Shows
ESICM TalkEuropean Society of Intensive Care Medicine guidelines on end of life and palliative care in the intensive care unitThe latest guidelines released from the European Society of Intensive Care Medicine (ESICM) are about end-of-life (EOL) and palliative care for critically ill adults! This comprehensive work, developed by an international, multi-disciplinary team of clinical experts, a methodologist, and patient and family representatives, is now accessible to all clinicians. We had the privilege of interviewing Prof. Kesecioglu, who led this remarkable project. Listen to this interview and explore the rationale and methodology behind the guidelines and hear the initial feedback following their release.2024-12-1107 min
ESICM TalkTTP Centenary by Takeda 2024-07-2405 min
ESICM TalkARDS Phenotyping: from disease understanding to future bedside perspectivesTo date, no specific pharmacotherapy has proven effective against acute respiratory distress syndrome ARDS. Results on the research domain have been ineffective in human trials, a gap attributed in part to clinical and biological heterogeneity in human ARDS. Therefore, a precision medicine approach is intended to address explicitly how such underlying heterogeneity influences response to therapy among different patients with the same diagnosis. “You can find treatment for the disease but not for syndromes and ICU is a syndrome-forward approach to patient care” says Dr Pratik Sinha who is working on ARDS phenotyping. Listen to his interview and l...2024-06-1946 min
ESICM TalkMechanical circulatory support for cardiogenic shock: a network meta-analysis of randomized controlled trials and propensity score-matched studiesCardiogenic shock accounts for up to 5% of acute heart failure presentations and around 14–16% of patients reported in cardiac intensive care datasets. It complicates up to 15% of all myocardial infarctions and is the leading cause of death post-infarction. Using pharmacological agents alone may increase left ventricular afterload and myocardial oxygen demand, resulting in complications. Thus, mechanical circulatory support (MCS) devices have emerged as important therapeutic options. As evidence remains uncertain, MCS selection depends on clinician preference and local availability.An updated systematic review and meta-analysis of high-quality RCTs and propensity score-matched studies (PSMs) was performed to compare the ou...2024-06-1241 min
ESICM TalkN&AHP – ICU diariesThe communication between families of critically ill patients who manifest prolonged disturbances in the consciousness such as patients under sedation, in a coma, or delirium, and the caregivers became very difficult during the stay of the patient in the ICU. On the other side, the memories of the patients are distressing and confusing and make the ICU experience for this patient very unpleasant.To overcome these difficulties and to bridge the communication, written diaries by nurses and families for and to the patients are recommended during the ICU stay. You will get a...2024-05-2220 min
ESICM TalkBurned out in ICU professionalsProfessional burnout has been described by WHO as a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed. Intensive care unit (ICU) professionals are at high risk of experiencing burnout due to the presence of patients with life-threatening illnesses, the observed discrepancies in job demands, responsibility overload, workload, end-of-life issues, perception of futility and other constituting potential stressors. To talk about the prevalence, outcomes, ethical implications and management strategies of ICU professional burnout we have interviewed Dr. Michalsen. Listen to the interview in the following podcast. 2024-05-1513 min
ESICM TalkInflammatory subphenotypes in patients at risk of ARDS: evidence from the LIPS-A trialAcute respiratory distress syndrome (ARDS) remains a life-threatening syndrome, resulting in high morbidity and mortality. In ARDS patients and mechanically ventilated critically ill patients, two distinct subphenotypes, presenting hyper- and non-hyperinflammatory characteristics, have been identified. Studies show that early identification of the inflammatory subphenotypes in patients at risk of ARDS could serve as a predictive or prognostic strategy that will lead to an early intervention and individualization of care. A study has been carried out to prove the hypothesis that the inflammatory subphenotypes are present before ARDS development in at-risk patients presenting to the emergency...2024-05-0821 min
ESICM TalkBrain ultrasound for the general intensivistCerebral ultrasound is a developing point-of-care tool for intensivists and emergency physicians, with an important role in diagnosing acute intracranial pathology. The use of transcranial Doppler has expanded over the last years, opening a new window to the assessment of cerebral anatomy not only in neurocritical patients but also in general ICU and emergency room patients. To discuss the use of cerebral ultrasound for young intensivists we have interviewed Dr. Bertuetti. Listen to the interview in the following podcast. 2024-04-2416 min
ESICM TalkPhenotyping and endotyping patients to optimally set nutrition targetsNutrition plays a vital role in the management of critically ill patients, and a tailored approach based on patient assessment, nutritional requirements, and clinical status is essential for optimising outcomes and promoting recovery.The concept of patient phenotyping and endotyping will help clinicians to better target nutrition interventions for a patient by categorising patients based on observable behaviours and underlying biological mechanisms, respectively.About these concepts, their clinical use and limitations we have interviewed Dr. Arthur Van Zanten. Listen to his explanations in our podcast offered by NEXT. 2024-04-1047 min
ESICM TalkUncovering heterogeneity in sepsis: a comparative analysis of subphenotypesSepsis is a life-threatening organ dysfunction caused by a dysregulated host response to an infection. Despite progress in the understanding of sepsis pathophysiology, no specific treatment has proven successful. The precision therapy, a greater understanding of the heterogeneity of sepsis is needed.Recent approaches to measuring sepsis heterogeneity used unsupervised computational methods on clinical, biomarker, or gene expression data from observational studies or clinical trial datasets. At present, more than 100 sepsis subtypes are proposed, without awareness of overlap (or clinical implications). It is unknown whether each new subtype strategy is an added value for the patient.2024-03-2019 min
ESICM TalkECMO PAL: using deep neural networks for survival prediction in venoarterial extracorporeal membrane oxygenationVA-ECMO outcome scores have been previously developed and used extensively for risk adjustment, patient prognostication, and quality control across time and centres. The limitation of such scores is the derivation by using traditional statistical methods which are not capable of covering the complexity of ECMO outcomes. The Extracorporeal Life Support Organization Member Centres have developed a study where they aimed to leverage a large international patient cohort to develop and validate an AI-driven tool for predicting in-hospital mortality of VA-ECMO. The tool was derived entirely from pre-ECMO variables, allowing for mortality prediction immediately after ECMO initiation.To...2024-03-0611 min
ESICM TalkTowards model-informed precision dosing of piperacillin: multicenter systematic external evaluation of pharmacokinetic models in critically ill adults with a focus on Bayesian forecastingNumerous Population Pharmacokinetic (PopPK) models have been developed for Piperacillin (PIP), most of which are based on small monocentric studies and may not be generalizable to other populations. A recent evaluation of six PIP models in 30 ICU patients receiving CI demonstrated large inter-model variability regarding predictability. The transferability of these results to other populations is uncertain due to the limited number of patients and the monocentric setting. Furthermore, a clinically oriented model assessment in conjunction with TDM (Bayesian forecasting) was lacking. A recent study aimed to evaluate the predictive performance of available PIP PopPK models with and...2024-02-1417 min
ESICM TalkGreen ICU - Environmental Sustainability in intensive careThe concept of a "green ICU" is increasingly important in today's world, as sustainability and environmental considerations become integral to healthcare practices. Hospitals, including ICUs, can have a substantial environmental footprint due to energy consumption, waste generation, and resource use. Implementing green practices reduces this impact and contributes to overall environmental sustainability. Integrating sustainability into healthcare practices not only benefits the environment but also supports the overall mission of providing high-quality patient care. To learn more about Green ICU implementation listen to the interview with Nicole Hunfeld. 2024-02-0712 min
