ICU Discharge Practices Survey
The aim of this survey was to gain insight into the situation of ICU patient care transitions to the next lower level of care. The focus was on transfer practices from the ICU, stakeholders involved, transfer criteria, established processes and tools used, metrics related to ICU transfer processes, and barriers to timely and safe discharge to the next lower level of care.
Contact: Maike Hiller, PhD candidate, Erasmus MC University Medical Center, Dept. of Intensive Care Adults, Rotterdam (The Netherlands) m.hiller [at] erasmusmc.nl
Current Practice in the management of new-onset atrial fibrillation in critically ill patients – a international survey of intensivists. The primary objective of this survey was to observe variations in practice in the management of new onset atrial fibrillation in critically ill patients internationally. This survey focused on prevention of the arrhythmia, management in terms of rate/rhythm control, anticoagulation, and long-term follow up. The secondary objective was to gauge international interest in an atrial fibrillation platform trial and inform potential treatment arms of prevention, treatment, anticoagulation and long-term follow-up.
Contact: Stephanie Sibley, Queen’s University, Kingston, Ontario, Canada
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Intracranial pressure predictions (ICP) at the bedside: international expert survey that aimed to asses, the needs and clinical impact that ICP predictions may have on the therapeutic management of patients with Traumatic Brain Injury in the ICU.
Contact: Brenda Pörteners, University Maastricht (NL), brenda.poerteners [@] kuleuven.be and Prof. Dr. Geert Meyfroidt, Clinical division and laboratory of intensive care medicine, Department of Cellular and Molecular Medicine, KU Leuven (BE), geert.meyfroidt [@] kuleuven.be
Monitoring Respiratory Effort during Invasive mechanical ventilation: a multinational survey of the current clinical practice. The MoRE survey addressed an important gap in knowledge – understanding current ventilatory practices that determine clinician attitude and response to insufficient and excessive respiratory efforts in targeting lung and diaphragm protective ventilation.
Contact: Idunn Morris, University of Toronto Hospital, Canada at idunn.morris [@] uhn.ca
The aim of this project was to perform an international survey about practical issues (i.e. diagnosis, monitoring, prophylaxis and management) of cerebral vasospasm associated with delayed cerebral ischemia (DCI) in spontaneous subarachnoid haemorrhage (SAH) adult (> 18 years old) patients, requiring intensive care unit (ICU) admission.
Contact: Edoardo Picetti, Parma University Hospital, Parma, Italy at edoardopicetti [@] hotmail.com
This survey, initiated in the ESICM INF Section and endorsed by ESICM, aimed to describe the diagnostic approach to severe pneumonias (pneumonia requiring management in ICU), comparing and contrasting community acquired (CAP), hospital-acquired (HAP) and ventilator-associated pneumonia (VAP); it aimed to assess the availability and use of invasive vs non-invasive diagnostic techniques in CAP, HAP and VAP.
Contact: Andrew Conway Morris, University of Cambridge/Addenbrooke’s Hospital, UK at mozza [@] doctors.org.uk
Initiated in the ESICM SIS and MEN Sections, this survey aimed to understand the impact of the use of vitamin C as an adjunctive treatment for the inflamed critically ill patient, as well as for other critically ill patients (those with ARDS, severe pneumonia due to SARS-CoV-2).
Contact: Luis Chiscano-Camón MD, Vall d’Hebron University Hospital, Barcelona, Spain at lchiscano [@] vhebron.net
Initiated within the ESICM Sections Neurointensive Care and Cardiovascular Dynamics, the aim of this survey was to evaluate the clinical practice, hemodynamic targets, monitoring and management of patients with ischemic stroke, hemorrhagic stroke and subarachnoid hemorrhage.
Contact: Chiara Robba, MD, PhD, Anaesthesia and Intensive Care, Policlinico San Martino, Genova, Italy at kiarobba [at] gmail.com
Endorsed by ESICM and other societies, the European Sepsis Care Survey (ESCS)’s objective was to investigate the current state of sepsis care around Europe. The survey aimed at hospital structure, emergency departments, wards, intensive care units and clinical diagnostic and microbiological service.
Contact: Christian S Scheer, MD University Medicine Greifswald, Greifswald, Germany at Christian.Scheer [at] uni-greifswald.de
ESICM Family-Centered Care
The first Family-Centered Care survey of a series of ESICM surveys closed in April 2022. This study aims to describe ICU family-centered care practices. The questions concern your usual practices, excluding the pandemic period. The leads are: Elie Azoulay, Maurizio Cecconi, Nancy Kentish-Barnes.
Contact: Réanimation Médicale, Hôpital Saint-Louis, Université Paris VII, Paris, France, Elie Azoulay, MD, PhD elie.azoulay [at] sls.aphp.fr
Survey on the Administration of Systemic Corticosteroids among Critically-Ill Patients with Covid-19.
Contact: Dept. Anaesthesiology & Intensive Care Medicine, University Hospital Brno, Czechia, Jan Maláska MD, PhD, EDIC jan.malaska [at] gmail.com
Renal replacement therapy modalities in intensive care units in 2021: An international survey describing practices and their explanatory factors. The objective was to determine factors influencing the choice of RRT modality among the intensive care units and to describe RRT epidemiology in ICUs.
Contact: Dept Anesthésie-Réanimation, Hôpital Edourard Herriot-Hospices Civils de Lyon,Lyon, France,Thomas Rimmelé, thomas.rimmele [at] chu-lyon.fr
The objective of the international survey on Headaches in Subarachnoid Haemorrage – How do you treat them was to characterize practice patterns and identify variability in treating headaches in spontaneous subarachnoid hemorrhage.
