• Providing Optimum Support for children facing ICU bereavement Experiences – The POSIE Study

The POSIE Study is a multi-phase, mixed-methods project using an experience-based co-design (EBCD) methodology. Phase 1 comprises an international scoping survey of adult ICUs and qualitative semi-structured interviews with ICU nurses and family-facing staff to understand current practices, challenges, and system-level variation. Phase 2 involves qualitative data collection with bereaved children and their surviving parent or primary caregiver, using ethically informed, child-sensitive creative methods (e.g., digital postcards, story prompts, and optional remote interviews).

Primary objective: To develop lived experience-informed recommendations for child-inclusive bereavement support in adult intensive care units (ICUs), using a multi-phase experience-based co-design (EBCD) methodology involving ICU professionals, bereaved parents, and bereaved children.
Secondary objectives: The secondary objectives are organised into four inter-related thematic areas:
1. Mapping current practice: To describe existing approaches to supporting children in families affected by death in adult ICUs, including current policies, protocols, training, and informal practices relating to child involvement and bereavement support.
2. Understanding lived experience : To explore and document the experiences of bereaved children and their surviving parents following a death in adult ICU, including how children understand the ICU environment, perceive communication and involvement, and make sense of loss and bereavement.
3. Organisational and cultural influences : To examine how emotional, ethical, organisational, and cultural factors within adult ICUs shape clinicians’ decision-making, confidence, and consistency in relation to child involvement at end of life and during early bereavement.
4. Co-design and implementation : To work collaboratively with ICU professionals, parents, and children to co-design practical, implementable resources, guidance, and recommendations that support equitable, child-inclusive bereavement care, and strengthen workforce confidence and capability across diverse ICU settings.

Steering Committee: Dr Carole Boulanger, Pr Jos Latour, Dr Margo Van Mol, Prof. Louise Dalton, Dr Elizabeth Rappa, Kate Wells.

FOR MORE INFORMATION:  Chief Investigator:  Annelies Rowland Oxford School of Nursing and Midwifery, The Centre for Psychological Research, Oxford Brookes University, Oxford, UK
[arowland@brookes.ac.uk]

• Observational iNternational study of TRACHeostomy practice in adult intensive care units – the ON TRACH Study

This is an international, multicentre, prospective cohort study. ICU’s internationally are invited to participate and recruit patients over a 12-week period while the study is ongoing. Each intensivist led unit at a contributing centre will be permitted to participate as a site, meaning there can be more than one site per hospital.

Primary objective: The number of patients alive and free of invasive ventilation (ventilator free days) to day 60 after tracheostomy insertion, in patients with early (≤7 days) compared to late (> 7 days) tracheostomy insertion.
Secondary objectives: To describe the practice of tracheostomy insertion including indication, timing and insertion technique; To describe the demographics, reason for ICU admission and severity of illness of patients requiring tracheostomy; To describe the care of patients with a tracheostomy in relation to ventilation, sedation, method of weaning from mechanical ventilation and decannulation; To determine outcomes of patients with a tracheostomy including return to vocalisation, oral intake, mobilisation, length of stay, and mortality at hospital discharge; To assess the incidence and nature of adverse events experienced by patients with a tracheostomy; To assess long-term functional and neuropsychological outcomes of patients with a tracheostomy; To evaluate organisational aspects of tracheostomy care internationally including multidisciplinary care, standardised protocols and equipment, staff training and education at ICU and ward level, including discharge location following ICU and management of weaning from this point.

Steering Committee: Dr Aisling McMahon, Ms Michelle Smyth, Prof Ger Curley, Prof John Laffey,Dr James O Rourke, Dr Vincenzo Russotto, Dr Massimo Muraccini, Dr Lise Piquilloud Imboden, Dr Maria Vargas, Dr Denise Battaglini, Assoc Prof Michael Brenner, Dr Brendan Mc Grath, Assistant Prof Elisabeth Riviello, Prof Shiela Myatra, Prof Andrew Udy.