ICU Ed and Todd-CastATS vs ESICM ARDS GuidelinesSend us a Text Message (please include your email so we can respond!)Episode 29! We stray a little bit from our new and old article structure to talk about two recently published but slightly different ARDS recommendations from ATS and ESCIM. We compare and contrast them and give our takes on the data and evidence.Thanks to everyone who emails in and gives feedback, we will do our mail bag next episode!ATS Guidelines: https://pubmed.ncbi.nlm.nih.gov/38032683/ESICM guidelines: https://pubmed.ncbi.nlm.nih.gov/37326646/If you...2024-01-1648 min
ESICM TalkDiving into ARDS with Prof. Gattinoni. From the new guidelines to bedside applied physiology.Acute respiratory distress syndrome (ARDS) is the term applied to a spectrum of conditions with different etiologies that share common clinical-pathological characteristics including: increased permeability of the alveolo-capillary membrane, resulting in inflammatory edema; increased non-aerated lung tissue resulting in higher lung elastance (lower compliance); and increased venous admixture and dead space, which result in hypoxemia and hypercapnia. The new updated ESICM guidelines have been published highlighting a new approach to ARDS in terms of definitions, phenotyping, and respiratory support strategies. To discuss ARDS from the new guidelines to bedside applied physiology we have interviewed Professor...2023-12-2039 minICU Ed and Todd-CastNew/New/New: COVID Trials (ESICM Part 2)Send us a Text Message (please include your email so we can respond!)Episode 24! Three trials about COVID were published with ESICM which we talk about all three here. COVID has been decreasing in prevalence in our ICU at least so we anchor our discussion around what we can learn from these trials about ARDS in general or what we can carry forward to future pandemics compared to our typical "Are we using this in our practice".Simvastatin: https://pubmed.ncbi.nlm.nih.gov/37888913/Vitamin C: https://pubmed.ncbi.nlm.nih.gov/37877585/Convalescent...2023-11-2156 min
ESICM TalkSepsis-associated acute kidney injury in the intensive care unit. A multicenter observational studySepsis‐associated acute kidney injury (SA‐AKI) is a common, increasingly prevalent problem in the intensive care unit (ICU). The association between sepsis and AKI has been studied previously. However, the lack of a reproducible and standardized consensus definition has limited the interpretability of available knowledge. In order to assess SA-AKI incidence, patient characteristics, timing, trajectory, treatment, and associated outcomes a multicenter, observational study was conducted. In order to know more about the study methodology and findings we have interviewed Dr White. Listen to the interview in the following podcast. 2023-11-0815 minICU Ed and Todd-CastNew/New: AMIKINHAL and STRESS-L (ESICM Part 1)Send us a Text Message (please include your email so we can respond!)Episode 23! We spend a little bit of time talking about our recent conference related travel and food experience but dive into our coverage of the trials that released with ESICM including "Inhaled Amikacin to Prevent Ventilator-Associated Pneumonia" by Ehrmann et al published in NEJM and "Landiolol and Organ Failure in Patients With Septic Shock" by Whitehouse et al in JAMA, both October 2023AMIKINHAL: https://pubmed.ncbi.nlm.nih.gov/37888914/STRESS-L: https://pubmed.ncbi.nlm.nih.gov/37877587/If you enjoy...2023-11-0753 min
PEBMED - Notícias e atualizações médicasHighlights ESICM 2023 – European Society of Intensive Care MedicineEntre os dias 21 e 25 de outubro aconteceu em Milão, na Itália, o European Society of Intensive Care Medicine – ESICM 2023, congresso que abordou diversos temas sobre a área da medicina intensiva com os maiores especialistas do mundo. Neste episódio, Yuri Albuquerque, intensivista e conteudista do Portal, reúne as principais discussões sobre medicina intensiva abordadas no evento, que deu ênfase à monitorização hemodinâmica, à ventilação mecânica e à sepse. Confira agora dando o play!
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2023-10-2715 min
ESICM TalkPatient Transportation in Critical Care: introduction to our ACE courseTransportation of critically ill patients is inevitable in most health systems. Prehospital transportation (PHT) may be necessary after a major injury or as a result of a life-threatening illness – for example, myocardial infarction, intracranial haemorrhage, or metabolic coma. On our ESICM Academy, we offer a course series on Patient Transportation, from the general introduction to conducting interfacility and intrahospital patient transportation and prehospital transport in Critical Care. Hear more from one of the authors in this podcast. The ESICM Academy is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) and offers updated, pe...2023-10-0412 min
ESICM TalkInterprofessional teamwork in ICUIntensive care units (ICU) are the most peculiar units in hospitals where the quality and safety of health care delivery should be at the highest level. The most critical patients are treated in this unit, posing all healthcare professionals working there with continuous physical and emotional challenges. ICU teams are composed of different profiles with the same goal of satisfying the needs of the patients. Combining each one's skills and abilities to make the best clinical decisions requires healthy multidisciplinary teamwork. Recent studies show that the ability to work in a team in the ICU r...2023-09-2724 min
ESICM TalkArtesunate treatment in severely injured patients with traumatic haemorrhageMultiple organ dysfunction syndrome (MODS) is common after major trauma, affecting up to two-thirds of patients with critical injuries. Post-trauma MODS is associated with a mortality of over 20% and poor long-term outcomes in those who survive. Current management is supportive, and there are no specific pharmacological agents that prevent organ dysfunction. The TOP-ART randomised clinical trial, a two-stage study, has tested firstly the safety and efficacy of the early artesunate administration on a cohort of severely injured and bleeding trauma patients and, secondly, the outcomes of artesunate administration on trauma patients at risk of developing MODS. 2023-09-2018 min
ESICM TalkLife after sepsis in adult and paediatric patientsSepsis is a life-threatening acute organ dysfunction secondary to infection and affects more than 19 million people annually. In 2017, it was estimated that almost 49 million people were infected by sepsis, and half of those cases occurred in children under 5. In-hospital mortality has declined over the years, resulting in a large number of sepsis survivors. Emerging data suggest that patients who survive sepsis frequently experience new symptoms, long-term disability, and worsening chronic health conditions for which they will seek care from many clinicians.Elena Conoscenti has interviewed two experts in the field who will explain better what...2023-09-1325 min
ESICM TalkSevere meningoencephalitis in the ICU: results from the EURECA studyCentral nervous system (CNS) infections significantly burden ICU physicians' daily clinical work. Diagnosis can be challenging, and timely management is of the utmost importance. Meningoencephalitis is one of the CNS infections for which the epidemiological studies conducted in adult patients suggest that approximately one in two will require care in an intensive care unit. In those patients requiring ICU admission, meningoencephalitis is associated with a poor prognosis, including refractory seizures, prolonged hospital stay, neurological disability, and death. The EURECA study endorsed by the ESICM intended to characterise the clinical presentation, etiologies, and outcomes in adult...2023-09-0618 min
ESICM TalkDiabetes mellitus in old critically ill COVID-19 patientsSeveral studies have found an association between diabetes mellitus, disease severity and outcome in COVID-19 patients. Old, critically ill patients are particularly at risk. A recent multicentre international prospective cohort study was performed in 151 ICUs across 26 countries to investigate the impact of diabetes mellitus on 90-day mortality in a high-risk cohort of critically ill patients over 70 years of age.Original article: Diabetes mellitus is associated with 90-day mortality in old critically ill COVID-19 patients: a multicenter prospective observational cohort study Help us review our educational podcasts! Complete this short survey here. ...2023-08-3010 min