This survey may inform further inquiries into practice patterns by group and may contribute to future standardization of certain aspects of treatment in this complex patient population.
Contact: Neurocritical Care, Department of Neurology,University of Florida College of Medicine,University of Florida, Gainesville, FL USA: Katharina M. Busl, Katharina.Busl [at] neurology.ufl.edu
The International Survey on Antibiotic Dosing and Monitoring in Adult Intensive Care Units, aimed to survey a large cross-section of clinicians working in ICUs worldwide to describe contemporary practices in dosing, administration and monitoring of commonly prescribed antibiotics including beta-lactams, aminoglycosides and glycopeptides?
Contact: Paul Willliams MD, PhD (Sunshine Coast University Hospital, Birtinya, QSLD, Australia). paul.williams3 [at] uqconnect.edu.au
Diagnostic, monitoring and rehabilitation strategies in patients with intensive care Uni-Acquired Weakness was a survey aimed at informed about the different screening and diagnostic practices regarding ICUAW. It aimed to enable discussion about the responsibilities in the interprofessional team. Furthermore, it might detect educational needs on the topic on national or ICU characteristic level. The results will also enable to know which screening and diagnostic approaches can be expected for a multinational multicentric study on the topic without adding additional workload on the ICU or research team because it is standard of care.
Contact: Stefan.Schaller [at] charite.de (MD, PhD, Universitätsmedizin Berlin, Germany)
Survey of Practices and Physician Attitudes on Post-Cardiac Arrest Care.The purpose of this survey was to analyze current practices and attitudes regarding post-cardiac arrest care, specifically targeted temperature management (TTM) and coronary reperfusion strategies. The team aimed at investigating practice patterns among a transdisciplinary group of clinicians, with the ultimate objective of identifying possible heterogeneity of practices, and the perception of these practices, on key components of care that warrant future prospective studiesrisbane,
Contact: Div. Critical Care, Dept Emergency Medicine, University of Florida, Gainsville, USA, Casey Carr MD PhD CCarr [at] anest.ufl.edu
This survey endorsed by ESICM and initiated by the ESICM Peri-Operative Intensive Care Section (POIC) aimed at providing an inside about the true prevalence of bedside echocardiography. By doing so, it will give valuable information on how to shape the speciality and accreditation programme in the future.
Contact: Ib.Jammer [at] else-bergen.no (MD, PhD, Haukeland University Hospital, Bergen, Norway)
This survey endorsed by ESICM aimed at describing the organisation of information and visiting policies for relatives of ICU patients and the services available to support them in the COVID pandemic times..
Contact: Alexis Tabah alexis [@] tabah.org (MD, PhD (Redcliffe ICU, MNHHS, Brisbane, Australia)
Publication: Tabah A et al, Journal of Critical Care 71 (2022) 154050. https://doi.org/10.1016/j.jcrc.2020.06.005
COMPASSIONATE CARE IN THE ICU
This survey endorsed by ESICM aimed at understanding what physicians consider as compassionate care, what are the background factors affecting this in the ICU and whether they consider certain actions as compassionate care or not. It was developed by expert opinions of leaders in the field of social psychology, compassion and empathy, critical care and medical ethics.
Contact: S. Siddiqui (Harvard University, USA), C Hartog (2019-2022 Chair ESICM Ethics Section), A.Kleinman, Harvard University, USA), B. Lown (Harvard University, USA), M.Nurok (SCCM, Anesthesia Section), M.Cobas (SCCM, Anesthesia Section), B.Subramaniam (Harvard University, USA), R.Gillon (Imperial College, UK).
AMI Survey – A worlwide survey to assess the management of patients with mesenteric ischaemia & infarction
This survey was an initiative of ESPN – The European Society for Clinical Nutrition and Metabolism and has been endorsed by ESICM and the ESICM MEN Section.
Published in Clin Nutrition ESPEN 54 (2023) 194-205. DOI: https://doi.org/10.1016/j.clnesp.2022.12.022.
Training programmes might differ among countries and proper training should be based on what is defined by national training bodies. The survey aimed at gaining a better understanding of the adoption of competency-based training programmes in intensive care medicine. And overall, it aimed at guiding the future strategy for improving CoBatrICE.
This survey has been endorsed by the Research Committee and the CoBa-Faculty (CoBaTrICE Steering Committee) of the European Society of Intensive Care Medicine.
Steering committee: Alvaro Castellanos (Spain), Hans Ulrich Rothen (Switzerland), Frantisek Duska (Czech Republic), Sharon Einav (Israel)
McMaster University Covid-19 Survey
Mcmaster issued a survey to learn more about practice during COVID-19 wth a potential for inclusion in the guidelines.
In preparation for the Surviving Sepsis Campaign COVD-19 clinical practice guidelines update, a survey has been prepared on geographic, time and specialty-related practice variation in the management of critically ill COVID-19 patients. Severe COVID-19 is defined as requiring admission to the intensive care unit (ICU) or to another high dependency unit. The survey had two parts – one concerning mostly with medication use (coviddrug), and the other with ventilation and oxygenation strategies (covidvent).
The Hamilton Integrated Research Ethics Board had reviewed and approved this research study on June 25th, 2020. All survey data and study information is kept on file for 10 years after the end of the study period, after which it will be deleted.
This survey has been endorsed by ESICM – the European Society of Intensive Care Medicine and ESCMID ESGCIP and the Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI). It has been approved as a quality assurance activity by the Human Research Ethics Committee, Royal Brisbane and Women’s Hospital, Australia. Contact Waleed Alhazzani
Personal Protective Equipment and healthcare worker Safety in the COVID-19 Era (The PPE-SAFE survey)
The aim was to describe availability and use of PPE by healthcare workers (HCW) caring for COVID-19 patients who require intensive care unit (ICU) treatment worldwide and variations within and between countries.