FOR MORE INFORMATION:  CO Chief Investigators:  Aisling Mc Mahon, Mater Misericordiae University Hospital, Dublin, Ireland. [aislingmcmahon@mater.ie] and Michelle Smyth, Beaumont Hospital, Dublin, Ireland [michellecsmyth@rcsi.ie]

• Acute Kidney Injury-Epidemiology in ICU patients 2 – The AKI-EPI 2 study

This is an international, multicentre observational cohort study (>100 centres across the world). The AKI-EPI 2 study is a full product of the AKI section of the ESICM. The study is the follow-up from the AKI-EPI study (DOI: 10.1007/s00134-015-3934-7) which, at the time was endorsed by ESICM. Of note, the paper was published in ICM in 2015, was cited more than 2500 times, and, to date, remains the standard on the epidemiology of AKI in ICU patients.

Primary objective: To provide a contemporary update on the epidemiology (rates, severity,duration, and etiology) of AKI and associated outcomes in critically ill patients.
Secondary objectives:  To assess temporal aspects of AKI (timing relative to ICU admission and duration).  To describe utilization and practice of RRT (indications, timing, modality, anticoagulation, duration, discontinuation).  To explore differences in rates and outcomes between regions and health care
systems according to geographical location and resources.

Steering Committee: Sean Bagshaw, Edmonton (CA); Rinaldo Bellomo, Melbourne (AUS); Lui Forni, Surrey (UK);  Michael Joannidis, Innsbruck (A); John Kellum, Pittsburgh (USA);  Marlies Ostermann, London (UK); John Prowle, London (UK); Thomas Rimmelé, Lyon (FR); Emily See, Melbourne (AUS); Wim Vandenberghe, Ghent (BE); Alexander Zarbock, Münster (DE).

FOR MORE INFORMATION,  Principal Investigators:  Eric Hoste, Ghent University Hospital C. Heymanslaan 10, 9000 Gent, Belgium. [eric.hoste@uzgent.be] and Antoine Schneider, CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland. [antoine.Schneider@chuv.ch]

• Multicentre Prospective Observational Study on the Management of Septic Shock – The OSS study

This is a prospective, observational, multicentre, international study initiated by the ESICM CD and SIS Sections.  This study should provide a better understanding of how septic shock is managed, check how practices are consistent with guidelines, evaluate which part of guidelines are applicable, and describe the variability in practices (at a country and hospital level), and assess how different practices influence 28-day mortality.

Primary objective: To assess current clinical practices for the treatment and monitoring of patients with septic shock.
Secondary objectives:  To check how practices are consistent with current guidelines;  To evaluate which part of guidelines are applicable, and describe the variability in practices (at a country and hospital level); To evaluate the 28-day mortality of septic shock in current life; To assess how different practices influence 28-day mortality;  To estimate how factors are associated with this mortality rate.

Target population: Clinicians (Physicians, nurses and respiratory therapist) involved in the decision-making process for switching between controlled and assisted mechanical ventilation in the ICU and vice versa.

Steering Committee: Members of the (planned) steering Committee
President: Michelle Chew (Sweden); Members:  Djillali Annane (France), Daniel De Backer (Belgium), Vanina Edul (Argentina), Marc Leone (France),  Xavier Monnet (France), Sheila Myatra (India), Tai Pham (France), Rui Shi (China).

FOR MORE INFORMATION,  Principal Investigator:  Xavier Monnet, MICU, Bicêtre Hospital, Paris-Saclay university Hospitals, AP-HP, France  [xavier.monnet@aphp.fr]

• Factorial Vignette-Based Survey on Decision-Making for Transitioning from fully Controlled to Assisted Ventilation in Acute Hypoxemic Respiratory Failure – The VentiSwitchGnette study

Aim: By capturing how clinicians balance oxygenation, mechanics, and respiratory drive, the study aims to improve recognition of high-risk states for ventilatory failure or patient self-inflicted lung injury. Ultimately, this work may contribute to more consistent and physiologically grounded practice around the management of assisted ventilation, improving patient outcomes while reducing unnecessary exposure to deep sedation and controlled ventilation.