ESICM TalkResults from the TAME trialInternational guidelines recommend targeting normocapnia in adults with coma resuscitated after out-of-hospital cardiac arrest. However, normocapnia may be insufficient to restore and maintain adequate cerebral perfusion. Conversely, mild hypercapnia increases cerebral blood flow and may improve neurologic outcomes. Nevertheless, the most effective Paco2 target in adults with coma resuscitated after out-of-hospital cardiac arrest has not been well studied in randomized trials. Therefore, the Targeted Therapeutic Mild Hypercapnia After Resuscitated Cardiac Arrest (TAME) trial was conducted to test the hypothesis that targeted mild hypercapnia would improve neurologic outcomes at 6 months as compared with targeted normocapnia in...2023-06-2725 min
ESICM TalkGuidelines for the management of severe community-acquired pneumoniaSevere community‐acquired pneumonia (sCAP) is a clinical entity to describe ICU-admitted patients with community‐acquired pneumonia (CAP) as they might require organ support, and it is associated with high morbidity and mortality. While European and non‐European guidelines are available for CAP, there are no specific guidelines for sCAP. Therefore, a team of experts have joined efforts to prepare a summary document to guide the most effective treatments and management strategies for adult patients with sCAP. Listen to the following podcast to learn more about these guidelines produced by the European Respiratory Society (ERS), the Eu...2023-05-2420 min
ESICM TalkPermissive azotemia during AKI enables more rapid renal recovery and less renal fibrosisPreclinical models of acute kidney injury (AKI) consistently demonstrate that a uremic milieu enhances renal recovery and decreases kidney fibrosis. Reduced renal clearance has the surprising and counterintuitive effect of being an effective treatment for AKI. In this perspective, Dr Lakhmir S. Chawla suggests a hypothesis describing why the uremic milieu is kidney protective and proposes a clinical trial of ‘permissive azotemia’ to improve renal recovery and long-term renal outcomes in critically ill patients with severe AKI. Hear more about the explanation of this hypothesis in the following podcast, organised by the ESICM...2023-05-1743 min
ESICM TalkHow to manage coagulopathies in critically ill patientsCoagulopathy is a severe and frequent complication in critically ill patients, for which the pathogenesis and presentation may be variable depending on the underlying disease. Therefore, a review has been conducted to differentiate between hemorrhagic coagulopathies, characterised by a hypercoagulable and hyperfibrinolysis state, and thrombotic coagulopathies with a systemic prothrombotic and antifibrinolytic phenotype, based on the dominant clinical phenotype. Dr Julie Helms, our podcast guest, will explain more about the review and discuss the differences in pathogenesis and treatment of the common coagulopathies. Original paper: How to manage coagulopathies in critically ill patients ...2023-05-1020 min
ESICM TalkEnd of Life Care concepts in intensive careEnd-of-life care is an approach to a terminally ill patient that shifts the focus of care to symptom control, comfort, dignity, quality of life, and quality of dying rather than treatments aimed at cure or prolongation of life. A detailed description of the concept of the end of life care and as well how to deal with end-of-life situations are discussed in the podcast. SpeakersJulie BENBENISHTY. Hadassah Hebrew University Medical Center, Jerusalem (IL). Head of the European critical care doctoral educated nurses group. Ahmed ZAHER. Oxford University Hospitals (UK). NEXT...2023-05-0330 min
ESPNIC Hot Topics PodcastESICM and ESPNIC, adults and children are really different? Together we are intensive care!Listen to Prof Maurizio Cecconi (ESICM Past President) and Prof Daniele De Luca (ESPNIC Medical President) discussing the role that ESICM and ESPNIC are playing in Intensive Care2023-05-0212 min
ESICM TalkMachine-learning-derived sepsis bundle of careThe Surviving Sepsis Campaign (SSC) produces and regularly updates guidelines for managing patients with sepsis and septic shock. However, deviation from guidelines is frequently observed in the intensive care unit. The last iteration of the SSC includes 79 recommendations where the impact on mortality remains unclear for some of them. Prioritising the recommendations based on their relative impact on mortality would be helpful to the clinician. A recent study has been carried out to identify among all SSC recommendations applicable during the first 24 h following sepsis onset, a subset of guidelines that should be prioritised to...2023-03-2226 min
ESICM TalkHow to use biomarkers of infection or sepsis at the bedsideSepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. In this context, biomarkers could be considered indicators of either infection or dysregulated host response or response to treatment and/or aid clinicians in prognosticating patient risk.A recently published narrative review provides current data on the clinical utility of pathogen-specific and host-response biomarkers, offers guidance on optimising their use, and proposes the need for future research. In this podcast, Dr Povoa, one of the leaders of this review, details these findings. Original paper: How to use biomarkers of infection or...2023-03-1524 min
ESICM TalkMIPD of beta-lactam antibiotics and ciprofloxacin in critically ill patientsIndividualising drug dosing using model-informed precision dosing (MIPD) of beta-lactam antibiotics and ciprofloxacin has been proposed as an alternative to standard dosing to optimise antibiotic efficacy in critically ill patients. However, randomised clinical trials (RCT) on clinical outcomes have been lacking.In this podcast, Drs Ewoldt and Abdulla relate how they conducted a multicentre RCT in 8 Dutch hospitals. It included patients admitted to the intensive care unit (ICU) treated with antibiotics and randomised to MIPD with dose and interval adjustments based on monitoring serum drug levels (therapeutic drug monitoring) combined with pharmacometrics modelling of beta-lactam antibiotics and...2023-01-2517 min
ESICM TalkManagement of severe bronchiolitis in infants <12 months old admitted to paediatric ICUBronchiolitis is a common lung infection in young children and infants. Approximately one-tenth of the affected children are admitted, and between 2 and 6% of them present a severe form and are referred to paediatric intensive care units. Nevertheless, the definition of severe acute bronchiolitis is mainly clinical and based on low levels of evidence.In this podcast, Dr Milési presents guidelines for managing infants under 12 months of age with severe bronchiolitis to create a series of pragmatic recommendations for a patient subgroup poorly individualised in national and international guidelines. Original paper: Clinical practice g...2023-01-1813 min
ESICM TalkClustering analysis of geriatric and acute characteristics in very old patients on ICU admissionThe outcome of very old patients admitted to the intensive care unit (ICU) is determined by both the severity of the acute condition and the age-related decline of resilience to stress. However, that decline is characterised by substantial inter-individual heterogeneity, which is considered a hallmark of the ageing process. A recent study investigated the heterogeneity within the very old population by clustering analysis of patient characteristics recorded on admission to the ICU. The researchers hypothesised that acute and geriatric features result in distinct phenotypes that may help early prognosis and indicate options for...2023-01-1112 min
ESICM TalkMy evidence-based nutrition protocolNutrition is an essential care we provide to critically ill patients aiming to avoid severe muscle wasting and weakness, which correlate with mortality and long-term burdens. Considering that the ICU patients' nutritional needs vary with the phase of critical illness, evidence-based nutrition protocols are so much needed. Dr Tarcukovic, one of the participants of the ESICM Nutrition Pathway, shares with us her experience in this Education Programme and discusses a few key points of the physiopathology of nutrition and how to feed and treat such critical patients. Help us review our educational podcasts! Complete this...2022-11-2322 min
PEBMED - Notícias e atualizações médicasHighligths ESICM 2022Neste episódio, Hiago Bastos, intensivista e colunista do Portal PEBMED, traz os principais destaques do European Society Of Intensive Medicine Congress (ESICM 2022).