This survey has been endorsed by ESICM – the European Society of Intensive Care Medicine and ESCMID ESGCIP and the Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI). It has been approved as a quality assurance activity by the Human Research Ethics Committee, Royal Brisbane and Women’s Hospital, Australia.
The results have been published in the J Crit Care. 2020 Oct;59:70-75. doi: 10.1016/j.jcrc.2020.06.005. Epub 2020 Jun 13.
ESICM SURVEY ABOUT SEVERE COVID-19 MANAGEMENT (SUR-COVID)
The objective of this survey was to document the prevalence of mental health problems in intensivists facing the COVID-19 outbreak. Symptoms of severe anxiety and depression (Hospital Anxiety, and Depression Scale) were collected. Factors independently associated with mental health problems were assessed using Cox model.
Publication: Azoulay, E., De Waele, J., Ferrer, R. et al. Symptoms of burnout in intensive care unit specialists facing the COVID-19 outbreak. Ann. Intensive Care 10, 110 (2020). https://doi.org/10.1186/s13613-020-00722-3
International survey regarding Used Definitions, Incidence, Current Treatment Strategies and Perceived Outcomes of Hypotension in Intensive Care Patients (HYPOTENSION)
The aim of this Survey was to form a baseline on these topics. Besides the results of this Survey are expected to improve future guidelines, patient care and guide new topics for research. The Steering Committeee was composed of Pr Jan Bakker, Pr Thomas Scheeren and Pr Alexander Vlaar. This Survey was endorsed by the ESICM Research Committeee and the ESICM CD Section.
Neurosedation survey: Sedation Management in Patients with Severe Traumatic Brain Injury Survey
Over-sedation in the ICU has profound consequences including delayed mobilization, prolonged mechanical ventilation, longer lengths of stay, and long-term cognitive impairment. However, the optimal approach to sedate neurocritically ill patients, and more specifically TBI, is unknown. The potential for secondary cerebral injury has driven clinical protocols aiming to decrease brain oxygen consumption and intracranial pressure with high doses of sedatives. Given the long-term cognitive morbidity of TBI and lack of randomized controlled trials, it is important to better understand sedation management in this population.
The goal of this research study was to understand the current practices employed by clinicians when sedating patients with severe traumatic brain injury in the Intensive Care Unit.
The survey was endorsed by ESICM (European Society of Intensive Care Medicine), ESICM NIC Section and NCS (Neurocritical Care Society)
Coordinator: Dr. V. McCredie
Current Practice of High Flow Nasal Cannula and Transnasal Aerosol Delivery in Adult Intensive Care Units: An International Survey
High-flow nasal cannula (HFNC) delivers oxygen at a warmed humidified flow with high velocity, and it has become a broadly utilized modality of oxygen therapy in adult patients. Randomized control trials and meta-analyses have demonstrated benefits. However, the actual utilization such as indication, flow setting, temperature setting, weaning, is still unknown. For patients who need aerosol therapy during HFNC treatment, the optimal route to deliver aerosol is still controversial.
The results of the survey aimed at understanding the global practice of HFNC, which ultimately will guide future studies in HFNC treatment.
This survey was a research project, approved by the ethical committee in multiple countries (China, France, USA, Taiwan)
Lead by Dr Stephan Ehrmann. Steering Committee: Jie Li, MS, James B Fink, PhD, Lixing Xie, MD, Yuan Xu, MD, Zongan Liang, MD, Meilien Tu, MS, Thomas Piraino, RRT.
Indications and intensive care management of patients with acute ischemic stroke (STRIKE Survey)
An increasing proportion of patients with severe stroke require admission to an intensive care unit (ICU) for neurological monitoring and management of post-stroke complications. Because of the rapid and irreversible nature of ischemic brain injury, the best goal-directed therapies must begin as early as possible.
However, there is a lack of consensus regarding the recommended general management of the patients, starting from the locally agreed ICU admission criteria and therapeutic strategies. This survey has been developed to gain insight into the current clinical practice, ICU admission criteria, and management of acute ischemic stroke (AIS) patients.
The aim of this survey was to gain insight into the current clinical practice, ICU admission criteria, and management of acute ischemic stroke (AIS) patients.
Steering Committee: Dr Chiara Robba, Prof Giuseppe Citerio, Prof Martin Smith
Results were presented by Chiara Robba at the Hot Topics Session at ESICM Lives 2020 (update 9 Dec. 2020)
Transfusion practice on the intensive care unit (ICU) in patients with active bleeding; an international online survey -The TRACE2 survey
The ESICM Transfusion Guideline Task force is currently preparing the first international transfusion guideline specifically for bleeding adults in the intensive care setting. In succession if the TRACE-1 survey where we studied transfusion practice in none-bleeding patients, we now aim to examine transfusion practice in the actively bleeding critically ill patients. As there is no international guideline on this subject yet, we hypothesize a great heterogeneity in the use of blood products.
Steering Committee: Prof. Jan Bakker, Prof. Thomas Scheeren, Dr. Alexander Vlaar, Drs. Sanne de Bruin
Current Practice of infectious disease management in the ICU – International survey (PRACT-INF-ICU Survey)
Infection affects half of the ICU patients while antimicrobials are prescribed to about 70% of them. It is recommended to start antimicrobial early and appropriately to improve outcome. However, overuse is leading to a widespread resistance. To tackle the problem, stewardship programs are increasingly implemented but the heterogeneity managing infectious diseases in the ICU remains a main obstacle. Many specialties are sharing in the decision-making with poorly defined roles and responsibilities and wide variability even in the same country.
