• INTOXICATE, Intoxicated patients outcome in Europe and other continents

This ESICM-endorsed study is an observational, multicenter study conducted in Europe and other continents to look at the outcomes and prognosis of intoxicated patients at intensive care units. The project project started in 2020 and closed for patient inclusion on 1 July 2023.  More details at https://toxicstudy.org/

Contact: Claudine Hunault and Samatha Zwaag (Intensive Care, UMC Utrecht, The Netherlands) contact@toxicstudy.org

 

• SQUEEZE, a prospective multi-centre international observational study of postoperative vasopressor usage

Initiated in the ESICM APM Section (ex-POIC Section), this ESAIC study aimed to evaluate the proportion of non-cardiac surgical patients receiving postoperative vasopressors, to evaluate the characteristics of patients, surgery and anaesthesia that lead to postoperative vasopressor use, to evaluate the incidence of organ injury in patients who receive postoperative vasopressors and finally to evaluate the variability in postoperative vasopressor use across healthcare environments.

Contact: Ib JAMMER (Haukeland University Hospital – Bergen, Norway), Ben Creagh-Brown (Royal Surrey County Hospital NHS Foundation Trust – Guidlford, United Kingdom) SQUEEZE@esahq.org

 

• VENTIBRAIN – Multicenter ObserVational Study on PracticE of VeNTilation In Brain Injured PAtIeNts

This observational study aimed to determine the ventilation practice of consecutive intubated and ventilated neuro-ICU patients in the first week from admission in intensive care units.

Contact: Chiara Robba, IRCCS San Martino, Genova, Italy kiarobba@gmail.com

 

• InPUT – International Point Prevalence Study of Intensive Care Unit Transfusion Practices

The objective was to evaluate and describe ICU RBC transfusion practices worldwide.

Contact: Jorinde Raasveld, Amsterdam UMC, The Netherlands

Publication: Senta Jorinde RaasveldSanne de BruinMerijn C. Reulandet al. Red Blood Cell Transfusion in the Intensive Care Unit. JAMA. Published online on October 12, 2023. doi:10.1001/jama.2023.20737

 

• Concise: Core Outcome Measures for Clinical Effectiveness Trials of Nutritional and Metabolic Interventions in Critical Illness

The purpose was to undertake a modified Delphi consensus process, selecting a core set of patient function outcome measures that should be reported in clinical effectiveness trials of nutritional and metabolic interventions in the critically ill population.

Contact: Zudin Putucheary, Royal London Hospital, WhiteChapel, London, UK

Publication in Open Access in 2022:  Critical Care volume 26, Article number: 240 (2022). Critical Care volume 26, Article number: 240 (2022)

 

• iCareWean: Weaning from mechanical ventilation: comparison of open-loop decision support system and routine care, in general medical ICU

The purpose of this study is to compare mechanical ventilation following advice from the Beacon Caresystem to that of routine care in patients from the state of requiring invasive mechanical ventilation until successful extubation. The Beacon Caresystem will be compared to routine care to investigate whether use of the system results in similar care and reduced time for weaning from mechanical ventilation.

The patient recruitment is closed.

REC reference: 17/LO/0887; IRAS Project ID: 226610; HRA: NIHRA under review; Clinicaltrials.gov Registered; the project was endorsed by ESICM in 2017.

Contacts: James R White, Marcela VizcaychipiAmandeep Gupta

 

• EURECA: European study on Encephalitis in Intensive Care

This is a prospective observational multicentre study in European ICUs. All patients admitted to the ICU for probable or confirmed AE (2013 IDSA criteria)  were eligible. The target was 1000 patients admitted to the ICU for AE (5 consecutive patients in each participating ICU, targeted number of ICUs in Europe: 200).

Aims

Acute encephalitis (AE) is a severe neurological disorder associated with significant morbidity and mortality. Approximately 60% of patients with AE require ICU admission because of coma, seizures or acute respiratory failure. Determinants of neurological prognosis of these patients are not known. The main aims of the project are to describe the epidemiology and outcomes of patients admitted to the ICU with all-cause acute (meningo-) encephalitis in European countries. Specifically, the study aims to identify early indicators of poor neurologic outcome in this population and to identify challenges in the management in the ICU, namely: temperature management, neuromonitoring, seizure management, specific therapy (antibiotic therapy, steroids, IVIg..).

The study is closed for patient inclusion.

