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

Lead Investigator: Dr. Karen E.A. Burns

Project Start Date: February 1st, 2013

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.


• DALI – Defining Antibiotic Levels in Intensive care unit patients

Lead investigator: Prof Jeffrey Lipman

The aim of the project was to determine whether contemporary antibiotic dosing for critically-ill patients is achieving concentrations associated with maximal activity.

icTV interview with the investigators: Jason Roberts and Jeffrey Lipman

Link to the related publication:
Roberts JA. et al. DALI: defining antibiotic levels in intensive care unit patients: are current β-lactam antibiotic doses sufficient for critically ill patients? Clin Infect Dis. 2014 Apr;58(8):1072-83. doi: 10.1093/cid/ciu027. Epub 2014 Jan 14.


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

Lead Investigator: Louis Puybasset

Project start date: January 2011 (36 + 12 months)

Predicting long-term outcome of critical neurological conditions such as traumatic brain injury (TBI), aneurysmal subarachnoid haemorrhage (aSAH), intraparenchymal haematoma (ICH) and severe hypoxic-ischaemic encephalopathy (HIE) at the sub-acute phase remains complex, inadequate and unsatisfactory.

Advanced MRI techniques offer a unique opportunity to improve our prognostication tools of the disorders of consciousness (DOC).


• AspICU2 – Invasive Fungal Disease in the ICU

Lead Investigator: Stijn Blot

Project start date: February 2011 (48 months)

Diagnostic criteria for IFD are only described for patients with “classical host factors” (immunocompromised). Hence, diagnosing IFD in non-immunocompromised ICU patients and, in the absence of histological evidence, is per definition impossible. Diagnostic uncertainty may lead to either delayed initiation of antifungal therapy (and poor survival), or unnecessary consumption of expensive antifungal agents. Additionally, the total burden of IFD is difficult to estimate.

Objectives of AspICU2:

– to identify distinct risk profiles for IFD in critically ill patients,

– to define diagnostic categories for (non-immuocompromised) critically-ill patients, and

– to estimate the burden of IFD in terms of incidence and outcomes.

Further info at the study website: www.aspicu2.org


• Prospective, randomised, multi-centre trial of lateral trendelenburg versus semi-recumbent body position in mechanically ventilated patients for the prevention of ventilator-associated pneumonia

Principal investigators: Gianluigi Li Bassi and Mauro Panigada
Project start date: December 2010 (36 months)
This study is planned to compare, in patients sedated, intubated/tracheostomized and mechanically ventilated, the efficacy and safety of two body positions in reducing incidence of ventilator-associated pneumonia. The semi-recumbent position prevents gastro-oropharyngeal aspiration of bacteria laden gastric contents and the “gastro-pulomnary” route of colonisation. The lateral-Trendelenburg position aims to promote outward drainage of pathogen-laden oropharyngeal secretion, while avoiding translocation of pathogens from the oropharynx into the lungs.

More information on www.gravityvaptrial.org


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

Lead investigator: Claudia Spies

Project start date: 2011 (3 years)

The aims of the project are noval global balanced measures for an early and safe use of antibiotics in severe infections in order to cut costs and mortality.

Project website


• CAPUCI II – Community Acquired Pneumonia in Europe

Lead Investigator: Jordi Rello

Project start date: July 2009 (60 months)

CAPUCI II is a specific targeted research project (STREP) which joins different European countries to develop security policies and to discover the factors involved in severe community acquired pneumonia.


• MOnIToR – Monitoring Organ Donors to Improve Transplantation Results

Lead investigator: Rupert Pearse

Project start date: September 2010

The objective of MOnIToR is to determine whether protocol guided resuscitation of brain dead organ donors using Pulse Pressure Variation (PPV) will increase the number of organs transplanted per donor.


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

Lead investigator: Claudia Spies

Project start date: November 2010

The aims of IMPROVE-ICU are to determine the prevalence of ICU delirium and to evaluate the methodology of delirium detection as current measures of interventions and treatment of delirium at different European/International institutions and hospitals.


• European mortality & Length Of ICU Stay Evaluation (ELOISE)

Lead investigator: Maurizia Capuzzo
Project start date: June 2011 (24 months)

Primary aim: To assess whether the patients admitted to the Intensive Care Units (ICUs) with availability of Intermediate Care Unit (IMCU) have lower hospital mortality than those admitted to the ICUs without availability of IMCU.

Secondary aims: To compare Lengths Of ICU and Hospital Stay (LOIS and LOHS, respectively) of patients admitted to ICUs with or without availability of IMCU. The LOIS will be used as a surrogate of ICU costs.