The aim of this survey is to understand the current infectious disease practice in the ICU in order to improve infectious disease management including training and role allocation.
Steering Committee: Ashraf Roshdy (St George’s university hospitals NHS foundation trust, London, UK) , Ahmed Samy Elsayed (King Fahd Military Medical complex, KSA)
The survey was accepted in ESICM LIVES 2020 as a poster (update 9 Dec. 2020)
ESA & ESICM – patient safety survey
ESICM, in collaboration with ESA (the European Society of Anaesthesiology), has prepared a joint survey concerning patient safety – in particular preoperative risk assessment and the preparation of patients undergoing surgery/intervention. Leading members of both Societies discussed visibility and reputation of both Societies in particular by Citizens and Politicians within Europe.
The results will be used to establish a joint position paper to be published and sent to the EU institutions and health ministers of the EU member states. The survey was initiated by Presidents, Vice-Presidents and Secretaries of ESA & ESICM.
Automatic tube compensation practice in the ICU – ATC survey
ATC survey aimed to compensate for the resistance of endotracheal tube based on the internal diameter of a clean tube and on a percentage of compensation. There were physiologic studies and also some trials about ATC in the past with no clear message. We have no idea about this practice. We are currently systematically investigating ATC on the bench and have been doing a clinical study on it. This survey is expected to give more relevance and background to these studies.
The survey was led by Prof. Dr. Claude Guérin. Steering Committee:Nicolas Terzi, MD PhD Medical ICU, Grenoble University hospital, France; Louis-Marie Galerneau, MD Medical ICU, Grenoble University hospital, France
A-TEAM-ICU Antibiotic Stewardship, Therapeutic Drug monitoring and Early Appropriate infection Management in worldwide ICUs.
The management of severe infections is a daily challenge in the intensive care unit and must therefore be a core competence of intensivists. A “hot topic” in the field of infectious diseases is the use of therapeutic drug monitoring (TDM) to optimize the application of anti-infective. This approach is highly relevant in critically ill patients and many hospitals are already employing TDM to guide therapy. Additionally, efforts to improve the treatment of infections can be seen in the broader concept of antimicrobial stewardship (AMS). The intention was to gain insight into the distribution of TDM and AMS in ICUs.
The survey was led by Prof. Dr. Hendrik Bracht. Steering Committee: Dr. Christian Lanckohr, Prof. Jan de Waele MD PhD, Dr. Jeroen Schouten, Prof. Dr. D.W. de Lange and Prof. Dr. Menno Prins.
Respiratory virus-associated severe lower respiratory tract infections in critically ill adult patients: a survey of knowledge and practice patterns among European intensivists: LRTIinICU Survey
The purpose of this survey was to provide data regarding the knowledge and the management of respiratory virus-associated severe LRTI by European intensivists. These data will guide future prospective studies aiming to better characterize the use and the impact of molecular diagnostic tests and the optimal therapeutic management of viruses-associated LRTI.
Investigators: Guillaume Voiriot, Quentin Philippot, Intensive Care Unit, Tenon Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
Acute liver failure In Intensive Care Units: ALFinICU survey
Acute liver failure (ALF) is a rare condition characterized by new (no previous cirrhosis) and rapidly evolving (≤26 weeks) hepatic dysfunction associated with neurologic dysfunction (any grade of hepatic encephalopathy) and coagulopathy (INR ≥1.5). This disease may be due to several aetiologies (e.g. drug toxicity such as paracetamol and viruses such as hepatitis A, B or E), with great regional variability. The outcomes of patients with ALF have been improving throughout the decades largely because of optimized access and quality of intensive care and emergent liver transplantation.
The aim of this survey was to characterize the current practice of European ICUs in treating patients with ALF and to contribute to generate debate and identify future educational points about this rare disease. The lead Investigator is Filipe Sousa Cardoso
Invasive Aspergillosis among Patients with Severe Influenza in Intensive Care Units: IPAFLU survey
Invasive pulmonary aspergillosis (IPA) is widely recognized as a major cause of mortality and morbidity among immunocompromised patients. Recently, attention has been given to IPA as a complication of critically ill patients with severe influenza. However, multi-center data on influenza-associated aspergillosis (IAA) are lacking.
This IPAFLU survey aimed to assess the burden of IAA in European ICUs and the use of galactomannan in the diagnosis of IPA in adult critically ill influenza patients. Furthermore, we also want to raise awareness of IAA among European intensivists.
The survey is led by Prof. Dr. Joost Wauters with the help of Dr. Michelle Holtappels. It has been endorsed by CDC (US), the INF Section and ESICM.
Initial Resuscitation In Shock Survey (IRIS) survey
Several guidelines have been published with the intention of framing the context and justifications for the administration of vaso-active drugs. However, the real-life practices remain unclear. Most interventions provided in the intensive care unit remain based on individual decisions.
This survey aims to capture how vasopressors and catecholamines are actually managed in your intensive care unit.
Steering Committee: Marc Leone, Luciano Azevedo, Dan Benhamou, Maurizio Cecconi, Sharon Einav, Jeffrey Lipman, Ignacio Martin-Loeches, Jan De Waele
Ventilatory strategies in patients with severe traumatic brain injury Survey (VENTILO)
The potential role of protective lung ventilation, which demonstrated demonstrated a reduce in postoperative complications in the general population with and without acute distress respiratory syndrome, has been suggested even in Traumatic brain injured patients.
The surveys was endorse by the NIC Section and ESICM. Its was to assess the current clinical practice, the ventilatory targets and management in patients with traumatic brain injury with or without acute distress respiratory syndrome.