Clique e ouça o episódio!2022-11-0121 min
ESICM TalkManagement and outcomes of pregnant women with COVID-19Pregnant women with COVID-19 are more likely to be admitted to the ICU and require invasive mechanical ventilation or venovenous extracorporeal membrane oxygenation (VV-ECMO). Nevertheless, only a few case series have focused on ventilatory management and outcomes of pregnant women with COVID-19 admitted to the ICU.COVIDPREG study primarily aimed to assess the ventilatory management of pregnant women with COVID-19 admitted to ICU. Secondly, the study aimed to evaluate obstetric management and report maternal and neonatal outcomes.Listen to Dr Mathieu Jozwiak for more insights from this study. Original paper: Management and outcomes...2022-10-1212 min
ESICM TalkEvolution of sedation management in the ICUIntensive care unit (ICU) sedation practices have dramatically changed over the last 20 years. Nowadays, they include light levels of sedation, SAT, and the use of non-benzodiazepines. An overview of ICU sedation practices’ evolution over the years has been recently published in the ICM Journal.This publication highlights the challenge faced by clinicians during the COVID-19 pandemic regarding sedation practices and recommends reengaging bundled-based strategies such as the ABCDEF Bundle to promote liberation from the ventilator and promote recovery and survivorship.We have interviewed Dr Stolling for more details relating to this study.Original pa...2022-09-1414 min
ESICM TalkWhen to initiate RRT?Acute kidney injury is common in critically ill patients, and 10-15% of ICU patients receive renal replacement therapy (RRT). The timing of therapy initiation is limited by heterogeneity, but until 10-15 years ago there was a trend toward early initiation, as noted by several meta-analyses.In the past 5 years, several large PRCTs have addressed this topic: ELAIN, AKIKI, IDEAL-ICU, STARRT-AKI, and AKIKI-2. In this ESICM NEXT educational podcast, we will find out what is the most recent consensus and what are the clinical tools to facilitate the initiation of RRT.Help us review...2022-09-0746 min
ESICM TalkFrailty and the COVIP studyOver the last few years, the assessment of frailty at admission to the ICU has become increasingly popular. Frailty is also considered one of the potential prognostic indicators in patients with COVID-19. The degree of frailty could be used to assist both the triage into intensive care and decisions regarding treatment limitations.The COVIP study led by prof Jung sought to determine the interaction of frailty and age in elderly COVID-19 ICU patients. Listen to the podcast to learn more about the findings of the study.Help us review our educational...2022-08-3125 min
ESICM TalkClinical course of children with acute liver failure admitted to the ICUA recent outbreak of acute non-A-E hepatitis with serum transaminases greater than 500 IU/L identified in children under 16 years reported in the United Kingdom (UK) has become a serious cause for concern for public health authorities and paediatric liver and critical care services. From 1 January to 16 May 2022, UK public health authorities have reported 197 cases with a median age of 3 years, male (50%), from all regions of the UK, with 11 children requiring liver transplantation (LT).A letter to the editor was sent to the ICM journal, and in this podcast, you can listen to Dr Deep, Dr...2022-08-2427 min
ESICM TalkEchocardiography findings in COVID-19 patients admitted to ICUThe ECHO-COVID study investigated the effects on cardiac function in critically ill COVID -19 patients. The primary aim of this study was to investigate the incidences and patterns of left and right ventricular dysfunction in the first echocardiographic examination performed after admission to the intensive care unit (ICU) in a large series of patients hospitalised for severe COVID-19. The study referred to previous international collaborations with experts in critical care echocardiography (CCE) that use it in their usual practice to manage critically ill patients. Listen to the following podcast to learn more about this study's...2022-06-2221 min
30 minutes with...30 minutes with...Prof Elisa Estenssoro“30 minutes with…” is the talk format where you can ask all your questions to world-renowned experts in the field of Intensive Care Medicine.In this session, Élie Azoulay, ESICM President-Elect, will engage in conversation with Prof Elisa Estenssoro on critical ICU topics and moderate questions coming from the audience.Prof Estenssoro has led numerous critical care studies in Argentina and South America, primarily focusing on ARDS, sepsis, septic shock, and, more recently, COVID-19. She was the first female president of the Argentine Society of Intensive Care (2008–2010) and is a senior consultant for the Ministry of Health of the Pro...2022-06-2133 min
ESICM TalkResults from the UNITE-COVID studyThe European Society of Intensive Care Medicine (ESICM), initiated a study to describe the extent of the COVID-19 ICU surge worldwide and the clinical characteristics, management, and outcomes of critically ill COVID-19 patients. Additionally, the goal was to study the impact of critically ill COVID-19 patients admitted to a surge capacity bed on the treatment and outcomes. The study hypothesised that admission to surge capacity beds increased mortality compared to standard ICU beds and that need for early invasive mechanical ventilation was associated with higher mortality.We have gone through the main findings...2022-06-1512 min
ESICM TalkBullets in haemodynamicsThe haemodynamic instability most patients present in the ICU may lead to organ dysfunction, deterioration into multi-organ failure, and eventually death. Proper medical management is essential to prevent or treat organ failure and improve the outcomes for these patients. This podcast will tackle a few crucial points regarding haemodynamic monitoring starting from the first hours of patients admitted to the ICU. Listen & receive important advice from our experts Prof Xavier Monet and Prof Michelle Chew. Help us review our educational podcasts! Complete this short survey here. SpeakersChristopher LAI...2022-06-0839 min
ESICM TalkThe brain in paediatric critical careThe practice of neurocritical care for children with injured or vulnerable brains entails clinical assessment, a range of monitoring methods within the paediatric intensive care unit (PICU), and the follow-up of children's long-term neurodevelopment. These activities involve inherent challenges related to the diversity of the case mix and age range. Different concepts were discussed in a recently published 'state of the art' paper about critically ill children. With the paper's authors, we went through what is needed to take PICU survivorship to the next level.Original paper: The brain in pediatric...2022-06-0126 min
ESICM TalkThe role of acute hypercapnia on mortality and short-term physiology in patients mechanically ventilated for ARDSRecent evidence suggests that acute hypercapnia could have harmful physiological and clinical effects in patients with ARDS, particularly impacting the haemodynamic system. A review and meta-analysis were performed to summarise the clinical consequences of acute hypercapnia in mechanically ventilated patients. The primary objective was to determine the association between acute hypercapnia and mortality in adult patients mechanically ventilated for ARDS. The secondary goal was to identify the association between acute hypercapnia and haemodynamics (systemic and pulmonary circulation) in adult patients mechanically ventilated for ARDS.Original paper: The role of acute hypercapnia on mortality and short-term...2022-05-2511 min30 minutes with...30 minutes with...Prof Glenn HernándezGlenn Hernández is an Intensivist and Full Professor at the Pontificia Universidad Católica de Chile, with expertise in systemic and regional perfusion, resuscitation and management of septic shock. He was the Principal Investigator of the ANDROMEDA-SHOCK trial, which compared CRT- versus lactate-targeted resuscitation in early septic shock.2022-04-2731 min