This project won the ESICM Established Investigator Award 2017.

Contact: Romain SONNEVILLE – Bichat Claude Bernard University Hospital

 

• PROTECTMO: Prospective Obstervational study on Transfusion practice in vv-ECMO Patients

Summary of the rationale

The principal aim was to describe current effective blood product usage, during VV-ECMO. The secondary aim was to describe in a large cohort of ECMO patients the current anticoagulation strategy and bleeding episodes occurrence. This ESICM endorsed study was designed as a prospective observational multicenter cohort study. No intervention. No additional tests. All data were collected from the patient’s file and just data adopted in the current practice of each ECMO center were recorded. The data collection included pre-ECMO characteristics, transfusion strategies and blood test results during the first twenty-eight days after ECMO cannulation or until the end of ECMO support if the length was shorter, and clinical outcomes up to the end of ICU stay.The study is now closed for data inclusion. You can find more details on the study here.

Download the final Newsletter here (October 2021).

Contact: Gennaro Martucci (IRCCS-ISMETT, Palermo, Italy).

 

• INTUBE:INternational observational study To Understand the impact and BEst practices of airway management of critically ill patients

Summary of the rationale

This study endorsed by ESICM aimed at evaluating the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients.  The study was an international, multicenter, prospective cohort study involving consecutive critically ill patients undergoing tracheal intubation in the intensive care units (ICUs), emergency departments, and wards, from October 1, 2018, to July 31, 2019 (August 28, 2019, was the final follow-up) in a convenience sample of 197 sites from 29 countries across 5 continents.

The first paper has been published in the Jama on 23 March 2021 (JAMA . 2021 Mar 23;325(12):1164-1172.  doi: 10.1001/jama.2021.1727).

Contact: Vincenzo Russotto (School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy).

 

• STARRT-AKI: STandard versus Accelerated initiation of Renal Replacement Therapy in Acute Kidney Injury

Aims

To determine whether, in critically ill patients with severe acute kidney injury (AKI), a strategy of accelerated (early) initiation of renal replacement therapy (RRT), compared to a standard (delayed) strategy for initiation of RRT contributes to improved 90-day survival and recovery of kidney function.

The first paper has been published in Can J Kidney Health Dis. 2019 2019; 6: 2054358119852937. Published online 2019 Jun 10. doi: 10.1177/2054358119852937

Contact: Sean M Bagshaw (University of Alberta, Canada)

 

• Extubation strategies in Neuro-ICU patients and associations with outcomes – ENIO

Aims

The ENIO study is an international observational study, about the practices of the mechanical ventilation weaning processes in patients hospitalised in the ICU with a severe brain-injury (trauma, haemorrhage, stroke…). The study focus  is on extubation and/or tracheostomy. One of the primary target is to identify factors of extubation success in these patients and delineate the consequences on outcomes, which is collected in the ICU and at hospital discharge.

Recruitment

The goal was to recruit at least 60 centres worldwide in order to include 1500 patients with extubation and/or tracheostomy. Each centre has been expected to include at least 20 patients with extubation and/or tracheostomy over a 6-month period. The trial started in 2018 and the recruitment is now closed.

Contact: Raphael Cinotti

 

• PROTECTION: PRessure suppOrT vEntilation + sigh in a CuTehypoxemic respiratOry failure patieNts

Summary of the rationale

This study initiated within the ESICM PLUG (Pleural Pressure) Working Group, is a randomised controlled (RCT) on the effects of short cyclic recruitment maneuver (Sigh) added to pressure support ventilation (PSV) that will be conducted in several ICUs in different countries.

More information about the primary/secondary endpoints and on the inclusion and exclusion criteria available in the protocol here.

The trial started in July 2017 and is now closed. It was supported partly by ESICM (Clinical Research Award 2016) and by “Ricerca Corrente” of the Policlinico Hospital, Milan, Italy.

Contact: Tommaso Mauri

Publication: Chest, 2020 Nov. 13. PMCID: PMC7664474  PMID 33197403

 

• VIP-2 – Very old Intensive Care Patient-study 2: Development and validation of a prognostic score

This study sought to develop a prognostic score for specifically very old, critically ill patients  defined as patients ≥ 80 years). This was a large, prospective, multinational, multicentre study. We gathered age-specific information about the elderly patient: frailty (Clinical Frailty Scale), cognitive function (IQCODE), activity of daily life (KATZ ADL) and co-morbidity, in addition to organ failure score (SOFA). Outcomes were registered as outcome at 30 days (alive or dead) and 6 months in a sub-study. Also, an Frailty score interrater variability was recorded in a sub-study.

