Acute Respiratory Failure

ARF & MV learning pathway

ECLS/ECMO pathway

Free live webinars are available for members & non members on the ESICM Media Library.

APRONET

APRONET is a ONE-day prevalence study initiated by the ESICM Acute Respiratory Failure Section (ARF), which will be repeated four times during a one year period. It is a multicentre observational prospective study with no patient follow-up. Prone position is used in almost 14% of severe ARDS patients according to the results of the LUNG-SAFE study. This rate is rather low given the results of the most recent trial that showed a beneficial effect of proning on patient outcome, a finding which is in line with previous meta-analyses. The reasons why the use of proning is still limited are unclear.

WEAN SAFE

WorldwidE AssessmeNt of Separation of pAtients From ventilatory assistancE is a multi-centre, prospective, observational, 4-week inception cohort study being carried out by the Acute Respiratory Failure section of ESICM. Weaning represents a challenge for intensivists and patients spend a considerable amount of time in being liberated from mechanical ventilation. While guidelines do exist on the classification of weaning, a recent study has shown that these may not be applicable to all patients.

SUPERNOVA

A Strategy of UltraProtective lung ventilation With Extracorporeal CO2 Removal for New-Onset moderate to seVere ARDS. It was a pilot trial; a feasibility and safety trial This study will assess changes in pH/ PaO2 /PaCO2, Respiratory Rate and device CO2 clearance in the first 24 hours of ECCO2R following VT and plateau pressure reduction in patients with moderate ARDS. Safety variables during treatment will also be analysed.

LUNG SAFE

Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE is a multicentre, prospective, observational, 4-week inception cohort study, which has been carried out by the Acute Respiratory Failure section through the ESICM Trials Group. The study aimed to prospectively assess the burden of, management and therapeutic approaches to, and outcomes from acute hypoxaemic respiratory failure requiring ventilatory support, with a specific focus on ARDS as defined by the Berlin Definition.

PROJECT GROUPS
 – ECMO Project Group: Michael Quintel
To examine the indications for extracorporeal technologies [ECMO. Extracorporeal CO2 removal, etc]

– Pneumonia Project Group: Head Maria Deja

Train ECMO

TrainECMO Survey on packed red blood cells transfusion practice in vv-Ecmo patients. Mortality associated with Acute Respiratory Distress Syndrome (ARDS) remains high, despite continual improvement in mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Technical simplifications, and its use during the 2009 H1N1 influenza pandemic, prompted a sharp increase in the use of ECMO worldwide.

Publication: Martucci et al. Hemoglobin trigger and approach to red blood cell transfusions during veno-venous extracorporeal membrane oxygenation: the international TRAIN-ECMO survey

Greendyk et al. Gattinoni’s Legacy: Personalizing ARDS Management Through Physiology
Review work Gattinoni – 2025

Robba et al. Ventilation practices in acute brain injured patients and association with outcomes: the VENTIBRAIN multicenter observational study.
Original – 2025

Tuinman et al. How we use ultrasound in the management of weaning from mechanical ventilation.
Review – 2025

Stadlbauer et al. Management of high-risk acute pulmonary embolism: an emulated target trial analysis.
Original – 2025

Azoulay et al. Outcomes in immunocompromised patients with acute hypoxemic respiratory failure treated by high-flow nasal oxygen.
Original – 2025

Mongodi et al. How we use critical care ultrasound in the management of ventilatory settings in ARDS patients.
Review – 2025

Duan et al. Low versus high positive end expiratory pressure in noninvasive ventilation for hypoxemic respiratory failure: a multicenter randomized controlled trial.
Original – 2025

Pettenuzzo et al. Prone positioning during veno-venous extracorporeal membrane oxygenation: a systematic review and meta-analysis.
Review – 2025

Frat et al. Noninvasive respiratory supports in ICU.
Review – 2025

Combes et al. Extracorporeal life support for adult patients with ARDS.
Review – 2025

Futier et al. Personalized driving pressure-guided positive end-expiratory pressure in patients at risk of postoperative respiratory failure (IMPROVE-2): a multicenter, pragmatic, randomized clinical trial.
Original – 2025

Thille et al. Characteristics of ventilator weaning in patients intubated for Guillain–Barré syndrome or myasthenia gravis: a nationwide multicenter study
Review – 2025

DYSPNEA
Demoue et al. Dyspnoea in acutely ill mechanically ventilated adult patients: an ERS/ESICM statement.
Feb 2024.