Steering Committee: Chiara ROBBA PhD, Edoardo PICETTI MD, Fabio Silvio TACCONE MD PhD and Professor Paolo PELOSI
GSA Sepsis Quality Measures Global Survey
Despite a recent resolution by the WHO and increasing worldwide recognition that sepsis poses a major global health threat, our knowledge of what sepsis surveillance, treatment, quality improvement (QI), and reporting practices look like across the world is surprisingly limited and fragmented.
The purpose of this survey was to characterize the current practices related to sepsis surveillance, treatment, quality improvement, and reporting worldwide.
The survey was led by Pr. Konrad Reinhart, Jena University Hospital, Germany and organised by Global Sepsis Alliance.
More information: https://www.global-sepsis-alliance.org/
The survey is part of a study initiated by the ESICM POIC Section, this is a European Society of Anaesthesiology Clinical Trial Network (ESA CTN) sponsored study and it has been endorsed by ESICM.SQUEEZE is a prospective multi-centre international observational study of postoperative vasopressor usage.
The goal was to evaluate the proportion of non-cardiac surgical patients receiving postoperative vasopressors, the characteristics of patients, surgery and anaesthesia that lead to postoperative vasopressor use.The Squeeze micro-survey is about the use of vasopressors in the immediate postoperative period.The responses will inform an international observational study of this topic.
Steering Committee: Ib Jammer (Norway), Ben Creagh-Brown (UK), Lui Forni (UK), Ramani Moonesinghe (UK) and Hannah Wunsch (Canada).
A Survey of Fluid Removal Practices During Renal Replacement Therapy in Critically Ill Patients (FluidRRT).
The purpose of this research survey was to study the attitudes of care providers towards fluid removal practices during renal replacement therapy for critically ill patients with oliguric acute kidney injury and fluid overload in an adult intensive care unit.
This survey has been endorsed by ESICM and AKI Section.
The study was approved by the Human Research Protection Office of the University of Pittsburgh.
The Principal Investigator is Dr. Raghavan Murugan, University of Pittsburgh, Pittsburgh, USA.
Steering Committee: Professor Eric Hoste, University of Ghent, Ghent-Belgium, Chair of AKI section and Dr Marlies Ostermann Guy’s & St Thomas’ Hospital, London-UK
Murugan R et al. (2019) Net Ultrafiltration Prescription and Practice Among Critically Ill Patients Receiving Renal Replacement Therapy: A Multinational Survey of Critical Care Practitioners . Crit Care Med. 2019 Nov 13.
Transfusion Decisions in European ICUs
Despite clinical research showing benefits of restrictive red blood cell transfusion triggers, guidelines remain inconclusive about precise indications for the individual patient. Variation in transfusion practice still exists, possibly caused by physicians taking into account multiple clinical factors (besides haemoglobin concentrations).
This survey aimed to estimate the extent of variation in transfusion decisions within four clinical scenarios. This knowledge can add to further improve personalised care with respect to transfusion practice in critically ill patients.
The survey was organised by The INOX-ICU 1 team, composed of S. A Willems Bsc, Sesmu Arbous MD/PhD, Prof. J. Kesecioglu MD/PhD, Prof. J. van der Bom MD/PhD, Prof. S. le Cessie PhD, P.J. Marang-van de Mheen PhD, F. Kranenburg MD/PhD. Contact: S. A Willems
The TRACE Survey
The aim of the transfusion practice on the intensive care unit: an international online survey (TRACE survey) was to use the information gathered as a baseline measurement prior to implementation of the new European transfusion guideline, and use it for future comparison to determine whether the guideline resulted in a change of practice. In contrast to most transfusion practice surveys, this survey is not limited to red cells transfusion, but also includes transfusion practice of plasma and platelet concentrates.
The survey was organised by The ESICM Transfusion Guideline Taskforce and CD Section. Contact: S. de Bruin MD
Publication: Sanne de Bruin, Thomas W. L. Scheeren, Jan Bakker, Robin van Bruggen, Alexander P. J. Vlaar & on behalf of the Cardiovascular Dynamics Section and Transfusion Guideline Task Force of the ESICM (2019) . Transfusion practice in the non-bleeding critically ill: an international online survey—the TRACE survey. Critical Care volume 23, Article number: 309
International survey on the Structure and Organisation
Acute Nonphysician Provider Survey (ANoPPS)
In contrast to the US, the literature in Europe regarding implementation of nurse practitioners or physician assistants, as an alternative staffing model for residents in the Intensive Care Unit remains almost non-existent.
The aim of this survey was to obtain an insight into the implementation of (acute care) nurse practitioners or physician assistants (both called non-physicians providers) and nurse specialists on ICUs in Europe.
Survey organised by Herman Kreeftenberg, HSRO section
International survey on the Structure and Organisation of the Intensive Care Unit (ISOREA)
The objective was to evaluate the current structure and organisation of ICUs in a very large sample of countries with low, middle and high income, given the scarcity of data in this area.
This survey has been endorsed by the Société de Réanimation de Langue Française (SRLF), by the Subsaharian Society for Anesthesia and Intensive Care (SARANF) and by ESICM.
Contact: Armand MEKONTSO DESSAP
CHANGE IT! State of the art on the paediatric and neonatal lung/heart transplantation in Europe
The scope of CHANGE IT! was to take a picture of physicians awareness, and knowledge about lung/heart transplantation and related conditions in Europe. From this point onwards other steps could be taken to improve the health of the most vulnerable patients in Europe.
This survey from the ESPNIC Respiratory Section and endorsed by ESICM aims to assess the current state of paediatric (<12 m old) and neonatal lung (or heart/lung) transplantation including physicians’ awareness knowledge across Europe.