Results
The goal was to recruit 20 consecutive ICU patients ≥ 80 years.
3920 patients were recruited from 242 ICUs in 22 countries.

More information at www.vip2study.com

Contact:  hans.flaatten [ at ] k1 [ dot ] uib [ dot ] no

This project won the ESICM Clinical Research Award  2017

Guidet, B. et al. The contribution of frailty, cognition, activity of daily life and comorbidities on outcome in acutely admitted patients over 80 years in European ICUs: the VIP2 study. Intensive Care Medicine 46, 57–69 (2020).

Lange, D. W. de et al. Cumulative Prognostic Score Predicting Mortality in Patients Older Than 80 Years Admitted to the ICU. Journal of the American Geriatrics Society 67, 1263–1267 (2019).

more publications on https://vipstudy.org/vip-papers/

 

• BEARDS Study – Incidence of dysynchronous spontaneous Breathing Effort, breath-taking and reverse triggering in early ARDS

Summary of the rationale

This project, initiated by the ESICM PLUG (Pleural Pressure) Working Group, is an observational multicentre physiological study that has been conducted in several ICUs in different countries.

Aims:

1) To describe the incidence of spontaneous breathing efforts, reverse triggering (either inducing double cycles or associated with eccentric contractions during expiration), breath stacking and short cycles (with a potential for eccentric contractions of the respiratory muscles), as well as other asynchronies like wasted efforts.
2) To analyse the presence of main dysynchronies (including reverse triggering) with its corresponding changes in transpulmonary pressure swings, plateau pressure and volume delivered by the ventilator in those breaths, and quantify the breathing efforts generated
3) To associate the occurrence of dysynchronies (including reverse triggering) during the early phase of ARDS with outcome (ventilator free days, intensive care unit (ICU) stay, mortality, pneumothorax as secondary outcome).
4) Understand the relationship between sedation levels and regimens and the different types of dysynchronie

Population target

Mechanically ventilated patients under continuous sedation will be considered for enrolment in the first week of ARDS diagnosis.

Steering Committee: Tai Pham (Paris); Martin Dres (Paris); IreneTelias (Toronto); Tommaso Mauri (Milan); Jordi Mancebo (Barcelona); Ewan Goligher (Toronto); Giacomo Bellani (Monza); Lluis Blanch (Sabadell); Laurent Brochard (Toronto).

Publication: Crit Care. 2021 Feb 15;25(1):60.  doi: 10.1186/s13054-020-03387-3

 

• iSOFA Study – Intestinal-Specific Organ Function Assessment

Principal Investigators: Annika Reintam Blaser, Dept. of Anaesthesiology and Intensive Care, University Of Tartu, Estonia and Center of Intensive Care Medicine, Lucerne Cantonal Hospital (CH) and Martin Poeze, Maastricht University Medical Center, Dept of Surgery/Intensive Care Medicine (NL).

Summary of the rationale

Part A: To prospectively evaluate the value of gastrointestinal symptoms alone and in combination with intra-abdominal pressure (IAP), and acute gastrointestinal injury (AGI) grades, as defined by the ESICM Working Group on Abdominal Problems, in prediction of outcome in intensive care patients.
Part B: To determine whether biochemical markers (plasma and urine) of intestinal injury are of additional prognostic value compared to clinical gastro-intestinal symptoms and AGI grades.
The general aim of the project is to develop a five grade score (0-4 points) for assessment of GI function similar to SOFA sub-scores used for assessment of other organ systems.

Project Dates: October 2014 – March 2018

More info: contact Anika Reintam  


• DIANA Study – DetermInants of Antimicrobial use aNd de-escalAtion in critical care

Principal Investigators: Jan J. De Waele, and Liesbet De Bus, Ghent University Hospital, Belgium

Summary of the rationale

De-escalation is applied in no more than 15-50% of patients in most studies, and may consist of different components. There may be important differences between hospitals and countries in the use of de-escalation as well as the impact on outcome thereof. Large scale, multi-country studies are currently lacking.

Target

This study from the Infection Section aimed to include 2000 patients in whom empirical antibiotics are started. With an estimated de-escalation rate of 35%, we estimate to include 700 patients in whom de-escalation is performed which would allow for a suitable multivariable analysis.