Since, in terms of cost, LOS in the IMCU is not equivalent to LOS in ward or ICU, the possible decrease in the number of ICU days will not reflect an equivalent cost reduction. Hence, to assess the influence of IMCU on cost it will be necessary to determine the cost ratio between ICU and IMCU. This will be obtained by gathering information about staffing and number of beds of both ICU and IMCU of each hospital.

To assess whether the patients admitted to the Intensive Care Units (ICUs) with availability of Intermediate Care Unit (IMCU) have lower readmission rate than those admitted to the ICUs without availability of IMCU.


• EuSOS – European Surgical Outcomes Study

Lead investigator: Rupert Pearse

Project start date: March 2010

This was a multi-centre, international seven day evaluation of patient care and clinical outcomes for patients undergoing non-cardiac surgery.

Project website


• INTERNATIONAL SURVEY ON FROZEN PLASMA TRANSFUSION PRACTICES

Lead investigator: Oliver Karam

Project start date: March 2011 (2 months)

Frozen plasma transfusions are a common treatment in an intensive care setting, both for critically-ill adults and children. They are used mostly to correct abnormal coagulation tests or to prevent bleeding. Much of the clinical use of plasma lacks objective evidence to support its value. Actually, little is known about the appropriate indications and current guidelines are based on very few clinical trials and mostly expert opinion. Furthermore, there are some data suggesting that frozen plasma “contributes significantly to the morbidity and the mortality resulting from transfusion of blood components” (Pinkerton & Callum. CMAJ 2010). Our study is a large international survey to investigate the current frozen plasma transfusion stated practice pattern among pediatric critical care physicians. We have built a self-administered online survey specific to pediatric intensivists that work in North America and Europe. The survey contains the description of four similar scenarios and we ask participants to state what level of abnormal coagulation would prompt them to prescribe frozen plasma transfusion. The results will allow a better understanding of the current practice and will be used to build a randomised controlled trial on frozen plasma transfusion thresholds.


• ReFIT

Resuscitation from Shock Using Functional Haemodynamic Monitoring

Lead Investigator: Michael R. Pinsky

Project start date: end of 2009 (12 months)

The goal of this clinical trial was to quantify the therapeutic benefit, if any, of cardiovascular resuscitation from circulatory shock using the functional haemodynamic monitoring (FHM) resuscitation algorithm as compared to usual practice as defined by the Consensus Conference on Haemodynamic Monitoring.


• GENOSEPT – Genetics of Sepsis in Europe

Lead Investigator: Frank Stueber

Project start date: January 2005 (48 months)

A genetic epidemiologic study of genetic predisposition to sepsis-related mortality and morbidity in European intensive care units.

This unique European dataset on the effect of genetic variation on sepsis outcomes will help to explain the variation in response to new treatments for sepsis and will deliver data on gender-related mortality and morbidity.

Please consult the GenOSept website for further information www.genosept.eu


• PROSPECTIVE, OBSERVATIONAL, MULTICENTRE STUDY OF GASTROINTESTINAL DYSFUNCTION IN CRITICALLY-ILL PATIENTS. DEVELOPMENT OF GASTROINTESTINAL FAILURE SCORE

Lead Investigator: Manu Malbrain

Project start date: 19 October 2009 (6 months)

The study’s aim is to create the best possible gastrointestinal failure score in critically ill patients. After validation, the major applications of the future score would be the monitoring of dynamics of organ failure and to assess the effects of therapeutic interventions on its course. Future usage of the GIF-score together with SOFA-score would allow a better understanding of interrelation between the failures of the various organs. All ICUs are welcome to join the study. For further information, contact Manu Malbrain at manu.malbrain@skynet.be or Joel Starkopf at joel.starkopf@kliinikum.ee


• H1N1 Flu – H1N1 Flu Registry on Intensive Care

Lead Investigator: Jordi Rello

Project start date: June 2009 (13 months)

The H1N1 Flu Registry on Intensive Care is an observational prospective, multicenter study that will allow to describe patients’ characteristics and management practices in patients with H1N1 flu treated in ICU.


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

Jean-François Timsit for the Eurobact steering committee

Project start date: October 2009 (3 months)

A prevalent cohort study; no more than 10 patients per centre with HAB; no more than 45 minutes per patient. To read the protocol: http://www.eurobact.eu


• ICU NUTRITION DAY

Lead Investigator: Michael Hiesmayr

Project start date: March 2007 (24 months)

The specific aim of this project is to assess nutritional therapy in ICUs on a specific date in order to detect correlations between nutritional therapies and outcome based on a large European sample. Outcome includes length of stay and mortality in ICU and in hospital.

