Do not miss the ongoing surveys…
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.
Contact: Sherihane Bensemmane, Division of Scientific Affairs – Research ESICM
Carole Boulanger, Chair N&AHP Committee
Christiane Hartog, Deputy ETH Section
Lara Prisco, Deputy NIC Section
Lui Forni, Chair Research Committee
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.
Contact: Jean-Louis TEBOUL
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 Medicine; Letter, Online First ™ – July, 2016; Pages 1 – 3
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
EuroFasciitis survey: Management of necrotising fasciitis in European ICUs
Necrotising fasciitis (NF) is a rare and severe soft tissue infection that has no epidemiological data available in Europe. This survey, endorsed by ESICM’s Infection section, aimed to assess the burden of NF in European ICUs and the organisation of care in institutions managing patients with NFs, including aspects related to diagnostic strategy, organisation of surgery and the potential of multidisciplinary teams to care for patients with NFs. This survey closed in June 2015.
de Prost N et al. Management of necrotising soft tissue infections in the intensive care unit: results of an international survey. Intensive Care Medicine; Letter, Volume 41, Issue 8 / August, 2015; Pages 1506 – 1508
Nicolas de Prost et al. Therapeutic targets in necrotising soft tissue infections. Intensive Care Medicine; Editorial, Online First – May, 2017, Pages 1 – 3
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.
Letter published in ICM ONLINE FIRST (Jan 2016)
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.