The trial will give us further insights into the actual use of de-escalation in a global sample of patients, inform us about the determinants of de-escalation, as well as describe the impact of de-escalation, taking various potential confounders into account.

Publication: Intensive Care Med. 2020 Jul;46(7):1404-1417.  doi: 10.1007/s00134-020-06111-5.


• International Study on NoSocomial Pneumonia in Intensive CaRE – The PneumoINSPIRE study

Head investigator: Despoina Koulenti, 2nd Critical Care Department, Attikon University Hospital, Athens (Greece); Burns, Trauma & Critical Care Research Centre, School of Medicine, The University of Queensland (Australia).

PneumoINSPIRE is a prospective, international, multicentre, observational, prospective cohort study on nosocomial pneumonia in the ICU setting. The study was conceived and designed by the Working Group on Pneumonia of the European Society of Intensive Care Medicine (ESICM) and has received endorsement from the ESICM. The coordinating centre is the University of Queensland Centre for Clinical Research, located in Brisbane, Australia. Ethics approval was granted by the Royal Brisbane and Women’s Hospital Human Research Ethics Committee (HREC/15/QRBW/35) and the Medical Research Ethics Committee of the University of Queensland (2015000302), (ClinicalTrials.gov Identifier # NCT02793141).

PneumoINSPIRE started in Feb. 2016 and closed in Feb. 2021. It aimed to describe the epidemiology, diagnostic strategies and treatment modalities for nosocomial pneumonia in geographically diverse ICUs. It aimed to also explore implicated pathogens and their resistance patterns, resolution characteristics, prognostic factors and early indicators of patient outcomes. In addition, the study examined how a diagnosis of VAP in routine clinical practice is associated with official definitions, and depict any discrepancies and their implications. It is expected that the study findings will provide information that will be helpful for creating new clinical guidelines and identifying research priorities in the field of ICU nosocomial pneumonia.

Contact: Despoina Koulenti 


• DALI – Defining Antibiotic Levels in Intensive care unit patients

Published in 2014: Clin Infect Dis. 2014 Apr;58(8):1072-83.  doi: 10.1093/cid/ciu027

This was a prospective, multinational pharmacokinetic point-prevalence study including 8 β-lactam antibiotics.

Lead investigator: Jeffrey Lipman, University of Queensland, Australia


• The Ethicus II study – End-of-life practices in intensive care units around the world

Head investigator: Charles SPRUNG, Hadassah Hebrew University Medical Center

The project started in July, 2015. The objectives of this multicentre study were to observe and describe actual end of life practices in ICUs of several countries, to determine their overall incidence, to document variations in the pattern of practice and to analyze similarities and differences in terms of variables that might explain the findings.
In addition, the ICUs that participated in the ETHICUS study (30 of the original 37 European ICUs have agreed to participate) will be compared to their practice now and trends and/or changes will be studied.
Moreover, the project will mentor and include young intensivists worldwide in this research project and develop a worldwide network of young intensivists interested in clinical research on ethical and end-of-life care issues.

Contact: Charles Sprung


• VIP1 – Multinational, multicentre study of outcome of Very old ICU Patients

Lead Investigator: Hans Flaatten, Insitution: Haukeland University Hospital, Bergen Norway:

This study addressed the ICU care of the very old, defined as patients ≥ 80 years, admitted to the ICU. With more than 5,000 patients recruited , VIP-1 was the first large multinational study, with basis in Europe, to study the frequency of ICU admission in the very old patients, the use of common ICU resources including ICU and hospital LOS.
Publication: The results of this study were published in ICM and Hans Flaatten presented the results at the ESICM Annual Congress Lives2017 in Vienna (Sept.2017). Intensive Care Med. 2017 Dec;43(12):1820-1828. 

Contact: Hans Flaatten


• Sentinel Events Evaluation 3 (SEE 3), a Multinational observational study on safety of intrahospital transport in intensive care patients

Lead Investigator: Andreas Valentin, Institution: Rudolfstiftung Hospital, Vienna, Austria

This study aimed to determine the frequency, characteristics, and contributing factors of sentinel events during IHT of ICU patients on a multinational level. Secondary objectives are: i) to assess the impact of organisational, environmental and cultural factors, ii) to identify preventive measures to increase the safety of IHT in ICU patients, iii) to enhance awareness of safety problems during IHT of ICU patients in participating ICUs. Statistical Analysis will include a descriptive analysis and multiple logistic regression.