Contact: Daniele De Luca
Admittance in European ICUs
Across Europe there is a shortage of ICU beds. ICU admittance threshold differs between hospitals, regions and countries. The scope of this survey is to take a picture of patient admittance behaviour in European ICUs based on a case presentation.
Survey organised Max Bell and Erik Zettersten, Karolinska University Hospital Solna.
Publication: Zettersten E, Jäderling G, Larsson E, Bell M. The impact of patient sex on intensive care unit admission: a blinded randomized survey. Scientific Reports, volume 9, Article number: 14222 (2019
The optimal management of an anticoagulation target and transfusion practice in VV-ECMO patients is still under debate.  Traditionally, the threshold for transfusions of packed red blood cells (PRBC) in ECMO aims to keep haemoglobin values (Hb) in the normal range (12-14 g/dL). More recently, this notion has been challenged by several case series that reported on lower transfusion thresholds and good outcomes. Since blood management practices have evolved over the years, we hypothesise that practices vary widely among ECMO centres.
This survey primarily focuses on the transfusion triggers according to the centre workflow.
. Fan E, Gattinoni L, Combes A, Schmidt M, Peek G, Brodie D, Muller T, Morelli A, Ranieri VM, Pesenti A, Brochard L, Hodgson C, Van Kiersbilck C, Roch A, Quintel M, Papazian L, (2016) Venovenous extracorporeal membrane oxygenation for acute respiratory failure: A clinical review from an international group of experts. Intensive Care Medicine 42: 712-724
Contacts: Antonio Arcadipane, Gennaro Martucci.
Intra-abdominal Hypertension and Abdominal Compartment Syndrome World Survey
This survey, endorsed by ESICM and WSACS, is part of a research project which aims to determine the impact, if any, of the 2013 World Society of the Abdominal Compartment Syndrome (WSACS) IAH/ACS Consensus Definitions/Clinical Management Guidelines, IAP measurement practices, on IAH/ACS clinical awareness and management. Results from this survey will be compared with those obtained from a similar survey conducted in 2007.
Contact: Dr RD Wise
BURNS: Initial fluid management and use of vasopressors in adult severely burned patients: An European survey
Severe burn injury induces early haemodynamic alterations mainly related to rapid loss of intravascular volume due to severe capillary leak and hypovolemic shock. Fluid resuscitation is considered as a corner stone of initial management of burn patients. The ideal amount and type of fluid during initial resuscitation in severely ill burn patients remains largely unknown with a real lack of consensus. The main challenge in the initial fluid administration strategy (first 48 hours) is to maintain the intravascular volume and organ perfusion without inducing both under and over-resuscitation complications. Fluid overload could be at least as harmful as hypoperfusion related to under-resuscitation.
Due to uncertainty of evidence in this field, learning the general practice of severe burn cases management is one of the most important points for future publications.
Contact: Matthieu Legrand and Sabri Soussi, ESICM BurnICU working group
ESICM 35th Anniversary Survey: Evolution in ICU
Around 5 million adult patients are admitted to ICUs each year. The majority of these patients will survive, but 30% to 35% of the most severely ill patients will die.
In the last three decades, massive improvements have been made in intensive care, led by advances in research and technology. ICU practice, staffing and management has also evolved. As a result, the survival rates of patients certain complications such as intra-abdominal infections, or organ failure, has risen from 42% in the late 1980s to 70% today.
It has been proven that although the number of ICU beds has increased, there has not been any reduction in the number of patients admitted and this suggests a growing need for ICU services.
To coincide with its 35th anniversary, the European Society of Intensive Care Medicine launched a survey to examine how ICUs have evolved in terms of practice and organisation since the early 1980s.
Carole Boulanger, Chair N&AHP Committee (2017)
Christiane Hartog, Deputy ETH Section (2017)
Lara Prisco, Deputy NIC Section (2017)
Lui Forni, Chair Research Committee (2017)
ARISE: Antimicrobial Resistance in ICU – a Survey In Europe
ARISE aims to obtain current information on the perception and experience of European intensive care physicians with managing infections caused by antibiotic-resistant bacteria. This follows an earlier ESICM endorsed survey in 2009, which was designed by the European Centre for Disease Prevention and Control (ECDC) and EMEA (1). Since the antimicrobial resistance situation in Europe has evolved since 2009, this survey aims to determine the experiences of European physicians in the treatment of infections due to antibiotic-resistant bacteria and specifically in utilising last-line antibiotics.
(1) Lepape A, Monnet DL, participating members, European Society of Intensive Care Medicine. Experience of European Intensive Care physicians with infections due to antibiotic-resistant bacteria, 2009. Euro Surveill 2009;14(45).
Survey on the use of various ICU scoring systems
Scoring systems are recommended for use in ICUs by National as well as International ICU organisations, including ESICM, who has been instrumental in the development of such scores, most recently by the introduction of the SAPS 3 severity score. However, to date, we have little insight into the extent to which such scoring systems are actually used in ICUs, and which type of systems are preferred. This simple survey initiated by the HSRO section aimed to compile useful feedback about the use of ICU scoring in European ICUs and beyond.
Contact: Hans Flaatten, Chair HSRO section
Spontaneous hypothermia during sepsis
Current practice and beliefs regarding the management of hypothermic sepsis are unknown. Given the impact of body temperature on the outcome of sepsis, knowledge on this issue is relevant. The aim of this international survey among intensive care physicians is to characterise which definition of hypothermia is used and which rewarming practices are applied. Current opinions on the effects of hypothermia and rewarming on outcome, and the feasibility of a randomised controlled trial will also be assessed.