More information at www.nutritionday.org


• IHPOTOTAM – Induced Hypothermia to treat Adult Meningitis

Lead Investigator: Bruno Mourvillier

Project start date: March 2007 (36 months)

The objective of this project was to evaluate the benefit of mild hypothermia versus no hypothermia on clinical outcome of adult patients hospitalised to ICU for severe community-acquired meningitis.


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

Lead Investigator: Julian Bion

Project start date: November 2007 (24 months)

The CoBaTrICE project, funded by the Leonardo programme in 2003-2006, successfully created an international competency-based programme for ICM and the objective of this second project is to ensure that this unique and innovative project is translated into more effective training and better patient care in member states, by supporting & harmonising national initiatives in vocational education & training. More information can be found at www.cobatrice.org


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

Lead Investigator: Julian Bion

Project start date: 2003 (36 months)

The CoBaTrICE project, which is now complete, created an international competency-based programme for Intensive Care Medicine thanks to an international partnership of professional organisations and critical care clinicians working together to harmonise training in intensive care medicine worldwide.

For a complete overview visit www.cobatrice.org

Publications: Intensive Care Medicine (2006): 32: 1371-83

Intensive Care Medicine (2007): 33: 1913-20


•CORTICUS – Corticosteroid therapy of septic shock

Lead Investigator: Charlie Sprung

Project start date: October 2004 (36 months)

The objective of this project was to develop three tools that make diagnosis and treatment of septic shock more beneficial:

1. a Europe-wide diagnostic testing system;

2. diagnostic criteria for adrenal insufficiency;

3. recommendations for corticosteroid therapy in septic shock


• ECRF

Lead Investigator: Julian Millo

Project start date: January 2005 (9 months)

This project merged with GenOSept, which developed an electronic-case report form (database) necessary to capture the patients’ clinical and demographic data. ECRFs are accessible at www.genosept.eu


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

Lead Investigator: Charlie Sprung

Project start date: May 2002 (48 months)

The objective of this project was to make triage decisions for the elderly in Europe more transparent, beneficial and fair, as well as more cost-effective, and to harmonise European standards.


• IPOC – International Programme for Resource use in Critical Care

Lead Investigator: David Edbrooke

Project start date: 2002 (3 months)

The section has developed a programme which facilitates a comparison between costs of Intensive Care Units in different countries.

Methods: This was an observational, retrospective, cross-sectional, multicentre study set in four European countries: France, UK, Germany and Hungary. A total of 329 adult intensive care units participated in the study.

Results: The costs are reported in international dollars ($) derived from the WHO PPP programme. The results show significant differences in resource use and costs of ICUs over the four countries. On the basis of the sum of the means for the major components, the average cost per patient day in UK hospitals was $1512, in French hospitals $934, in German hospitals $726 and in Hungarian hospitals $280.

Conclusions:The reasons for such differences are poorly understood, but warrant further investigation. This information will allow to better adjust the measures of international ICU costs.


• PRICE – Physical Restraints in Intensive Care in Europe

Lead Investigator: Julie Benbenishty

Project start date: November 2003 (2 days)

The purpose of this study was to gather exploratory data on the incidence of and the reasons for physical restraints in adult ICUs in Europe.


• SAPS 3 – From the evaluation of the individual patient to the evaluation of the ICU

Lead Investigator: Rui Moreno

Project start date: October 2002 (18 months)

The aim of the SAPS 3 project was to develop a multi-dimensional performance indicator, not only for the assessment of patients, but also to evaluate Intensive Care Units (ICUs) and their performance on several dimensions.

One of the major aims of the SAPS 3 project was to develop a system that could be used free of charge by all intensivists worldwide. Thanks to the creation of this new system, severity of illness and probability of hospital mortality can be calculated with the use of ICU admission data.

More information at www.saps3.org. Publications on this project are available from the website.


• SEE & SEE 2 – Sentinel Events Evaluation

Lead Investigator: Andreas Valentin

Project start date: January 2004 / January 2007 (24 hours)

SEE is a one-day cross-sectional international study on the prevalence of unintended events in intensive care.

The first SEE study has revealed that patient safety is an urgent issue in ICUs all over the world. In 205 participating ICUs, 38 unintended events per 100 patient days were observed during the 24h study period. Medication errors occurred with considerable frequency.

Now a next step in the SEE project is focused on the causes and measures of error prevention. SEE 2 study aims to determine the frequency, characteristics, and contributing factors of parenteral medication errors at the administration stage and to assess related preventive measures.

More information at www.hsro-esicm.org