Contact: Andreas Valentin


• Monitoring resuscitation in severe sepsis and septic shock  ‘MORESS’, a prospective randomised multicentre study

Lead Investigator: Xaime García Nogales, Hospital de Sabadell, Barcelona, Spain.

The  hypothesis of this study was that haemodynamic fluid resuscitation guided by dynamic parameters will improve outcome in patients with severe sepsis and septic shock.

The principal objective of this study was to demonstrate a (>10%) decrease in mortality in septic patients resuscitated using a dynamic-parameter-based protocol versus a static-parameter-based protocol to guide fluid resuscitation. In addition, it is expected to observe an improvement in the length of the resuscitation time, mechanical ventilation and vasopressor support-free days, ICU and hospital length of stay, organ failure and renal function.

40-60 general ICUs from Europe and Chile participated. All ICUs are closed units with a critical care specialist on hand 24 hours per day, 365 days per year.

Newsletter

Protocol

Contact: Xaime Garcia  Nogales and Antonio Artigas Ravento


• Cardiovascular Monitoring & Management in Austrian, German and Swiss Intensive Care Units – The ICU CardioMan Study

Lead Investigators: Daniel Reuter and Michael Sander

The objective of this multicentre study was to analyse the reality of haemodynamic monitoring and therapy of the critically ill in Austrian, German and Swiss intensive care units. This included acquisition of data on which types of haemodynamic monitoring clinicians have available in their ICU. This study also aimed to investigate which indications lead to therapy decisions and/or extension of haemodynamic monitoring and which parameters serve as therapeutic goals. Additionally, this study investigated how the extension of haemodynamic monitoring guides and modifies therapeutic decisions and strategies in clinical practice.

Published in 2016: Funcke S et al. Practice of haemodynamic monitoring and management in German, Austrian, and Swiss intensive care units: the multicentre cross-sectional ICU-CardioMan Study. Ann Intensive Care. 2016; 6: 49. Published online 2016 May 31. doi: 10.1186/s13613-016-0148-2.


• Practice Pattern Variation in Discontinuing Mechanical Ventilation in Critically-ill Adults: An International Prospective Observational Study

Lead Investigator: Dr. Karen E.A. Burns

Actual Study Start Date: November 4, 2013. Actual study completion date: December 17, 2016.

This study was an International Observational Study of Mechanical Ventilation Discontinuation Practices that aimed to characterise variation in ICUs across Europe with regards to practice in weaning critically-ill adults from invasive mechanical ventilation and the influence of selected discontinuation strategies on important outcomes.

Published in open access: BMJ Open 2019 Sep 8;9(9):e031775.  doi: 10.1136/bmjopen-2019-031775.

Published in JAMA. 2021;325(12):1173-1184. doi:10.1001/jama.2021.2384 Karen E. A. Burns, MD, MScLeena Rizvi, BScDeborah J. Cook, MD, MScet al “Ventilator Weaning and Discontinuation Practices for Critically Ill Patients”


• DecoloniSation strategies in Intensive Care

This European-wide multicentre ICU trial aimed to determine the effect and safety of three decolonisation strategies:

–  Selective Digestive tract Decontamination (SDD)

–  Selective Oropharyngeal Decontamination (SOD)

–  Chlorhexidine mouthwash (Oro-CHX)

Primary outcome was the effect of SDD / SOD and chlorhexidine mouthwash on the rate of ICU acquired bacteremia and 28-day mortality. The effect on colonisation rates and presence of multi drug-resistant gram negative bacteria was also evaluated.

Link to the related publication:

Plantinga N, and Bonten M. Selective decontamination and antibiotic resistance in ICUs. Crit Care. 2015 Jun 24;19:259. doi: 10.1186/s13054-015-0967-9.


• PROSAFE – Promoting patient safety and quality improvement in critical care

Lead investigator: Guido Bertolini

Project start date: November 2008 (28 months) and is now closed

The aim of the project is to promote patient safety and quality improvement in critical care towards a significant reduction of observed mortality rates and economic costs.

Further information at prosafe.marionegri.it

Publication in 2020: 01 Dec 2020, 86(12):1305-1320


• ASP-ICU – Aspergillus in Intensive Care Units

Lead Investigator: Stijn Blot

Published in 2015: Crit Care . 2015 Jan 12;19(1):7.  doi: 10.1186/s13054-014-0722-7.