Primary Objective 1: To determine the clinical and physiological factors influencing the transition from controlled to assisted mechanical ventilation.

Primary Objective 2: To identify factors contributing to the decision to switch back to controlled mechanical ventilation.

Target population: Clinicians (Physicians, nurses and respiratory therapist) involved in the decision-making process for switching between controlled and assisted mechanical ventilation in the ICU and vice versa.

Survey: please fill out the research survey here

FOR MORE INFORMATION,  Principal Investigator:  Giacomo Bellani, Medical-Surgical Intensive Care Unit Director Santa Chiara Hospital, University of Trento, Trento (Italy). Contact: Eleonora Balzani, Centre for Medical Sciences-CISMed, University of Trento, Trento (Italy), [eleonora.balzani@unitn.it]

• Priority Setting Partnership – Critical Illness Communication And Swallowing Difficulty In Critical Illness

The aim of this project is to identify the unanswered questions about communication and swallowing difficulty in critical illness from patient, carer and clinical perspectives and then prioritise those that patients, carers and clinicians agree are the most important for research to address.

Primary objective: to identify uncertainties about communication and swallowing difficulty during critical illness.

Secondary Objectives: to publicise the results of the PSP and process and to take the results to research commissioning bodies to be considered for funding.

FOR MORE INFORMATION, PLEASE CONTACT: Amy Freeman-Sanderson, University of Technology, Sydney (Australia), [Amy.Freeman-Sanderson@uts.edu.au] and Louise Rose,  Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, United Kingdom, [louise.rose@kcl.ac.uk]

• Extubation in Acute Brain Injury (EABI)” Study 

Primary Objective: To develop expert consensus guidance on “readiness to extubate” criteria for extubation of patients with acute brain injury.

International study, open to all clinicians and researchers with expertise in the field.

This study has been approved by the ESCM NIC Section and ESICM Research Committee.

FOR MORE INFORMATION, PLEASE CONTACT: Chief Investigator  Arun Joseph, Nuffield Department of Clinical Neurosciences, University of Oxford. [arun.joseph@ndcn.ox.ac.uk]
Co-Investigators: Chiara Robba, Ceri Battle, Louise Rose, Andrew Farmery.

Please find the participant information sheet and consent form here and return to [Extubation-ABI@kcl.ac.uk]

• Rehabilitation Practices in Critically Ill Patients Undergoing Invasive Mechanical Ventilation (REPOrt Study)

This prospective, international, multicenter, observational study will capture the worldwide practice of rehabilitation (mobilization and respiratory physiotherapy), in particular modality, timing, intensity, and frequency, to assess their clinical impact across a large sample of ICUs. It is hypothesized that rehabilitation practice is highly variable across different geo-economic regions and can be associated with clinical outcomes.

This study has received the ESICM Next Start-up Grant 2025.

FOR MORE INFORMATION, PLEASE CONTACT: Denise Battaglini, Dept. of Surgical Sciences and Integrated Diagnostics (DISC) – University of Genoa; IRCCS Ospedale Policlinico San Martino, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genova, Italy; University of Genoa, Genova, Italy.   [denise.battaglini@unige.it]

• Healthcare Professionals’ Perspectives on AI Integration in Clinical Practice:  Current Applications and Legal Considerations (AI-CARE)

Primary Objective: Investigate healthcare professionals’ experiences with AI applications in clinical practice, focusing on impacts on decision-making dynamics, professional autonomy, and broader legal implications.

Secondary Objectives: Identify the specific impacts of AI on clinical workflows; Determine key areas for improving AI integration and training.

This project has been approved by the APM Section and ESICM Transfusion Task Force.

