paris, GSF National Research Centre for Environment and Health - Munich).
Please consult the GenOSept website at www.genosept.eu
ICU NUTRITION DAY
Lead Investigator: Michael Hiesmayr
Project start date: March 2007 (24 months)
The specific aim of this project is to assess nutritional therapy in ICUs on a specific date in order to detect correlations between nutritional therapies and outcome based on a large European sample. Outcome includes length of stay and mortality in ICU and in hospital.
Project description
More information at www.nutritionday.org
IHPOTOTAM
Induced Hypothermia to treat Adult Meningitis
Lead Investigator: Bruno Mourvillier
Project start date: March 2007 (36 months)
The objective of this project is to evaluate the benefit of mild hypothermia versus no hypothermia on clinical outcome of adult patients hospitalised to ICU for severe community-acquired meningitis.
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Supported PROJECTS- COMPLETED
COBATRICE
Competency-based Training in Intensive Care Medicine in Europe
Lead Investigator: Julian Bion
Project start date: 2003 (36 months)
The CoBaTrICE project, which is now complete, created an international competency-based programme for Intensive Care Medicine thanks to an international partnership of professional organisations and critical care clinicians working together to harmonise training in intensive care medicine worldwide.
Publications: Intensive Care Medicine (2006): 32: 1371-83
Intensive Care Medicine (2007): 33: 1913-20
CORTICUS
Corticosteroid therapy of septic shock
Lead Investigator: Charlie Sprung
Project start date: October 2004 (36 months)
The objective of this project was to develop three tools that make diagnosis and treatment of septic shock more beneficial:
1. a Europe-wide diagnostic testing system;
2. diagnostic criteria for adrenal insufficiency;
3. recommendations for corticosteroid therapy in septic shock
Please consult the abstract which was presented at the 2006 Barcelona Congress or the article published on the 10th January 2008 in the New England Journal of Medicine
ECRF
Electronic case report
Lead Investigator: Julian Millo
Project start date: January 2005 (9 months)
This project merged with GenOSept, which developed an electronic-case report form (database) necessary to capture the patients’ clinical and demographic data.
ECRFs are accessible at www.genosept.eu
ELDICUS
Triage decision making for the elderly in European Intensive Care Units
Lead Investigator: Charlie Sprung
Project start date: May 2002 (48 months)
The objective of this project was to make triage decisions for the elderly in Europe more transparent, beneficial and fair, as well as more cost-effective, and to harmonize European standards.
IPOC
International Programme for Resource use in Critical Care
Lead Investigator: David Edbrooke
Project start date: 2002 (3 months)
The section has developed a programme which facilitates comparison between costs of Intensive Care Units in different countries.
Methods: This was an observational, retrospective, cross-sectional, multicentre study set in four European countries: France, UK, Germany and Hungary. A total of 329 adult intensive care units participated in the study.
Results: The costs are reported in international dollars ($) derived from the WHO PPP programme. The results show significant differences in resource use and costs of ICUs over the four countries. On the basis of the sum of the means for the major components, the average cost per patient day in UK hospitals was $1512, in French hospitals $934, in German hospitals $726 and in Hungarian hospitals $280. Conclusions:
The reasons for such differences are poorly understood but warrant further investigation. This information will allow to better adjust the measures of international ICU costs.
PRICE
Physical Restraints in Intensive Care in Europe
Lead Investigator: Julie Benbenishty
Project start date: November 2003 (2 days)
The purpose of this study was to gather exploratory data on the incidence of and the reasons for physical restraints in adult ICU’s in Europe.
For further information on the study findings, please refer to the abstract on Physical restraint use in European ICUs as disseminated as an oral presentation during the 2006 Barcelona Congress.
SAPS 3
From the evaluation of the individual patient to the evaluation of the ICU
Lead Investigator: Rui Moreno
Project start date: October 2002 (18 months)
The aim of the SAPS 3 project was to develop a multidimensional performance indicator, not only for the assessment of patients, but also to evaluate Intensive Care Units (ICUs) and their performance on several dimensions.
One of the major aims of the SAPS 3 project was to develop a system that could be used free of charge by all intensivists worldwide. Thanks to the creation of this new system, severity of illness and probability of hospital mortality can be calculated with the use of ICU admission data.
More information at www.saps3.org. Publications on this project are available from the website.
SEE & SEE 2
Sentinel Events Evaluation
Lead Investigator: Andreas Valentin
Project start date: January 2004 / January 2007 (24 hours)
SEE is a one-day cross-sectional international study on the prevalence of unintended events in intensive care.
The first SEE study has revealed that patient safety is an urgent issue in ICUs all over the world. In 205 participating ICUs 38 unintended events per 100 patient days were observed during the 24h study period. Medication errors occurred with considerable frequency.
Now a next step in the SEE project is focused on causes and measures of error prevention. SEE 2 study aims to determine the frequency, characteristics, and contributing factors of parenteral medication errors at the administration stage and to assess related preventive measures.
ENDORSED PROJECTS - COMPLETED
CALOR 2003
Severe heat stroke admitted to ICUs across Europe in August 2003: an observational survey
Lead Investigator: Djillali Annane
Project start date: October 2003 (2 months)
This survey aimed at investigating the number of patients admitted in ICUs for heat stroke across Europe between August 1st and August 20th, as well as determining the prognosis factors and the hospital mortality and morbidity.
This study resulted in a thesis which will soon be available from this webpage.
