Research – Trials

Patients > 80 years old have a high mortality. This study, which is performed in Europe among 301 different ICUs aims to develop and validate a mortality risk score for very old intensive care patients. The VIP2 study builds on the successful VIP1 study which was published in 2017. ICU recruitment took place from the fall of 2017 until fall of 2018 and is now closed.

Patient recruitment started between May 2018 and October 2018 and is still ongoing until May 2019 or until 20 patients have been included for the individual ICU (whichever comes first). The first results are expected no later than in November 2019. More information can be found at www.vip2study.com.

> Visit website

The TOXIC-EU study is a multi-center, international, observational study looking at the Outcome of Intoxicated Patients in Intensive Care Units. We want to include all consecutive patients admitted to the ICU with a (presumptive) diagnosis of intoxication or overdose during a 12 month period. There are no interventions. The primary outcome that this study wants to assess is the 30-day mortality. This study will identify major risk factors for poor outcome of intoxicated patients; look at the diagnostics used for intoxicated patients in distinct intoxication subpopulations and countries.

This study will evaluate treatments that are applied for intoxicated and validate the “ICU requirement score” in a large cohort of patients. At this moment the protocol is being drafted and we are welcoming intensivists who want to become the national coordinator of their country. As national coordinator you will be part of the steering group, you are in charge of applying for ethical approval for your country and you need to find collaborating ICUs in your country. If you are interested, you can send an email to d.w.delange@umcutrecht.nl

A Multicentre International One-Day Prevalence Study on Pressure Injuries in Intensive Care Units.

The objective of this study is to provide an up-to-date, global picture of the extent and patterns of pressure injuries in ICUs.

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Multinational, multicentre study of outcome of Very old ICU Patients. This study will address the ICU care of the very old, defined as patients ≥ 80 years, admitted to the ICU.

The project studied the frequency of ICU admission in the very old patients, the use of common ICU resources including ICU and hospital LOS in Europe.

Publication

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Competency-based Training in Intensive Care Medicine in Europe – Innovation Transfer. The CoBaTrICE project created an international competency-based programme for ICM.

More information: www.cobatrice.org

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Sentinel Events Evaluation. SEE project is focused on the causes and measures of error prevention.

Results: Patient safety in intensive care: results from the multinational Sentinel Events Evaluation (SEE) study.

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Research – Surveys

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 aimed to compile useful feedback about the use of ICU scoring in European ICUs and beyond.

Results coming soon.

The survey 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.

WORKing time of DOCtors in the ICU (WorkDoc) survey.

Results coming soon.

Strategies to improve ICUs in resource-poor settings. 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.

Publication: Current challenges in the management of sepsis in ICUs in resource-poor settings and suggestions for the future.

>Read more

Survey about non-physician providers (physician assistants and nurse practitioners) on the ICU in Europe

Survey organised by Herman Kreeftenberg, HSRO section

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

This survey has been endorsed by the Société de Réanimation de Langue Française (SRLF), by the Subsaharian Society for Anesthesia and Intensive Care (SARANF) and by ESICM.

The objective is to evaluate the current structure and organisation of ICUs in a very large sample of countries with low, middle and high income, given the scarcity of data in this area.

Relevant research

Guidet B, Vallet H, Boddaert J, de Lange DW, Morandi A, Leblanc G, Artigas A, Flaatten H. Ann Intensive Care. 2018 Nov 26;8(1):114
Caring for the critically ill patients over 80: a narrative review.

Guidet B, Flaatten H, Boumendil A, Morandi A, Andersen FH, Artigas A, Bertolini G, Cecconi M, Christensen S, Faraldi L, Fjølner J, Jung C, Marsh B,Moreno R, Oeyen S, Öhman CA, Pinto BB, Soliman IW, Szczeklik W, Valentin A, Watson X, Zafeiridis T, De Lange DW; VIP1 study group. Intensive Care Med. 2018 Jul;44(7):1027-1038.
Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit.

Guidet B, De Lange DW, Christensen S, Moreno R, Fjølner J, Dumas G, Flaatten, H. Acta Anaesthesiol Scand. 2018 Feb;62(2):207-219.
Attitudes of physicians towards the care of critically ill elderly patients – a European survey.

Fronczek J, Polok KJ, Nowak-Kózka I, et al. Anaesthesiol Intensive Ther. 2018
Frailty increases mortality among patients ≥80 years old treated in Polish ICUs.

Flaatten H, Oeyen S, deLange DW. Intensive Care Med. 2018 Aug;44(8):1344-1345.
Predicting outcomes in very old ICU patients: time to focus on the past?

Muessig JM, Nia AM, Masyuk M, et al. BMC Geriatr. 2018 Jul 13;18(1):162.
Clinical Frailty Scale (CFS) reliably stratifies octogenarians in German ICUs: a multicentre prospective cohort study.

Article Reviews

Psychiatric symptoms after acute respiratory distress syndrome: a 5-year longitudinal study
> Read this article review

Is it dangerous to be admitted to an ICU during a weekend?
> Read this article review

Impact of Frailty on ICU & mortality in very elderly patients
> Read this article review

How to reduce physical and mental impairment post-ICU? Results from the RAPIT study
> Read this article review

Randomised trial on Condolence Letter for grief symptoms among ICU patients’ relatives
> Read this article review

Challenges in caring for critically ill, non-sedated, mechanically ventilated patients
> Read this article review

Worldwide determinants of time to death in critically ill patients
> Read this article review

The Value of E-Learning for the Prevention of HAIs
> Read this article review

Suggested talks

One-year outcomes after ICU discharge? FROG-ICU trial Results

Alexandre Mebazaa (Paris, France) sits down with icTV to discuss the results of his recent trial examining outcomes of patients following their release from intensive care. These results were presented on Monday during the Clinical Trials session at LIVES 2015

Visit our e-LIVES platform to see more…

RAPIT study

In this icTV interview, Janet Froulund Jensen (Hillerød, Denmark) discusses her novel study on QOL and recovery in post ICU patients.

Read the article in ICM here.

Post-ICU syndrome in patients relatives

In this icTV interview, Nancy Kentish-Barnes (Paris, France) discusses the surprising results from her randomised clinical trial on the effect of a condolence letter on post-intensive care unit syndrome among relatives of patients who died in the ICU.

Results from this study were presented during the HOT TOPICS session on Wednesday October 5th at LIVES 2016 in Milan.

Visit our e-LIVES platform to see more…

SPICE-PAD study

Can early pain, agitation, depth of sedation and mobilisation act as predictors of 180-day mortality?

In this icTV interview,  Yahya Shehabi discusses the results of his multinational prospective longitudinal cohort study on this topic.
Results were presented on Monday October 3rd during the President’s session at LIVES 2016 in Milan.

Visit our e-LIVES platform to see more…

Education