FOR MORE INFORMATION, PLEASE CONTACT: Dr. James W. Hazel, Postdoctoral Researcher, Law Centre for Health and Life, Amsterdam Law School, University of Amsterdam,Amsterdam, Netherlands. [j.w.hazeliii@uva.nl]

• The criticAl Care nUtrition mulTinational rEgistry “ACUTE”

Aims:
This is a multinational multicentre registry implemented in adult ICUs, where nutrition data will be prospectively collected and retrospectively analysed. Worldwide adult ICUs are invited to participate in this project. This project is an initiative supported by the ESICM FREM Section.

FOR MORE INFORMATION, PLEASE CONTACT Christian Stoppe, Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine University Hospital Wuerzburg; Department of Cardiac Anesthesiology and Intensive Care Medicine German Heart Center Charité Berlin, Germany [christian.stoppe@gmail.com]

• Can pulse pressure assessment at the bedside detect low values or track changes of stroke volume in critically ill patients? The multicenter, cross-sectional, observational –  “ANDROMEDA-PEGASUS”

Aims:
This multicenter, international, investigator-led, cross-sectional observational study aims to assess the predictive capacity of pulse pressure (PP) to detect low stroke volume (SV) as evaluated by bedside ultrasonography in critically ill patients. Secondary objectives include: To assess the predictive capacity of PP to detect low SV in different clinical contexts in ICU patients, such as in those with acute respiratory distress syndrome (ARDS), postoperative states, or septic shock, among others. To assess the impact of several demographic, clinical and technical issues on the predictive capacity of PP to estimate SV, such as mechanical ventilation, vasoactive medication, age, position of the arterial line, among others. To determine the capacity of PP to track changes of SV during common intensive care interventions such as passive leg raising (PLR) maneuver, fluid challenges, vasoactive drug initiation or titration.

FOR MORE INFORMATION, PLEASE CONTACT Glenn Hernandez and Eduardo Kattan, Co-chairs of the Project (both ESICM members), Departmento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. [glennguru@gmail.com]

• Sepsis in the ICU-II: Precision medicine models for sepsis-induced myocardial dysfunction – “SICU II”

Aims:
To determine the association between left and right ventricular systolic and diastolic dysfunction (Aim 1), novel biomarkers (Aim 2) and adverse outcome in SIMD. Finally, we will determine the combined value of clinical, biomarker, echocardiographic, and haemodynamic variables (Aim 3). Adverse outcomes are defined as acute myocardial injury (Effect 1), days free of organ support (Effect 2), 30-day mortality (Effect 3) and days alive and out of hospital at 30 days after ICU admission (Effect 4). We will use traditional statistical inference based on standard multivariable and mixed model analysis to explore the prognostic significance of individual and combined predictor variables.
(2) A machine learning algorithm to identify important features for prediction of short- and long-term mortality: To use an ensemble tree-based machine learning approach to identify the most important features (i.e. variables), among a set of supplied features, that can predict mortality, and examine how each feature alters the prior expectation of ICU outcome (Aim 4, Effect 5).
(3) Consensus definition of sepsis-induced myocardial dysfunction: Combining the results of our studies with current literature, we will invite key opinion leaders within the field to formulate a consensus for the definition, management and future research priorities for SIMD (Aim 5).

FOR MORE INFORMATION, PLEASE CONTACT Michelle Chew Dept of Anaesthesia and Intensive Care, Linköping University Hospital, S58185, Sweden. [Michelle.chew@liu.se]

• Early rehabibilitation of intensive care unit patients – a multinational prospective observational study on dosage and outcome – “ERUPT”

Aims:

The ERUPT study, initiated by an international and interprofessional team of experts in intensive care medicine and rehabilitation, is the first multinational, prospective observational study to improve the understanding of early mobilisation, its dosage and effects on patient outcomes. For the first time, patient groups such as patients who were functionally dependent prior to their ICU admission will also be included.The study aims to gather data on mobilisation practices and their dosing worldwide by collecting information from over 6,000 patients in more than 200 ICUs.The study objectives are (1) to assess the variety of different mobilisation practices worldwide, (2) to analyse the association of mobilisation dosage on patient outcomes, and (3) to assess the association of the prehospital functional status or invasive mechanical ventilation on patient outcomes.