ESICM TalkSepsis hospitalisation and risk of subsequent cardiovascular events in adultsSepsis refers to a dysregulated response to infection-causing end-organ dysfunction. It is associated with short-term risks such as shock and in-hospital death. Meanwhile, long-term consequences among sepsis survivors can include clinical deconditioning, recurrent sepsis, mental health issues, and increased risk of long-term mortality. Moreover, recent investigations have demonstrated a possible association of sepsis with subsequent cardiovascular adverse events, including myocardial infarction, stroke, and congestive heart failure.A large, population-based matched cohort study of adult patients without pre-existing cardiovascular disease has been performed to estimate the association between surviving a first sepsis hospitalisation and...2022-04-1315 min
ESICM TalkProphylactic melatonin for delirium in intensive care (Pro-MEDIC)Delirium is a condition of acute organic brain dysfunction with fluctuating disturbances of attention and cognition, and its prevalence in intensive care units (ICUs) is recorded as high as 80%.Delirium is highly distressing for patients and families and commonly reported as the worst experience of ICU admission. Melatonin has been described as an attractive intervention for delirium prevention, and a large study hypothesised that early administration of melatonin effectively reduces delirium in critically ill patients.In this podcast, Dr Wibrow details the results of this study with Dr Scaramuzzo.Original paper: Prophylactic melatonin...2022-04-0613 min
ESICM TalkRole of pre-clinical experimentation in intensive care: from ethical to clinical practicePreclinical studies precede most clinical trials. They help identify criteria for evaluating human safety, including signs and symptoms that should be monitored closely during early clinical trials.The importance of these preclinical studies in intensive care medicine starts from developing new surgical procedures, and hands-on training to new medical devices and prescription drugs. To have more insights into preclinical research and real examples of translation of such research in clinical practice, we interviewed Dr Marcin Osuchowski, an expert in the field. Help us review our educational podcasts! Complete this short survey here. 2022-03-2332 min
ESICM TalkMental health symptoms in family members of COVID-19 ICU survivorsThe prevalence of long-term mental health symptoms in the family members of COVID-19 ICU survivors is unknown and may differ from the prevalence rate in the family members of non-COVID-19 ICU survivors, given the pandemic circumstances.A better understanding of the impact of COVID-19 ICU admission on family members is needed to provide adequate support during and after the ICU stay. Therefore, the prevalence of mental health symptoms and quality of life in family members of COVID-19 ICU survivors 3 and 12 months after ICU admission was evaluated in the first study ever done. Risk factors associated...2022-03-1615 min
ESICM TalkERC-ESICM guidelines on temperature control after cardiac arrest in adultsThe aim of the ERC-ESICM guidelines on temperature control after cardiac arrest in adults is to provide evidence-based guidance in adults who are comatose after resuscitation from either in-hospital or out-of-hospital cardiac arrest, regardless of the underlying cardiac rhythm. These guidelines replace the recommendations on temperature management after cardiac arrest included in the 2021 post-resuscitation care guidelines co-issued by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). The invited experts of this podcast, Prof Sandroni and Prof Nolan, describe the methodology followed and explain the panel suggestions on guideline implementation...2022-03-0915 min
ESICM TalkEffect of therapeutic drug monitoring-based dose optimisation of piperacillin/tazobactam in sepsis patientsGrowing evidence suggests that insufficient antibiotic exposure (defined as failure to achieve the pharmacokinetic/pharmacodynamic (PK/PD) target to kill or inhibit the growth of a pathogen) is associated with worse clinical outcomes in sepsis patients.Moreover, up to 50% of critically ill patients receiving a β-lactam antibiotic with regimens based on manufacturers' recommendations fail to reach the target.Therapeutic drug monitoring (TDM)-guided therapy has been proposed as a strategy to further optimise the achievement of the PK/PD target of β-lactam antibiotics. However, there are no data on whether piperacillin/tazobactam TDM can improve cl...2022-03-0229 min30 minutes with...30 minutes with...Prof YoungPaul Young is a key member of the Australian and New Zealand Intensive Care Society Clinical Trials Group and Deputy Director at the Medical Research Institute of New Zealand.He has international experience in the design and conduct of large-scale multicentre RCTs in Intensive Care Medicine and clinical trial science methodology.2022-03-0130 min30 minutes with...30 minutes with...Prof Monty MythenMonty Mythen is the Smiths Medical Professor of Anaesthesia and Critical Care at University College London and Director of the UCL Discovery Lab at The London 2012 Olympic legacy Institute of Sport Exercise and Health.His wide research interests include peri-operative fluid management and trans-oesophageal Doppler, fitness for surgery, heart attack and stroke recovery, metabolism, fluids.2022-02-2332 min
ESICM TalkCurrent practice and evolving concepts in septic shock resuscitationClinical and pathophysiological understanding of septic shock has progressed exponentially in the previous decades, translating into a steady decrease in septic shock-related morbidity and mortality. Even though large randomised, controlled trials have addressed fundamental aspects of septic shock resuscitation, many questions still exist. A comprehensive review was carried out to describe the current standards of septic shock resuscitation. This review targeted the evolving concepts in different domains such as clinical resuscitation targets, adequate use of fluids and vasoactive drugs, refractory shock, and extracorporeal therapies. To know more about the study, listen...2022-02-1622 min
ESICM TalkNon-invasive respiratory support following extubation in critically ill adultsClinicians use noninvasive respiratory support interventions in the post-extubation period to mitigate the risk of extubation failure. These interventions [noninvasive positive pressure ventilation (NIPPV) and high-flow nasal cannula (HFNC)] have been shown to be efficacious in preventing initial intubation in patients with hypoxemic respiratory failure, but their efficacy in preventing post-extubation respiratory failure and reintubation is less clear. A systematic review and network meta-analysis of randomised controlled trials (RCTs) to evaluate the relative efficacy of conventional oxygen therapy, NIPPV, HFNC, and the strategy of alternating NIPPV and HFNC during the post-extubation period in reducing extubation failure and...2022-02-0230 min
ESICM TalkChallenges of renal transplant patients in intensive careKidney transplantation is the most common solid organ transplant performed worldwide. New advances in transplant medicine have expanded the indications for kidney transplantation, and nowadays, many kidney recipients are elderly patients who possibly have more comorbidities. Up to 6% of kidney transplant recipients experience a life-threatening complication requiring intensive care unit admission, primarily in the late post-transplant period (≥6 months). The most common medical complications requiring ICU admission in the immediate postoperative period are cardiac events and infections. Approximately 40% of recipients throughout their ICU stay require renal replacement therapy. In-hospital mortality can be as high as 30% and is...2022-01-2827 min
ESICM TalkPracticalities of NeuromonitoringNeuromonitoring is considered a crucial and fundamental process to monitor patients in critical care settings. In this podcast, ESICM NEXT member Denise Battagliani interviews Chiara Robba on the ultimate findings regarding neuromonitoring, including:basics of neuromonitoring research;indications for neuromonitoring of patients who do (not) suffer any direct brain injury;the rationale in neuromonitoring patients with sepsis, COVID-19 and liver failure and the most appropriate tools to use for each of this cohort of patients;the use of neuromonitoring tools during the perioperative period for neurosurgical patients and patients who undergo cardiac and vascular surgeries.2022-01-2113 min
