Indications and intensive care management of patients with acute ischemic stroke

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.

Steering Committee: Dr Chiara Robba, Prof Giuseppe Citerio, Prof Martin Smith

International Survey amongst Physicians and Nurses Regarding Used Definitions, Incidence, Current Treatment Strategies and Perceived Outcome of Hypotension in Intensive Care Patients.

The lack of consensus regarding an universal definition of hypotension for ICU patients and the need of being proactive rather than reactive towards hypotensive episodes formed a trigger to develop an international survey to map used definitions, treatment and outcome of hypotensive episodes in the ICU among physicians and non-physicians. The aim of this survey is to form a baseline on these topics. Besides, the results of the survey are expected to improve future guidelines, patient care and guide new topics for research.

This survey is endorsed by the Research Committee and the Cardiovascular Dynamics section of the European Society of Intensive Care Medicine.

Steering committee: Prof. Jan Bakker MD, PhD, Prof. Thomas Scheeren MD, PhD, Alexander Vlaar MD, PhD

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 will help understand the global practice of HFNC, which ultimately will guide future studies in HFNC treatment.

This survey is 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.

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 survey is endorsed by ESICM (European Society of Intensive Care Medicine), ESICM NIC Section and NCS (Neurocritical Care Society)

Coordinator: Dr. V. McCredie

International survey on the Structure and Organisation of the Intensive Care Unit (ISOREA)

The present survey aims to evaluate the structures and the organisation systems of the ICUs in a large sample from high, middle, and low income countries.

The survey is endorsed by:
– ESICM (European Society of Intensive Care Medicine)
– SRLF (Société de Réanimation de Langue Française)
– SARAF (Société d’Anesthésie Réanimation d’Afrique Francophone)
– ISCCM (Indian Society of Critical Care Medicine)

Coordinator: Pr. Armand Mekontso Dessap