Contact: Matt Harmon
Role of Active Deresuscitation After Resuscitation (RADAR)
RADAR sought to test the hypothesis that active deresuscitation (minimisation of fluid administration, together with diuretics and perhaps ultrafiltration) of critically ill patients who have fluid accumulation may lessen the morbidity of critical illness. This survey aims to characterise current beliefs and practice with regard to deresuscitation, the use of diuretics and/or renal replacement therapy to remove accumulated fluid in stable critically ill patients, with the aim of demonstrating equipoise on this issue and informing future trial design.
Contact: Jon Silversides
UCARDS: Use of CARdiovascular Drugs in Shock
In shock, organs are hypoperfused leading to dysfunction or death at a cellular level, as well as disruption in cardiovascular functions. Cardiovascular drugs are often used to manage patients in this state, despite the lack of consensus on their use. This survey from the Cardiovascular Dynamics Section aimed to evaluate the indications, current practice, and therapeutic goals in European ICU‘s on the use of cardiovascular drugs in the treatment of shock states.
Scheeren T WL et al, Ann. Intensive Care 2019 9 art.20 Current use of vasopressors in septic shock
Scheeren T WL et al, Ann. Intensive Care 2021 11 art.21 Current use of inotropes in circulatory shock
Survey on the ABCDEF bundle (Awakening and Breathing Coordination, Delirium monitoring/ management, Early exercise/mobility and Family)
Oversedation, immobility, and delirium have serious implications for critically ill patients who are on mechanical ventilation. The ABCDEF bundle has been proposed to reduce these conditions and improve patient outcomes. The aim of this ESICM-endorsed survey is to explore knowledge about the bundle and its implementation in intensive care units worldwide.
Contact: Nicola Latronico, University of Brescia, Brescia, Italy
Management of Dysphagia on the ICU (MADICU)
Dysphagia is the medical term for the symptom of difficulty in swallowing. The aim of this survey is to describe the current state of dysphagia diagnostics and therapy in different types of ICUs across different countries.
Contact: Rainer Dziewas, Universitätsklinikum Münster, Münster, Germany
WORKing time of DOCtors in the ICU (WorkDoc) survey
This survey initiated by members from the Health Services Research and Outcome (HSRO) section, aimed to evaluate and compare the level of implementation of the European Working Time Directive amongst intensive care physicians working in countries across Europe, as well as their working conditions and job satisfaction.
Contact: Philipp Metnitz
SUMMA: SUrvey on Fever Monitoring and Management in Patients with Acute Brain Injury
This European survey, initiated by the NIC section is about fever monitoring and management in acute brain injury [TBI, subarachnoid haemorrhage (SAH), intracerebral haemorrhage (ICH) and acute ischaemic stroke (AIS)] adult (> 18 years old) patients admitted to ICU. Main endpoints will be to examine a) definitions of fever, b) thresholds and triggers to start intervention, c) details and methods for targeted temperature management (TTM).
Contact: Edoardo PICETTI
Candida prophylaxis and treatment in intensive care patients after abdominal surgery in Europe
The aims of this survey are to document the extent of clinical practice variability in initiation of antifungal therapy in surgical critically ill patients and to study four potential scenarios:
1. Haemodynamically stable patient after urgent upper and lower gastrointestinal surgery with (a) and without (b) fungal growth in culture.
2. Haemodynamically unstable patient after urgent upper and lower gastrointestinal surgery with (a) and without (b) fungal growth in culture.
Contact: Sharon Einav
Management of primary spontaneous pneumothorax in the ICU: an international online survey endorsed by ESICM
The results of this survey fill gaps in knowledge and pave the way for further research aiming at improving the management of patients with PSP. The aim was to highlight the wide variations in primary spontaneous pneumothorax management and to assess the intensivist’s knowledge on international guidelines.
Contou et al. Management of primary spontaneous pneumothorax by intensivists: an international survey. Intensive Care Med 42, 1508–1510 (2016). https://doi.org/10.1007/s00134-016-4436-y
FLUID MANAGEMENT AND ALBUMIN IN THE ICU, an ESICM Survey supported by an unrestricted grant from GRIFOLS
This survey aimed to analyse the use of different fluid therapy options (particularly Human Albumin) in patients in differing clinical situations and conditions within the intensive care unit.
PLUG-IN EASI – (o)Esophageal catheters use for measurement of oesophageal pressure in the ICU
This survey from the ARF section’s PLUG Working Group aimed to assess the current understanding of the physiological background of oesophageal pressure measurement amongst ESICM member-intensivists.
PREVENTION OF CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS IN INTENSIVE CARE UNITS: AN INTERNATIONAL ONLINE SURVEY
This survey was conducted in 10 languages and aimed to document knowledge, attitudes and practices amongst doctors and nurses regarding CLABSI prevention in intensive care units worldwide. This survey closed Nov. 1, 2015.
Valencia et al. Poor adherence to guidelines for preventing central line-associated bloodstream infections (CLABSI): results of a worldwide survey. Antimicrobial Resistance & Infection Control20165:49; DOI: 10.1186/s13756-016-0139-y Published: 22 November 2016
Strategies to improve ICUs in resource-poor settings
The survey was conducted by the Global Intensive Care Working Group of ESICM. The aim of the study is to identify strategies to improve ICUs in resource-poor ICU settings and evaluate whether perceptions differ between ICU staff from the developed and developing world. This survey closed in January 2015.
International Survey on Fever Control Practices in Severe Sepsis and Septic Shock Patients
This survey is an initiative of the SIS section which aims to provide a better worldwide overview and understanding of the fever management in ICU septic patients. Data from this survey will be used to define goals and design future clinical trials on the topic. There are 27 questions and should take just a few minutes to complete. This survey was closed in November 2014.