FOR MORE INFORMATION, PLEASE VISIT https://www.erupt-study.eu or CONTACT Stefan Schaller, Medical University of Vienna

Are you interested in joining us? Please take a moment to participate in our brief survey: https://forms.office.com/e/cRJBMkuAnF

Coordinator: Vera Karner [erupt@muv.ac.at]

• PeriOPerative OUTcome Platform Study – “POP-OUT”

Aim:
Regarding the objectives of the first study within the platform entitled: Association of intraoperative Hemodynamic characteristics with postoperative Complications and Mortality (HeCoMo).  Hypothesis: The hemodynamic characteristics like amounts of intravenously administered fluids, vasopressors, or inotropes are associated with increased postoperative complication rates and severity as well as postoperative mortality.
– Primary: Short-term postoperative complications according to the Clavien-Dindo classification greater or equal to IIIb
– Secondary: Postoperative mortality (in-hospital, 3-months, one-year).

FOR MORE INFORMATION, PLEASE CONTACT Aarne Feldheiser [a.feldheiser@kem-med.com]  Dept. of Anaesthesiology, Intensive Care Medicine & Pain Therapy, Evang. Kliniken Essen-Mitte, Huyssens-Stiftung/Knappschaft, 45136 Essen, Germany.

• Cerebrovascular Investigation Related to Circulatory parameters Using Longitudinal Assessments on Transcranial Doppler based Evaluation in Mechanical Circulatory Support. Circulate MCS study

Aim:
Primary Aim: To characterize the relationship between all Transcranial Doppler(TCD)-derived cerebral blood flow(CBF) parameters ( mean blood flow velocity, pulsatility index and autoregulation index) with different systemic flow patterns in Mechanical Circulatory Support(MCS) (type of device, degree of support, native cardiac output, vasopressor/inotrope use, pulsatile vs non- pulsatile, different flow volumes, varied peak flow rates, resistance of systemic circuit measured with pulsatility Index) and develop reference ranges adjusted to age, gender, race, comorbidities & extracranial carotid values.
Secondary aim: To identify the association of individual TCD-derived parameters adjusted for MCS settings, age, gender, race, co-morbidities with adverse neurological events in critically ill patients receiving MCS

FOR MORE INFORMATION, PLEASE CONTACT AArti Sarwal 3160 Allerton Lake Drive, Winston Salem, NC (USA) [aartisarwal@gmail.com] +1(573) 823-5878

• Prospective, multicenter study to validate the GastroIntestinal Dysfunction Score (GIDS) and describe prevalence, outcomes, and management of phosphate disorders in intensive care patients (the GUTPHOS study).

Observational, prospective, multicentre trial. This study does not include any intervention, routine practice in participating sites is observed.

Objectives

Aim 1: To validate the Gastrointestinal Dysfunction Score in predicting mortality and duration of ICU dependency and duration of PN dependency among consecutive adult patients admitted to participating ICUs worldwide.
Aim 2: To identify the prevalence, management practices, and outcomes of Pi abnormalities during the first week of ICU admission in consecutive adult patients admitted to ICUs worldwide.

Recruitment of sites and target population

We aim for 20 ICUs to include adult patients (≥18 y) admitted to ICU during recruitment period. Exclusion criteria: restrictions of care at ICU admission; admitted for treatment as organ donors; continuous chronic home ventilation for neuromuscular disease; declined participation or informed consent; or readmission to ICU during the study period.

Funding: This project received the 2023 ESICM Fresenius Kabi Clinical Nutrition Award.

FOR MORE INFORMATION, PLEASE CONTACT:

Arthur van Zanten, Gelderse Vallei Hospital, Ede, The Netherlands [zantena@zgv.nl]
Annika Reintam Blaser,  University of Tartu Hospital, Tartu, Estonia [annika.reintam.blaser@ut.ee]

• A European Survey on MIgRAnts in the Intensive Care Unit – The AMIRA Study

A prospective observational study in 100 ICUs from 10 European countries. A 1 week survey performed 4 times over a 1-year period.