ESICM TalkDexamethasone 12 mg versus 6 mg for patients with COVID-19 and severe hypoxaemiaSystemic corticosteroids decrease mortality in critically ill patients with COVID-19, and the World Health Organization, therefore, recommends dexamethasone 6 mg daily for up to 10 days for patients with severe or critical COVID-19. In addition, higher doses of systemic corticosteroids have been used in patients with COVID-19 and non-COVID-19 acute respiratory distress syndrome [3, 5, 6], and higher doses have been hypothesised to benefit patients with severe or critical COVID-19. However, the balance between benefit and harm remains uncertain.The COVID STEROID 2 trial compared a higher (12 mg) versus recommended dose (6 mg) of dexamethasone daily, for up to 10 days, in patients with COVID-19...2022-01-1914 min
ESICM TalkExtracorporeal cardiopulmonary resuscitation in adults: evidence and implicationsAttempts at improving cardiac arrest outcomes have increasingly included extracorporeal techniques to re-establish circulation. In particular, the application of veno-arterial extracorporeal membrane oxygenation (ECMO) during cardiac arrest is called extracorporeal cardiopulmonary resuscitation (ECPR).However, there is much debate about the impact of ECPR use on survival and neurological and functional recovery in adults suffering cardiac arrest. These issues have been evaluated in a systematic review conducted by Dr Abrams et al. Listen to the following podcast to hear more about which patients are most likely to benefit from EPCR, required resources and relevant...2022-01-1216 min
ESICM TalkEffect of adjunctive vitamin C, glucocorticoids, and vitamin B1 on longer-term mortality in adults with sepsis or septic shockMetabolic resuscitation is an adjunctive therapy for sepsis and septic shock, which consists of a combination of vitamin C, glucocorticoids, and vitamin B1 or their components. Recently, there has been considerable interest in this treatment. However, due to the wide range of combinations of its components, there is no evidence for the effectiveness of this therapy.To fill this gap, a network meta-analysis (NMA) and component NMA was conducted. This analysis summarised the available evidence concerning these therapies and determined any incremental effect of each component when added to sepsis treatment.In the following podcast...2022-01-0512 min
ESICM TalkPalliative care interventions in intensive care unit patientsIntegrating palliative care in critical care is advocated as a way to mitigate physical and psychological burdens for patients and their families and improve end-of-life care. Despite the emerging literature published that supports this positive association, the quality of evidence remains limited, in large part due to limitations in the definition of interventions, poor precision of effect estimates and the large variation in study designs. In a systematic review, Dr Victoria Metaxa et al. highlight the heterogeneous interventions and diverse outcome metrics used and propose a new classification of interventions to facilitate future comparisons. 2021-12-2132 min30 minutes with...30 minutes with…Prof Derek AngusProfessor Derek Angus's research interests include clinical, epidemiologic, and translational studies of sepsis, pneumonia, and multisystem organ failure and health services research of the organization and delivery of critical care services. He has led several large NIH-funded multicenter studies in the critically ill, the most recent of which is ProCESS (Protocolized Care for Early Septic Shock), a 40-center study focusing on how to best provide early resuscitation for septic shock. Prof Angus has published several hundred papers, reviews and book chapters, and is currently section editor for “Caring for the Critically Ill” for JAMA.2021-12-1434 min
ESICM TalkTransfusion strategies in bleeding critically ill adultsGiven the rapidity with which critically ill patients with bleeding can deteriorate, having a standardised approach to transfusion in these patients can be of great assistance to clinicians working in time-pressured circumstances.An expertise task force created within ESICM has developed an international guideline that provides guidance for clinicians caring for critically ill patients with massive and non-massive bleeding. 26 clinical practice recommendations (2 strong recommendations, 13 conditional recommendations, 11 no recommendations), and 11 PICO (population, intervention, comparison, and observation) with insufficient evidence to make recommendations were generated and published.To understand and clarify further this research, Dr...2021-12-0713 min
ESICM TalkESICM consensus guidelines on basic ultrasound head-to-toe skills for intensivistsUltrasonography is an evolving skill in critically ill patients. We provide a large number of statements regarding the required ultrasonographic basic skills for the management of critically ill patients.Original article: Speakers: Basic ultrasound head-to-toe skills for intensivists in the general and neuro intensive care unit population: consensus and expert recommendations of the European Society of Intensive Care Medicine Chiara ROBBA. Anesthesia and Intensive Care, Ospedale Policlinico San Martino, IRCCS per l’Oncologia e le Neuroscienze, Genoa (IT) and Department of Surgical Sciences and Integrated Diagnostics (DISC), Genoa (IT). Chair, ESICM Neuro Intensive Ca...2021-11-3012 min
ESICM TalkCritical illness in patients with hematologic malignancyCritical illness occurs frequently after a new diagnosis of hematologic malignancy and has high associated mortality. Baseline characteristics at diagnosis can help identify those patients at the highest risk of critical illness.Original article: Critical illness in patients with hematologic malignancy: a population-based cohort studySpeakers:Bruno L. FERREYRO. Interdepartmental Division of Critical Care Medicine, University of Toronto (CA).Laveena MUNSHI. Interdepartmental Division of Critical Care Medicine, University of Toronto (CA).Gaetano SCARAMUZZO. Department of Translational medicine, University of Ferrara (IT).2021-11-1023 min30 minutes with...30 mins with...Prof Sheila MyatraSheila Myatra is the President-Elect of the Indian Society of Critical Care Medicine (ISCCM). She is the lead author of the first published ICU airway guideline - “Guidelines for Tracheal Intubation in the ICU” and the guideline on “Unanticipated Difficult Tracheal Intubation in Adults”. She conducted the first national sedation survey and is the lead author of the end of life care guidelines for India.2021-11-0931 min30 minutes with...30 mins with...Prof Margaret HerridgeMargaret Herridge is currently Director of the RECOVER Clinical and Research Programme for patient- and family-centred follow-up care after critical illness. She was also co-lead of CANCOV (Canadian multi-centre 1-year follow-up of patients/caregivers after COVID-19).2021-10-2631 min
ESICM TalkCritically ill cancer patient’s resuscitationWe report the results of a consensus conference based on a systematic review of the literature and experts opinions assessing the management of cancer patients in the ICU.Original article: Critically ill cancer patient’s resuscitation: a Belgian/French societies’ consensus conferenceSpeakers: Rahul COSTA-PINTO. Austin Hospital, Melbourne - Australia; ESICM NEXT Committee Member.Anne-Pascale MEERT: Service de Médecine Interne, Soins Intensifs et Urgences Oncologiques, Institut Jules Bordet (Université Libre de Bruxelles, ULB), Brussels (BE).2021-10-2509 min
ESICM Talk30 minutes with...Prof Mervyn Singer"30 minutes with…" is the talk format where you can ask all your questions to world-renowned experts in the field of Intensive Care Medicine.
This session will see Adrian Wong, ESICM Chair of the Social Media and Digital Content Committee, engage in conversation with Prof Mervyn Singer on critical ICU topics and moderate questions coming from the audience.