The AspICU project wass an international observational web-based survey that aims to collect a large series of ICU patients with either Aspergilluscolonisation or invasive disease, in order to: investigate the epidemiology of invasive aspergillosis in ICU patients, and  to validate a diagnostic algorithm that discriminates colonisation from invasive disease.


• 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


• SATURN – Impact of Specific Antibiotic Therapies on the prevalence of hUman host ResistaNt bacteria

Lead investigator: MJM Bonten

Project start date: January 2011 and is now closed.

SATURN is a cluster-randomised cross-over multi-centre trial of 10 ICUs. Its aim is to assess the effect of mixing vs cycling of antibiotic empiric treatment on gram-negative prevalence in the ICU population.


• ELDICUS – Triage decision making for the elderly in European Intensive Care Units

Lead investigator: Charles Sprung

Part I – European Admission Triage Scores. Published in 2012:Cr it Care Med. 2012 Jan;40(1):125-31. doi: 10.1097/CCM.0b013e31822e5692.

Part II – Intensive Care Benefit for the Elderly. Published in 2012: Crit Care Med. 2012 Jan;40(1):132-8. doi: 10.1097/CCM.0b013e318232d6b0.


• PRICE – Physical restraint use in intensive care unit across Europe

Lead investigator: Julie Benbenishty

Published in 2010: Intensive & critical care nursing: the official journal of the British Association of Critical Care Nurses 26(5):241-5.  DOI:10.1016/j.iccn.2010.08.003


• IPOC – International Programme for Resource use in Critical Care

Lead Investigators: D Edbrooke, D Negrini.

Published in 2006: Acta Anaesthesiol Scand. 2006 Jan;50(1):72-9.  doi: 10.1111/j.1399-6576.2006.00901.x.


• SAPS 3 – From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission

Lead investigator: Rui Moreno

Project published in 2005: Intensive Care Med. 2005 Oct;31(10):1345-55.  doi: 10.1007/s00134-005-2763-5. Epub 2005 Aug 17.


• 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.


• 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.

For more information, please consult the website at www.intensive.org/epic2/index.asp


• CORTICUS – Corticosteroid Therapy of Septic Shock

Lead Investigator: Charles Sprung

Published in 2008: January 10, 2008. N Engl J Med 2008; 358:111-124.DOI: 10.1056/NEJMoa071366


• AKI-EPI – Acute Kidney Injury – Epidemiologic Prospective Investigation

Lead Investigator: Eric Hoste

Project started in 2008 and is now closed.

The aim of the study was to evaluate the epidemiology and early management of acute kidney injury, according to the RIFLE classification in ICU patients.

Published in 2015: Intensive Care Medicine volume 41, pages1411–1423 (2015)


• 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).

Main publication in 2006: Sprung, C.L., Carmel, S., Sjokvist, P. et al. Attitudes of European physicians, nurses, patients, and families regarding end-of-life decisions: the ETHICATT study. Intensive Care Med 33, 104–110 (2007). https://doi.org/10.1007/s00134-006-0405-1

Comments Publication: Intensive Care Med. 2007 Apr; 33(4): 747. Published online 2007 Mar 2. doi: 10.1007/s00134-007-0570-x


• 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 includes 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 an insight into the current status of CAP/HAP/VAP diagnosis, pathogenic organisms, and therapies in European ICUs, as well as the utilisation of this information as a tool in the effort to improve outcomes.

More than 2,500 patients have been recruited for the study and the interpretation of the collected data is ongoing. Preliminary results were presented in the ATS 2008 International Conference and ESICM CONGRESS in Lisbon in 2008.


• GAINS – Genomic Advances in Sepsis

Lead Investigator: Charles Hinds

Project started in 2005 and is snow closed.

The project aimed at identifying factors that determine the incidence, severity 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 has required 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 was 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.

Further info at the study website: www.ukccg-gains.org


• GLUCONTROL – Comparative effects of two glucose control regiments by insulin in ICU patients

Lead Investigator: Jean-Charles Preiser

Published in 2009: Intensive Care Med. 2009 Oct;35(10):1738-48.  doi: 10.1007/s00134-009-1585-2.

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.