EPIC II
European Prevalence of Infection in Intensive Care II
Lead Investigator: Jean-Louis Vincent
Project start date: 8/05/2007 (1 day)
The impact of hospital infection is greatest in the intensive care unit and an effective response to the problem relies on the availability of up-to-date, adequate epidemiological data. The first EPIC study was performed on April 29, 1992, and allowed the collection of data from more than 10,000 patients in Western Europe.
On May 8, 2007, EPIC II was conducted to provide an updated epidemiological database on infection in the ICU, 15 years after the original EPIC.EPIC II was extended from Europe to the rest of the world and has been a substantial success with more than 2.000 ICUs participating and more than 10.000 patients registered. Such epidemiological information is vitally important in increasing and maintaining awareness of the impact of ICU infection, in developing local and international management policies for infection diagnosis and treatment, and in ensuring adequate resource allocation.
ETHICATT
Systematic Study of General Ethical Principles Involved in End of Life Decisions for Patients in European Intensive Care Units
Lead Investigator: Charlie Sprung
Project start date: March 2000 (42 months)
Intensive Care Units are an area where moral dilemmas occur daily. Great advances in science and technology are most evident in ICUs where the majority of lives are saved. Unfortunately, there are many ICU patients who remain comatose or in a dying state for weeks or even months due to sophisticated therapies and technologies. This is a major medical, ethical, legal and socio-economic challenge facing the European Union. The average citizen is terrified of spending his last days in an ICU hooked up to machines, losing control and in pain. This project will help solve some of these end of life challenges. The present project is a prospective study of the general ethical principles involved in end of life decisions for patients in European ICUs.
Click here to consult the abstract submitted to the 2005 Congress.
Publication in the ICM (Apr. 2007): 33(4):747
ETHICUS
End of life practices in European Intensive Care Units
Lead Investigator: Charlie Sprung
Project start date: August 2000 (36 months)
The aim of this project was to standardize definitions for foregoing life-support including withholding and withdrawing life sustaining treatments and end of life procedures, incl. euthanasia.
Click here to consult the abstract submitted to the 2005 Congress.
GLUCONTROL
Comparative effects of two glucose control regiments by insulin in ICU patients
Lead Investigator: Jean-Charles Preiser
Project start date: October 2004 (18 months)
This project, which is now over, aimed at defining whether a tight glucose control by insulin improved the vital outcome in a mixed population of critically ill patients.
The results have been submitted for publication and will soon be available on this webpage.
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ENDORSED PROJECTS - ONGOING
AKI-EPI
Acute Kidney Injury – Epidemiologic Prospective Investigation
Lead Investigator: Eric Hoste
Project start date: January 2008 (6 months)
The aim of the study is to evaluate the epidemiology and early management of acute kidney injury according to the RIFLE classification in ICU patients.
ASP-ICU
Aspergillus in Intensive Care Units
Lead Investigator: Stijn Blot
Project start date: November 2006 (60 months)
Recent data indicate that invasive aspergillosis must be considered as an emerging and devastating infectious disease in ICU patients even in the absence of an apparent predisposing immunodeficiency. The AspICU project is an international observational web-based survey that aims to collect a large series of ICU patients with either Aspergillus colonization or invasive disease, in order to:
- investigate the epidemiology of invasive aspergillosis in ICU patients, and
- to validate a diagnostic algorithm that discriminates colonization from invasive disease.
EU-VAP/CAP
Pneumonia in Patients requiring mechanical ventilation in European Intensive Care Units
Lead Investigator: Jordi Rello
Project start date: January 2006 (36 months)
The scientific literature is plenty of articles about the diagnosis and treatment of pneumonia in the ICU. However, the information concerning both the actual clinical practice and the reason for the implementation of such a practice is limited.
The EU-VAP/CAP is the first prospective, observational study that is specifically designed to look at the clinical management of pneumonia in the European ICUs (28 participating ICUs from 9 European countries). The aim of the study was to provide insight on the current status of CAP/HAP/VAP diagnosis, pathogenic organisms, and therapies in European ICUs, as well as the utilization of this information as a tool in the effort to improve outcomes.
More than 2500 patients have been recruited in the study and the interpretation of the collected data is ongoing. Preliminary results will be presented in the ATS 2008 International Conference and ESICM CONGRESS in Lisbon.
EVIDENCE
Evidence of Infection Prevention in Intensive Care Nurses’ Daily Practice
Lead Investigator: Stijn Blot
Project start date: November 2006 (72 months)
The EVIDENCE-study is a project that aims to evaluate intensive care nurses’ knowledge of evidence-based guidelines for prevention of ventilator-associated pneumonia (VAP), central venous catheter-related infection (CVC) and surgical site infection (SSI) on an international scale by submitting them to an anonymous knowledge test. Results of the knowledge tests will be analysed and used for implementation of targeted educational programmes. Eventually, a website-based e-learning platform, which is accessible for intensive care nurses all over the world, will be developed.
Project's website: http://www.vvizv.be/Pages/Evidence.php
GAINS
Genomic Advances in Sepsis
Lead Investigator: Charles Hinds
Project start date: January 2005 (36 months)
The project is aimed at identifying factors that determine the incidence and severity of, and the outcome from life-threatening infections (severe sepsis/septic shock) in patients admitted to High Dependency Units (HDUs) or Intensive Care Units (ICUs) with community acquired pneumonia (CAP) or with faecal peritonitis (FP). This will require the acquisition of a large, high quality resource of genetic material (DNA), plasma, urine, white blood cells and clinical information from well characterised groups of similar patients with, or at risk of, severe sepsis/septic shock. The principal objective is to perform studies that are sufficiently large to establish beyond doubt the influence of a series of selected “candidate” genes on the development, progress and outcome of sepsis.
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