Study population:
Non-national patients residing in the recruiting center country will be defined as migrants. Non-migrants will be considered as belonging to the general population.
Among migrants, sub-groups will be defined a priori:
– Documented migrants: regularly living according to the country’s laws concerning immigration
– Asylum seekers: patients than have filled in an asylum demand
– Refugees: patients that benefit from a refugee status
– Undocumented migrants: patients living irregularly in the country
– Undocumented migrants, asylum seekers and refugees (UMASR) will be compared to documented migrants and to general population (control groups).

Methods and Analysis:

Design: multicentric prospective observationnal study.
Participating Centers: 100 European ICUs in the 10 European countries where immigration was the most important in 2019 (Germany, France, Spain, Greece, United-Kingdom, Italy, Belgium, Sweden, Netherlands, Finland).
Study periods: 4 time one week period (1 week / season at predetermined dates) over 1 year.
Study groups: UMASR, documented migrants and general population.
Non-national patients residing in the recruiting center country will be defined as migrants. Non-migrants will be considered as belonging to the general population. Documented migrants and UMASR will be analyzed separately. Patients will be classified according to their affiliation to the national healthcare system and administrative informations recorded at hospital admission.
Timing:
This study Starting date: 2023
Study Duration: 12 months (it can be extended on request)

Expected result:
This endorsed study will describe the characteristics of UMASR admitted to the ICU (demography, economic and social context, comorbidities, reason for admission, need for invasive support during ICU stay), their outcomes (ICU and hospital survival) compared to general population and documented migrants. To have an insight into the practices related to communication with the patients and his relatives considering language barrier and cultural/religious differences and to end of life process.

FOR MORE INFORMATION, PLEASE CONTACT:

Sami HRAIECH Medical ICU, APHM, Marseille France, Aix Marseille University
Elie AZOULAY, Medical ICU, APHP, France, Paris University

[sami.hraiech@ap-hm.fr]; [elie.azoulay@ap-hp.fr]

• ReLatIonship BEtween implementation of evidence-based and suppoRtive ICU cAre and ouTcomes of patIents with acute respiratOry distress syndrome – The ICU LIBERATION Study

Aim: This study aims to investigate the epidemiology and treatments given to the patients and evaluate the implementation of evidence-based ICU care and its association with the outcomes of patients with ARDS admitted to the ICU. The contents of mechanical ventilation settings, respiratory conditions, and evidence-based ICU care, such as analgesia, sedation, rehabilitation, and nutrition, given to the patients will be collected on a daily basis to perform a robust statistical analysis.

Methods and Analysis: This study will be a prospective observational study, with case enrollment beginning after Ethics Committee approval during the patient enrollment period. Up to 10 patients who meet the inclusion and exclusion criteria will be enrolled in the central online database. Upon admission to the ICU of patients who meet the selection criteria, the principal investigator or collaborator at each collaborating institution will assess their suitability for the study.

Timing:
This study Starting date: June 2023
Study Duration: 60 months (it can be extended on request)
Patient enrollment period: June 2023 to May 2024 (12 months)

Expected result:
This ESICM-endorsed study will reveal the epidemiological outcomes and PICS related-outcomes of ARDS on a large scale. Furthermore, this registry will demonstrate how ICU-ventilated patients with ARDS receive the treatments and evidence-based ICU care during their ICU stay on a daily basis in detail.

FOR MORE INFORMATION, PLEASE CONTACT:

Check for more details on the study webpage here

or contact the research office at [keiliu0406@gmail.com]; [liberation-office@googlegroups.com]

To take part in the project, please register here

1. CRF
2. Protocol
3. Study explanation sheet
4. Consent form
5. Data sharing – authorship secondary analysis
6. Application form for secondary analysis
7. Confidentiality Agreement
8. Ethical approval – Amendment 1 – Amendment 2

Stefan Schaller, Deputy Clinical Director, Department of Anesthesiology and Operative Intensive Care Medicine (CVK, CCM), Charité – Universitätsmedizin Berlin, Germany.