ESICM Talk

In 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).

Prof Samir JABER. Head of the Critical Care and Anesthesia Department of Saint-Eloi University Hospital, Montpellier (FR). Full "exceptional class" (highest degree) professor in Anesthesiology and Critical Care, Faculty of Medicine of Montpellier. Senior Deputy Editor of the ICM Journal.

We 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.

Prof Erwin Kompanje. Consultant in Clinical ethics at Erasmus University Medical Center, Department of Intensive Care in Rotterdam (NL), and interestingly he is Honorary curator and senior taxidermist at the Natural History Museum Rotterdam. He has lots of papers, more than 4000 citations about biomedical ethics, clinical ethics and intensive care medicine.

In 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 Institute of Child Health (Faculty of Pop Health Sciences).

Prof Kathryn MAITLAND. British paediatrician, professor of infectious diseases at Imperial College London, director of the ICCARE Centre at the Institute of Global Health Innovation and an Honorary Fellow at MRC Clinical Trials Unit, University College, London. Since 2000 she has been based at the KEMRI-Wellcome Trust Research Programme, in Kilifi, Kenya.

Expanding 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:

1. First, it describes the process of determining a prognosis that justifies the WLST (withdrawal of life-supporting therapies).
2. Second, it establishes the permanent cessation of circulation to the brain as the standard to determine death by circulatory criteria.
3. Finally, the Statement highlights the value of perfusion repair for increasing the success of cDCDD organ transplantation.

Speakers:

Prof Giuseppe CITERIO. Associate Professor, School of Medicine and Surgery of the University of Milano-Bicocca in Monza, (IT); director of the NeuroIntensive Care Unit, San Gerardo Hospital in Monza (IT).

Prof Francis L. DELMONICO. Chief Medical Officer, New England Donor Services (US), Professor at Harvard Medical School at Massachusetts General Hospital and Emeritus Director of Renal Transplantation.

Dr Beatriz DOMÍNGUEZ-GIL. General Director, Organización Nacional de Trasplantes, Madrid (ES).

Following 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.

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 Medical Intensive Care Unit of the Bicêtre Hospital. Prof. Monnet’s main fields of research are acute circulatory failure and its treatment, haemodynamic monitoring and heart-lung interactions. He is the Chair of the ESICM cardiovascular dynamics section. 

Severe 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).