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Mechanical Ventilation
State of the Art 2017

ESICM Advanced Training Courses in Intensive Care

Over three days, the course directors Jean-Daniel Chiche, David Chiumello and Claude Guérin with top expert faculty will cover the State of the Art in Mechanical Ventilation in two parts encompassing five practical modules for learning.

November 28-30, 2017 – ESICM Brussels office – 3 days Postgraduate course.

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Info

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Research – Trials

APRONET is a ONE-day prevalence study initiated by the ESICM Acute Respiratory Failure Section, which will be repeated four times during a one year period. It is a multicentre observational prospective study with no patient follow-up

Apronet

Prone position is used in almost 14% of severe ARDS patients according to the results of the LUNG-SAFE study. This rate is rather low given the results of the most recent trial that showed a beneficial effect of proning on patient outcome, a finding which is in line with previous meta-analyses. The reasons why the use of proning is still limited are unclear…

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WorldwidE AssessmeNt of Separation of pAtients From ventilatory assistancE is a multi-centre, prospective, observational, 4-week inception cohort study being carried out by the Acute Respiratory Failure section of ESICM.

WEAN SAFE

Weaning represents a challenge for intensivists and patients spend a considerable amount of time in being liberated from mechanical ventilation. While guidelines do exist on the classification of weaning, a recent study has shown that these may not be applicable to all patients.

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A Strategy of UltraProtective lung ventilation With Extracorporeal CO2 Removal for New-Onset moderate to seVere ARDS. It was a pilot trial; a feasibility and safety trial

This study will assess changes in pH/ PaO2 /PaCO2, Respiratory Rate and device CO2 clearance in the first 24 hours of ECCO2R following VT and plateau pressure reduction in patients with moderate ARDS. Safety variables during treatment will also be analysed.

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Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE is a multicentre, prospective, observational, 4-week inception cohort study, which has been carried out by the Acute Respiratory Failure section through the ESICM Trials Group.

The study aimed to prospectively assess the burden of, management and therapeutic approaches to, and outcomes from acute hypoxaemic respiratory failure requiring ventilatory support, with a specific focus on ARDS as defined by the Berlin Definition.

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The Intensive Care GLObal Study on Severe Acute Respiratory Infection is a multicentre, prospective, observational,14-day inception cohort study designed and conducted by the ESICM Trials Group to investigate the epidemiology and microbiology profiles of ICU-SARI.

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Sakr et al. The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study.
Intensive Care Med. Seven-Day – Profile Publication, Online First™ – February, 2016; Pages 1 – 12

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Weaning from mechanical ventilation: comparison of open-loop decision support system and routine care, in general medical ICU

The aim of this project is to perform an international multicentre prospective observational cohort study of nosocomial pneumonia in intensive care units (ICUs) worldwide in order to provide up-to-date and comprehensive descriptive data on the diagnosis, microbiology, time course of resolution, management and outcomes in a global ICU population.

PRessuresuppOrTvEntilation + sigh in aCuTehypoxemIcrespiratOry failure patieNts. This study, initiated within the ESICM PLUG Working Group, is a randomised controlled on the effects of short cyclic recruitment maneuver  added to pressure support ventilation that will be conducted in several ICUs in different countries

Incidence of dysynchronous spontaneous Breathing Effort, breath-stacking and reverse triggering in early ARDS

This project, initiated by the ESICM PLUG (Pleural Pressure) Working Group, is an observational multicentre physiological study that will be conducted in several ICUs in different countries.

Research – Surveys

TrainECMO Survey on packed red blood cells transfusion practice in vv-Ecmo patients. Mortality associated with acute respiratory distress syndrome (ARDS) remains high despite continual improvement in mechanical ventilation and extracorporeal membrane oxygenation (ECMO).

Technical simplifications, and its use during the 2009 H1N1 influenza pandemic prompted a sharp increase in the use of ECMO worldwide.

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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.

Relevant research

Alain Combes et al. The ICM research agenda on extracorporeal life support.
> Read article (Free Access)

Samir Jaber et al. The intensive care medicine research agenda for airways, invasive and noninvasive mechanical ventilation.
> Read article (Free Access)

Cambiaghi B et al. Effects of regional perfusion block in healthy and injured lungs.
> Read article (OPEN ACCESS)

Fan E et al. Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome.
> Read more

Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome.
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High flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) for the initial respiratory management of acute viral bronchiolitis in young infants: a multicentre randomised controlled trial (TRAMONTANE study).
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Assessment of heart rate, acidosis, consciousness, oxygenation, and respiratory rate to predict noninvasive ventilation failure in hypoxemic patients.
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Article Reviews

Want to reduce reintubation rates? Reconnect to Mechanical Ventilation for 1h after a successful spontaneous breathing trial

> Read the article review

Diaphragm weakness in the ICU: What do we know?

> Read the article review

A clinical prediction tool for mortality in ARDS

> Read the article review

Atelectrauma during ARDS: new insights on a classic concept

> Read this article review

The TRAMONTANE trial

> Read this article review

Awards

Headspace analysis of airway fluid samples for the prediction of ventilator-acquired pneumonia

Lieuwe Bos
Junior Investigator Research Award 2012

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Hemodynamic efeof lung function optimization in Acute Respiratory Distress Syndrome (HEARDS)

Arnaldo Santos Oviedo
Basic Science Award 2012

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Suggested talks

icTV update with Claude Guerin

Claude Guerin discusses the APRONET study on prone positioning in ARDS patients.

Visit our e-LIVES platform to see more…

WEAN SAFE study

In this icTV interview, John Laffey and Giacomo Bellani discuss the ESICM Trials Group international study on weaning strategies in mechanically ventilated intensive care patients.

Visit our e-LIVES platform to see more…

ECLAIR STUDY: Avoiding invasive MV with ECCO2R?

The feasibility and safety of avoiding invasive mechanical ventilation (IMV) by using extracorporeal CO2 removal (ECCO2R) in ICU patients  is explored in this short video summary from ICM.

Education – webinar