Mervyn Singer has co-chaired the Sepsis-3 Definitions International Task Force that redefined sepsis in 2016. He developed an oesophageal doppler haemodynamic monitor; moreover, he co-developed the UCL Ventura CPAP&nb...2021-10-2531 min
ESICM TalkTTM following out-of-hospital cardiac arrestIn this network meta-analysis, as compared to normothermia (37–37.8 °C), we found that deep hypothermia (31–32 °C), moderate hypothermia (33–34 °C) and mild hypothermia (35–36 °C) may have no effect on survival and functional outcome among comatose survivors of out-of-hospital cardiac arrest. However, both deep and moderate hypothermia were associated with an increased risk of arrhythmia compared to normothermia. Original paper: Targeted temperature management following out-of-hospital cardiac arrest: a systematic review and network meta-analysis of temperature targetsSpeakers:Claudio SANDRONI. Institute of Anesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome (IT) and Department of Intensive Car...2021-10-1314 min
ESICM TalkSSC: international guidelines for management of sepsis and septic shock 2021The updated version of the guidelines will be presented during the ESICM LIVES virtual conference, LIVES 2021. The evidence-based guidelines, published in Critical Care Medicine and Intensive Care Medicine, reflect best practices and recommendations for the treatment of sepsis and septic shock in adults and are revised regularly to account for new research. Speakers:Manu SHANKAR-HARI. Department of Critical Care Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK; School of Immunology and Microbial Sciences, Kings College London, London, UK.Andrew RHODES. St George's Hospital, London, UKLaura EVANS. Div...2021-10-0407 min
ESICM TalkManagement of arterial PaCO2 in the first week after TBIThe manipulation of arterial carbon dioxide levels (PaCO2) is easy, and hyperventilation (HV) has been a common ICP-lowering strategy for over half a century. However, hyperventilation-induced vasoconstriction is a double-edged sword. It reduces cerebral blood volume and intracranial volume, and therefore, lowers ICP.We observed huge variability among centres in PaCO2 values and use of HV. Although causal inferences cannot be drawn from these observational data, our results suggest that, in patients with severe intracranial hypertension, HV is not associated with worse long-term clinical outcomes.Original article: Management of arterial partial pressure of...2021-09-2815 min30 minutes with...30 minutes with…Prof Mervyn SingerMervyn Singer has co-chaired the Sepsis-3 Definitions International Task Force that redefined sepsis in 2016. He developed an oesophageal doppler haemodynamic monitor; moreover, he co-developed the UCL Ventura CPAP device to support the breathing of COVID-19 patients in respiratory failure.2021-09-2131 min
ESICM TalkAssociation between Sepsis Survivorship and Long-Term Cardiovascular Outcomes in AdultsSepsis is associated with an increased long-term risk of cardiovascular events, which is observed for at least 5 years after the index admission. This risk represents a critical area of potential intervention to improve post-sepsis outcomes.Systematic Review and Meta-Analysis Speakers:Ignacio MARTIN-LOECHES. Department of Anaesthesia and Intensive Care, St. James's Hospital, Dublin (IE) and Multidisciplinary Intensive Care Research Organization (MICRO), Trinity College Dublin, Dublin (IE). Associate Editor of Intensive Care Medicine.Patrick LAWLER. Peter Munk Cardiac Centre, University Health Network, Toronto (CA).Leah B. KOSYAKOVSKY. Peter Munk Cardiac Centre...2021-09-1316 min30 minutes with...30 minutes with...Dr Arthur KwizeraDr Arthur Kwizera is a member of the Ugandan Ministry of Health scientific Advisory Committee for COVID-19 and chairs a committee tasked with developing the National Intensive Care Strategic Plan to guide the expansion of Uganda’s intensive care capacity to at least 4,000 ICU beds.Together with a team from the University of Cambridge (UK), he is developing a ventilator to be used in hard-to-reach places in the world. 2021-09-0828 min
ESICM TalkImplementation of new ECMO centers during the COVID-19 pandemicIn this multicenter international cohort in 19 ECMO centres from five countries in the Middle East and India, 307 critically ill COVID-19 patients received ECMO therapy, of whom 138 (45%) survived to home discharge. The current study showed that new satellite ECMO centres could be safely implemented with appropriate close supervision of regional experts and may provide favourable outcomes in highly selected critically ill patients.Original study: Implementation of new ECMO centres during the COVID-19 pandemic: experience and results from the Middle East and India Speakers:Prof Alain COMBES. Professor of Intensive Care Medicine at...2021-08-2416 min
ESICM Talk30 minutes with...Prof Rinaldo Bellomo"30 minutes with…" is a new talk format where you have the opportunity to ask any question you might have to world-renowned experts in the field of Intensive Care Medicine.
After https://esicm-tv.org/fr/replay/30-minutes-with/24eb3661153a97375d5e1eae7c360560d7d1a2bf/ (Prof Luciano Gattinoni) and https://esicm-tv.org/fr/replay/30-minutes-with/e94a02a2dc709d60ca19c66c0a5942957dccaaf0/ (Prof Flavia Machado), this third session saw Prof Bellomo challenged on critical ICU topics by ESICM Secretary Lui Forni.
Between the years 2014-2018, Professor Bellomo was named one of the world's most influential scientific mi...2021-07-2036 min30 minutes with...30 minutes with…Prof Rinaldo Bellomo"30 minutes with…" is a new talk format where you have the opportunity to ask any question you might have to world-renowned experts in the field of Intensive Care Medicine.After Prof Luciano Gattinoni and Prof Flavia Machado, this third session features Prof Bellomo challenged on critical ICU topics by ESICM Secretary Lui Forni.Between the years 2014-2018, Professor Bellomo was named one of the world's most influential scientific minds of our time by Clarivate Analytics, identified as "influencing the future direction of their field, and of the world", and "publishing work that their peers recognize as...2021-07-1936 min
ESICM TalkCaring for COVID-19 patients and their relatives with the ICU diaryFor family members of survivors, the ICU diary is an important source of medical information, provides a way for them to register their presence at the patient’s bedside and express their feelings, and contributes to humanizing the ICU staff. For relatives of non-survivors, the diary also works as a concrete memory of their loved one’s last days before dying, helping relatives to cope with bereavement.Systematic Review: Exploring family members’ and health care professionals’ perceptions on ICU diaries: a systematic review and qualitative data synthesis.Imaging in Intensive Care Medicine from the insi...2021-07-1318 min
ESICM Talk30 minutes with...Prof Flavia Machado“30 minutes with…” is a new talk format where you have the opportunity to ask any question you might have to world-renowned experts in the field of Intensive Care Medicine.
After starting with Prof Luciano Gattinoni, this second session was led once more by ESICM President Maurizio Cecconi, who engaged in conversation with Prof Flavia Machado on critical ICU topics and moderated questions coming from the audience.
Prof Machado is a leading expert in sepsis: she has served on the board of the Surviving Sepsis Campaign International Guidelines and the International Sepsis Forum (ISF) Council since 2014.
She has been involved in the...2021-07-1330 min
ESICM Talk30 minutes with...Prof Luciano Gattinoni“30 minutes with…” is a new talk format where you have the opportunity to ask any question you might have to world-renowned experts in the field of Intensive Care Medicine.
This first session was led by ESICM President Maurizio Cecconi, who asked Prof Gattinoni challenging questions on relevant ICU themes, and moderated those coming from the audience.
Prof Gattinoni introduced the concept of lung rest by extracorporeal CO2 removal in ARF and promoted the “baby lung” (1980’s), lung recruitability (2000’s) and mechanical power concepts (2016).