SEPREMA – Survey of Current Sepsis Recognition & Management
This survey from the SIS section aimed to assess how well the 2012 Surviving Sepsis guidelines are being put into practice. In many occasions, when recommendations are available, there is a lack of implementation to the target population of physicians. This survey was closed in November 2014.
Martin-Loeches, I., Quinn, A., Daniels, R. et al. SEPsis REcognition and MAnagement (SEPREMA survey). Intensive Care Med 42, 477–478 (2016). https://doi.org/10.1007/s00134-015-4201-7
European Traumatic Shock Survey – ETRAUSS Survey
This survey from the TEM section aimed to describe current critical care practices in the initial management of patients with traumatic haemorrhagic shock in Europe and compare these practices with contemporary guidelines. The survey closed in June 2014.
Ventilation practices during cardio-pulmonary resuscitation
This survey aimed to collect data on the different attitudes, decisions and approaches related to ventilation during CPR in adult patients victims of a non traumatic cardiac arrest. This survey closed in Spring 2014.
ADMIN-ICU: A survey on antimicrobial dosing and administration approaches
This survey was conducted by the Infection Section of ESICM with the aim to obtain information on differences between intensive care units and countries on dosing and administration approaches for several anti-microbials. This survey closed in January 2014.
Tracheostomy Procedures in Intensive Care Units: a European Survey
The main aims were to evaluate the tracheostomy procedures performed in the ICU, to evaluate the most common practice on tracheostomy and to build a snapshot about tracheostomy techniques and finally to underline the differences among European countries on this topic. This survey closed in November 2013.
Haemodynamic Monitoring for the Neuro-Critically Ill Patient ~ An Online Survey
This survey was endorsed by the ESICM NIC Section and the ECCRN and aimed to record current practices, understand decision-making on haemodynamic monitoring and further explore the integration of haemodynamic with neuromonitoring-derived data in the care of the critically-ill patient with acute brain injury. This survey closed in May 2013.
Influence of Wikipedia and other web resources on acute and critical care decisions. A web-based survey
This survey was aimed at evaluating how important Wikipedia, Google and other web resources have become in the daily work of intensive care professionals. This survey closed in May 2013.
Attitudes to and Uses of Central Venous Catheter & Pressure
This anonymous survey was part of a research project that aimed to assess the European intensive care communities use of and attitudes towards CVP. This survey closed in April 2013.
Nosocomial infections in the ICU: a survey of data collection systems to monitor and guide prevention efforts
This survey was part of the IMPLEMENT project, which focused on the prevention of hospital infections, financed by the European Union. The survey closed in December 2012.
Haemoglobin levels and blood transfusion thresholds in patients with acute brain injury
The aim of the survey was to investigate the practices of RBC transfusion in patients with primary acute brain injury and the exact haemoglobin thresholds that trigger RBC transfusion in this specific ICU population. This survey closed in 2012.
Current Practices for Neurological Prognostication after Cardiac Arrest
The aim of this survey was to investigate the current practice and timing of neurological prognostication after cardiac arrest in European ICUs. It closed in 2012.
Aerosol Therapy in the Intensive Care Unit: Practice and believes (AT@ICU I)
This survey served as a first step to evaluate aerosol therapy practice in order to better focus and design a subsequent prospective one week observational study about aerosol therapy in the ICU. The survey closed in 2011.
The Initiation of Renal Replacement Therapy in the ICU Survey (IRIS)
The aim of this survey was to gain insights into the way intensivists prescribe RRT in the ICU with a special focus on the criteria they choose to initiate RRT. The survey closed on 13th August 2010.
International Weaning Survey
The aim of this survey was to describe the current process of weaning from mechanical ventilation and to obtain a better understanding of weaning practices, especially diagnostic and therapeutic approaches of weaning failure.
What should the Ethics Section be doing?
The survey was intended to elicit and understand the expectations and experiences of all ESICM members with regard to the aims and activities of the Ethics Section.
Selective Digestive Decontamination
Survey on the use of SDD in different countries and comparison between UK practice and practice in other European countries.
The survey closed on 28th August 2009.
RRS Questionnaire (Rapid Response System)
The aim of this survey was to collect information on Rapid Response System in hospitals. This survey closed on 31st July 2009. Thank you to all those who participated.
Multi-drug resistant bacteria risk perception by European intensivits (MDR-ICU)
This survey provided an overview of multi-drug resistant bacteria risk perception by intensivists working in European ICUs. The survey closed on 8th June 2009.
Data on Intensive care unit SCOres & SAPS 3 (DISCO&SAPS 3)
The aim of this survey was to obtain information on collection and management of ICU clinical data, to know whether and where the SAPS 3 admission score is applied, and to identify difficulties in use of this or other severity scoring systems. The survey closed on the 7th April 2008.
Sedation and Analgesia Survey
This survey was aimed at learning more about the current practice of sedation and analgesia in the critical care units across Europe.
The information obtained will help in designing structured educational interventions. The survey closed on 31 January 2008.
Antibiotic Resistance and End-of-Life care
This survey was aimed at investigating a possible correlation between end-of-life care and the presence of antibiotic resistant bacteria in intensive care patients. The survey closed on 30 November 2007.
The survey has been initiated by the Section on Ethics (Phillip Levin & Charles Sprung).
ICU Fund survey
The aim of this survey was to better understand the different methods of reimbursement in use in European Intensive Care Units. The information will also help design a prospective study exploring the predictive accuracy of different intensive care reimbursement systems. This Survey closed on the 31 October 2007.