• EUROBEDHEAD – European evidence-based consensus recommendation on bed head elevation policies for mechanically ventilated patients

Lead investigator: Barbara Niël-Weise

Published in 2011: Crit Care. 2011;15(2):R111.  doi: 10.1186/cc10135.

The aim of the project was to turn the scientific evidence of bed head elevation policies in mechanically-ventilated patients into a European consensus recommendation.


• Practice Pattern Variation in Discontinuing Mechanical Ventilation in Critically-ill Adults: An International Prospective Observational Study

Lead investigator: Karen E.A. Burn.

Purpose: To characterize practice pattern variation in weaning and the consequences of weaning variation by implementing an international, prospective observational study in Canada, the United States, the United Kingdom, Europe, India and Australia/New Zealand

Anticipated date of closure of patient recruitment: 17 December 2016.

Protocol published in open access in BMJ Open. 2019 Sep 8;9(9):e031775.  doi: 10.1136/bmjopen-2019-031775.


• The use of MRI derived biomarkers to predict consciousness recovery in TBI, aSAH, ICH and HIE patients.

Lead investigator: Louis Puybasset.


• EGUARD – Early e-guided use of antibiotics related to resistance data.

Lead investigator: Claudia Spies. project started in 2011 and the anticipated date for closure was 2014.t.


• CAPUCI II – Community Acquired Pneumonia in Europe. (2000-2013)

Lead investigator: Jordi Rello

Last publication: Chest. 2014 Jul;146(1):22-31.  doi: 10.1378/chest.13-1531


• MOnIToR – Monitoring Organ Donors to Improve Transplantation Results

Lead investigator: Rupert Pearse

Publication: Crit Care Resusc. 2013 Sep;15(3):234-40.


• IMPROVE-ICU – International Multicentre one day Prevalence ObserVational study for dElirium on ICU

Lead investigator: Claudia Spies

The study day was 1 January 2011.

More details at https://ichgcp.net/clinical-trials-registry/NCT01278524.


• ELOISE – European mortality & Length Of ICU Stay study

Lead investigator: Maurizia Capuzzo

Published online on 9 Oct. 2014. doi: 10.1186/s13054-014-0551-8.  Crit Care v.18(5); 2014.


• EuSOS – European Surgical Outcome Study

Lead investigator: Rupert Pearse

Published in open access on 22 September 2012. doiI:https://doi.org/10.1016/S0140-6736(12)61148-9 The Lancet. Volume 380, Issue 9847  P1059-1065, September 22, 2012.


• INTERNATIONAL SURVEY ON FROZEN PLASMA TRANSFUSION PRACTICES

Lead investigator: Oliver Karam

Published in Transfusion. 2014 Apr;54(4):1125-32.  doi: 10.1111/trf.12393. Epub 2013 Aug 27.


• ReFIT – Resuscitation from Shock Using Functional Haemodynamic Monitoring

Lead investigator: Michael R. Pinsky

Published on 22 November 2005 in Critical Care volume 9, Article number: 566 (2005).


• Genosept – Genetics of Sepsis in Europe

Lead investigator: Frank Stueber


• Prospective, Observational, Multicentre Study of Gastrointestinal Dysfunction in Critically-ill patients. Development of Gastrointestinal Failure Score

Lead investigator: Manu Malbrain.

Published in Intensive Care Med. 2012 Mar;38(3):384-94.  doi: 10.1007/s00134-011-2459-y. Epub 2012 Feb 7.


• H1N1 Flu – H1N1 Flu Registry on Intensive CareGenetics of Sepsis in Europe

Lead investigator: Jordi Rello


• EURO-BACT – Epidemiology and outcome of Hospital-acquired bacteremia (HAB) in 2010

Lead investigator: Jean-François Timsit

Published in Intensive Care Med. 2012 Dec;38(12):1930-45.  doi: 10.1007/s00134-012-2695-9. Epub 2012 Sep 26.


• ICU Nutrition Day

Lead investigator: Michael Hiesmayer


• IHPOTOTAM – Induced Hypothermia to treat Adult Meningitis

Lead investigator: Bruno Mourvillier

Publication: JAMA. 2013 Nov 27;310(20):2174-83.  doi: 10.1001/jama.2013.280506.


• CoBaTrICE – Competency-based Training in Intensive Care Medicine in Europe

Lead investigator: Julian Bion

Publication: Intensive Care Medicine volume 32, pages1371–1383 (2006)