His research focuses on the pathophysiology and treatment of acute respirat...2021-07-1230 min30 minutes with...30 minutes with…Prof Flavia Machado“30 minutes with…” is a new talk format where you have the opportunity to ask any question you might have to world-renowned experts in the field of Intensive Care Medicine.After starting with Prof Luciano Gattinoni, this second session was led once more by ESICM President Maurizio Cecconi, who engaged in conversation with Prof Flavia Machado on critical ICU topics.Prof Machado is a leading expert in sepsis: she has served on the board of the Surviving Sepsis Campaign International Guidelines and the International Sepsis Forum (ISF) Council since 2014.She has been involved in the Co...2021-07-0630 min30 minutes with...30 minutes with…Prof Luciano Gattinoni“30 minutes with…” is a new talk format where you have the opportunity to ask any question you might have to world-renowned experts in the field of Intensive Care Medicine.This first session was led by ESICM President Maurizio Cecconi, who asked Prof Gattinoni challenging questions on relevant ICU themes, and moderated those coming from the audience.Prof Gattinoni introduced the concept of lung rest by extracorporeal CO2 removal in ARF and promoted the “baby lung” (1980’s), lung recruitability (2000’s) and mechanical power concepts (2016).His research focuses on the pathophysiology and treatment of acute respiratory fa...2021-06-2931 min
ESICM TalkICP monitoring in patients with acute brain injury in ICU (Synapse-ICU)Intracranial pressure monitoring in patients with acute brain injury in the intensive care unit (Synapse-ICU): an international, prospective observational cohort study.The practice of continuously measuring intracranial pressure (commonly referred to as ICP) in comatose patients after haemorrhagic stroke or head injury is standard practice in many countries. However, it is uncertain whether monitoring-guided therapies will yield significant results. Nevertheless, data collected from the study confirms what already seemed evident from experience. Furthermore, it offers valuable scientific support for both those realities where monitoring had not been used and for those where this...2021-06-1616 min
ESICM TalkEvolving changes in mortality of critical COVID-19Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months.Age, frailty and adjusted mortality of critically ill patients have progressively reduced over the course of the COVID-19 pandemic. Non-invasive respiratory support has been increasingly used and was independently associated with improved 30-day survival in our study.Future randomised trials are needed to determine if a management strategy based on early non-invasive support for respiratory failure improves outcomes.Speakers:Dr Otavio RANZANI. ICM Associate Editor. Barcelona Institute for Global Health, ISGlobal, Barcelona (ES) Pulmonary Division, Heart Institute (InCor...2021-06-1511 min
ESICM TalkWhat happened to mechanically ventilated COVID-19 patients in the UK?Natural history, trajectory, and management of mechanically ventilated COVID-19 patients in the United Kingdom.In a cohort of COVID-19 patients treated in the United Kingdom, progressive respiratory failure was increasingly associated with mortality. Evidence-based triggers for ARDS interventions, in particular prone position, were not implemented, had delayed application, or showed poor responsiveness in a sizeable proportion of patients with progressive hypoxaemia. How this implementation gap and lack of response to conventional ARDS interventions may have contributed to excess mortality across the pandemic deserves further interrogation.Speakers:Prof Stefan SCHALLER. Charité, Universitätsmedizin Berlin, Co...2021-06-0818 min
ESICM TalkEffect of the use of an endotracheal tube and stylet versus an endotracheal tube alone on first-attempt intubation successIn this randomized clinical trial that included 999 patients, the use of a stylet for tracheal intubation in critically ill adult patients resulted in significantly higher first‑attempt intubation success than the use of tracheal tube alone. The incidence of serious adverse events evaluated by the rate of traumatic injuries related to tracheal intubation was similar in the two groups.Speakers:Prof Sheila MYATRA. Consultant Critical Care Specialist, Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Mumbai (IN). Secretary, Indian College of Critical Care Medicine of the Indian Society of Critical Care Medicine (ISCCM).2021-06-0124 min
ESICM TalkEthical Issues in the ICUWe are confronted daily with complex ethical issues during the care of our patients in intensive care units. The principles of biomedical ethics may guide us with regard to concerns for ethical decision-making. Although globalisation brings enormous richness and diversity through multicultural structures, ethical issues may challenge intensivists in these conditions. However, the 'moral stresses' that health professionals experience are almost always ignored.Speakers: Dr Burcin Halacli. Internist and intensivist at Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Ankara, Turkey and ESICM NEXT Committee member. 2021-05-2818 min
ESICM TalkRandomised controlled trial of oxygen therapy and HFNT in African children with pneumoniaIn Africa, in children hospitalised with severe pneumonia with oxygen saturations between 80 and 91% who did not receive oxygen, mortality assessed at 48 h (1.4%) was comparable to the usual method of oxygen delivery (low-flow oxygen; LFO (2.5%)) and in those receiving high-flow nasal therapy (HFNT, 1.1%). The potential impact of HFNT on patient-centred outcomes and on resources, particularly oxygen supplies, should stimulate further exploration particularly in children with severe pneumonia managed in low resource settings. Read the article in the ICM Journal: https://rdcu.be/ckTgA.
Speakers:
Prof Mark PETERS. Professor of Paediatric Intensive Care, Infection, Immunity & Inflammation Dept - UCL GOS...2021-05-2623 min
ESICM TalkRCT of oxygen therapy and HFNT in African children with pneumoniaIn Africa, in children hospitalised with severe pneumonia with oxygen saturations between 80 and 91% who did not receive oxygen, mortality assessed at 48 h (1.4%) was comparable to the usual method of oxygen delivery (low-flow oxygen; LFO (2.5%)) and in those receiving high-flow nasal therapy (HFNT, 1.1%). The potential impact of HFNT on patient-centred outcomes and on resources, particularly oxygen supplies, should stimulate further exploration particularly in children with severe pneumonia managed in low resource settings. Read the article in the ICM Journal: https://rdcu.be/ckTgA.Speakers:Prof Mark PETERS. Professor of Paediatric Intensive Care, I...2021-05-2623 min
ESICM TalkExpanding controlled donation after the circulatory determination of deathExpanding controlled donation after the circulatory determination of death: statement from an international collaborative. This International Collaborative Statement aims at expanding cDCDD in the world to help countries progress towards self-sufficiency in transplantation and offer more patients the opportunity of organ donation. The Statement addresses three fundamental aspects of the cDCDD pathway:First, it describes the process of determining a prognosis that justifies the WLST (withdrawal of life-supporting therapies). Second, it establishes the permanent cessation of circulation to the brain as the standard to determine death by circulatory criteria. Finally, the Statement highlights the value of perfusion repair...2021-05-1114 min
ESICM TalkHaemodynamics, vasopressors, monitors – a chat with Thinking Critical CareFollowing on from the recent ESICM webinars on haemodynamic monitoring and vasopressors, Dr Wong interviews Dr Rola on his thoughts on a range of issues, from the use of ultrasound, venous congestion to the Pulmonary Artery Catheter as well as his predictions for the direction of future research.Speakers: Dr Adrian WONG. Consultant in Intensive Care Medicine and Anaesthesia, King's College Hospital, London (UK) and current Chair of the ESICM Editorial and Publishing Committee (EPC).Dr Philippe ROLA. Chief of Service, Intensive Care Unit, Santa Cabrini Hospital, Montreal, Canada.2021-04-2725 min
ESICM TalkUltrasound as a haemodynamic monitor?Ultrasound has become an indispensable tool while caring for critically ill patients. Increasing availability at bedside and the role that it plays in the diagnosis and management of patients had made that clinicians incorporate ultrasound as a part of their bedside clinical examination. Some colleagues argue that it can be a good hemodynamic tool too, however, others disagree.Speakers: Dr Laura GALARZA. Intensivist at the University General Hospital in Castellon, Spain and Deputy Chair of the ESICM NEXT committee.Prof Xavier MONNET. Professor of Intensive Care at the Paris-South University, working in the...2021-04-2312 minESICM TalkManaging Cirtically Ill Patients with COVID-19Prof. Yaseen ARABI and Dr. Lennie DERDE, two experts in respiratory syndrome, infectious threats and the treatment of severe infections presented the latest information on COVID-19.2021-03-3043 min
ESICM TalkSevere Traumatic Brain Injury - Next Podcast #1Severe traumatic brain injury (TBI) is a leading cause of morbidity and mortality, particularly in young adults, where 50% of survivors cannot live independently six months post injury. Speakers: Dr Rahul COSTA-PINTO. Austin Hospital, Melbourne - Australia; ESICM NEXT Committee Member.Prof Andrew UDY. The Alfred Hospital, Melbourne - Australia; principal investigator of the BONANZA study (Brain Oxygen Neuromonitoring in Australia and New Zealand Assessment Trial).2021-03-2320 min