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October 6, 2016

HOT TOPICS SESSION

Wednesday October 5th, 14:10~17:00        

#LIVES2016        

This session is called "Hot Topics" for a reason! Featuring presentation of results from a record eight clinical trials, some with corresponding papers that will be simultaneously published in major medical journals including JAMA, and ICM, this session is the one that cannot be missed! Be among the first to hear these long-awaited results and ask the speakers directly about their data and the clinical impact of their findings. This sessions trial presentations will begin with the addition of results from a brand new trial: EUPHRATES trial presented by Massimo Antonelli (Rome, Italy). Check out these brief previews of the other top trials…


Effect of conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit: A randomised clinical trial

Oxygen is a ‘drug’  essential for human life. Oxygen is the most widely prescribed therapy in critically ill patients to prevent and/or  correct hypoxemia. Despite suggestions of potential harm from unnecessary oxygen therapy, critically ill patients spend substantial periods in a hyperoxemic state. A strategy of controlled arterial oxygenation is thus rational but has not been validated in clinical practise.

Is a strategy aimed to maintain PaO2 within physiological limits safe and  beneficial in critically ill patients with an ICU stay > 72 hours?

In this trial, patients were randomly assigned to receive oxygen therapy to maintain arterial oxygen partial pressure (PaO2) between 70-100 mmHg and/or arterial oxyhemoglobin saturation (SpO2) between 94-98% (conservative group) or, according to standard ICU practice, allowing PaO2 values up to 150 mmHg and/or SpO2 values between 97-100% (control group).

  ~ Massimo Girardis (Modena, Italy)


Neuroprotective effect of therapeutic hypothermia versus standard care alone after convulsive status epilepticus: A multicentre randomised controlled trial   

Convulsive status epilepticus is followed by permanent neurological impairment in 50% of survivors requiring ICU admission.

In a multicentre randomised trial, we evaluated the effect of induced hypothermia (32-34°C) on neurological outcomes 90 days after convulsive status epilepticus.

The findings of this original trial deserve attention.

  ~ Stephane Legriel (Versailles, France)


Effect of postextubation high-flow nasal cannula vs noninvasive ventilation on reintubation in high-risk patients a randomised noninferiority clinical trial  

High-flow oxygen therapy reduces reintubation rate compared to conventional oxygen therapy in low-risk for reintubation patients. Noninvasive ventilation may reduce reintubation rate in patients at high-risk for reintubation, but no data are available about the role of high-flow oxygen therapy on high-risk for reintubation patients.
High-flow oxygen therapy has some advantages such as comfort or availability and it was compared to noninvasive ventilation in a noninferiority multicentre randomised trial.

The results were unexpected, but propel our ideas about high-flow oxygen therapy after extubation in high-risk patients.

~ Gonzalo Hernandez (Toledo, Spain)


Levosimendan for the prevention of acute organ dysfunction in sepsis: The LeoPARDS trial  

Catecholamines are first line treatment for cardiovascular resuscitation in septic shock but high levels of catecholamines are associated with poor outcomes.

Levosimendan is a calcium-sensitising drug with inotropic and other properties that may improve outcome of patients with sepsis.

The Levosimendan for the Prevention of Acute oRgan Dysfunction in Sepsis (LeoPARDS) trial is an academic-led 516 patient, double-blind, randomised clinical trial conducted in 34 ICUs in the UK, to establish whether levosimendan, when added to standard care, could reduce organ dysfunction in septic shock and to assess its safety profile in this condition.

Anthony Gordon (London, United Kingdom)


Effect of a condolence letter on post-intensive care unit syndrome among relatives of patients who died in the ICU: A randomised clinical trial

Family members of patients who die in the intensive care unit are at high risk of developing grief symptoms such as anxiety, depression, post- traumatic stress disorder, and/or prolonged grief. In a multicentre randomised trial, we evaluated whether these grief symptoms were alleviated when the patient’s physician and nurse sent the closest relative a handwritten condolence letter 2 weeks after the death. Our results are surprising!

Nancy Kentish-Barnes (Paris, France)


SIRS, qSOFA, and SOFA score as outcome predictors among infected critically ill patients: An external validation of the new sepsis definition  

The 2016 results of the Sepsis-3 Consensus meeting changed our understanding and definitions of sepsis, and introduced the qSOFA score.

This study tested, and the presentation will reveal, the external validity and predictive capacities of SIRS, qSOFA and SOFA for in-hospital mortality and ICU length of stay 3 days, in infected ICU patients, in the Australian and New Zealand setting.

Eamon P. Raith (Melbourne, Australia)       


Jean-François Timsit, Paris, France will also be presenting results from The EMPIRICUS randomised clinical trial: Effect of empiric treatment with micafungin on survival without invasive fungal infection among adults with ICU-acquired sepsis, Candida colonisation at multiple sites, and multiple organ failure.  

Check out the icTV HOT TOPICS PREVIEW with Timsit discussing his trial here:


ESICM President Daniel De Backer and JAMA Editor-In-Chief Howard Bauchner will chair this exciting session which will open with an awards ceremony in which Jacques Duranteau (Kremlin-Bicetre, France) and Francesca Rubulotta  (London, United Kingdom) will award winners of various ESICM and Industry awards.

 

Don't miss this final session of LIVES 2016! Catch it LIVE in Milan or watch online…

HOT TOPICS SESSION 

05.10.2016, 14:10 – 17:00, room Milan 

 
#LIVES2016 #lung #sepsis #periop #paed #cardio #trauma #cardio #ethic #neuro
 
 
 
 

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