Scientific Subcommittee 9 – Intensive Care Medicine

Scientific Subcommittee 9 – Intensive Care Medicine

  • Issue 72

Cesare Gregoretti, Chair SSC9

c.gregoretti@gmail.com

I could not write this brief report if I was not elected Chairman of Subcommittee 9 (SC 9) in 2016. So, first I would like to thank ESA for having given me the opportunity to have this position. I have been chairing SC 9 since January 2017, replacing Prof Einav Sharon who did a lot to improve the visibility of SC 9 during the years of her mandate. The mission ESA gave me was to further increase the visibility of critical care medicine within ESA through SC 9 activities. Let me describe what SC 9 has already done and ongoing and future projects.

 ESA Geneva 2017

In our SC 9 meeting in Geneva we discussed possible study protocols and we came out with interesting proposals. In particular, we re-evaluated the proposal of Prof Sharon on ventilation practices of patients admitted to ICU. We agreed that this proposal is still of interest and has elements of novelty if we consider the possible different approaches to ventilation by anaesthesiologists and intensivists. However, we also discussed the possibility to address another question, namely the different ventilation approach that anaesthesiologists may adopt compared to intensivists for those patients admitted to the OR from the ICU. Prof Einav also proposed a study investigating withdrawal of the practice of ECMO. Although the research question was considered relevant, some members had concerns regarding its wide interest in the ESA. Prof Davide Chiumello (SC 9) proposed a study investigating the practice of intraoperative fluid administration and its effect on acid-base status. This study would explore which are the most commonly used intraoperative fluids and their implications on a clinically relevant outcome. He will submit a draft of his proposal. Prof Gernot Marx (SC 9) expressed willingness to collaborate with Prof Chiumello. The protocol is pending. Prof Claude Martin advanced another interesting proposal: an observational study investigating the practice of weaning critically ill patients from vasopressors (with a particular focus on septic patients) among European intensivists. All these protocols are going to be finalized.

 ESA Copenhagen 2018

It was not easy for me to try to design something appealing for the upcoming Copenhagen meeting after the great job done by Prof Einav Sharon.

I would like to thank all the members of SC 9 who helped me in steering the ESA programme for the next ESA Congress. Although my field of interest is that of mechanical ventilation in any of its aspects, I tried to design a programme thinking of critical care medicine 24 hours a day.

First I asked my SC 9 members to make some proposals in the different fields of critical care medicine according to their expertise. Second, I revised all the critical care materials from the ESA meetings of last three years. Third, I tried to write down my proposals and those made by SC 9 members in a very preliminary draft. This was done by cutting all the overlapping topics and those topics that were already treated in the previous three years. Once I did that, I added speakers and chairmen who were contacted by me. Lastly, I tried to include at least once or, whenever possible twice, my SC 9 members as chairmen or speakers in their field of expertise.

My politics, although it could seem wrong, was centred in trying to invite more people coming from Europe in order to save money on their expenses. However, this does not preclude having people coming from across the ocean.

At the end I was quite happy with the first Copenhagen ESA draft. As a last step, I started to contact people of the other ESA subcommittees in order to have one of their people chairing or participating in one of the sessions dealing with topics related to their SC (e.g., I contacted SC 11 members for sessions on mechanical ventilation).

Last but not least, I sent to all involved SCs and to my all SC 9 members the programme draft to obtain their approval.

In Brussels, I was scared about the decision process of voting my proposals but, in the end, 90% of the programme, equal to a cumulative time of about 1100 minutes, was approved.

eLearning

After Brussels I kept moving as chairman of SC 9 in producing web-based educational products as eLearning modules (in the growing platform called ESA Academy) in cooperation with Prof Andreas Sandner-Kiesling (chairman) and Anny Lam (Education and Training Coordinator). We developed an E-Learning module (MOOC 5) authored by Dr Vincenzo Russotto and myself and co-authored by Dr Andrea Cortegiani and Dr Michela Rauseo. This module aimed at improving knowledge in respiratory support techniques to avoid desaturation of critically ill patients undergoing intubation. It will be ready in the next few months.

Affective skills acquired after listening to this module will be awareness of the risk of desaturation and severe hypoxemia in critically ill patients undergoing intubation and the importance of respiratory support for critically ill patients undergoing intubation. In addition, it will make the reader aware of advantages and shortcomings of available techniques of respiratory support to avoid desaturation of critically ill patients undergoing intubation and of which respiratory support technique is most effective to avoid desaturation.

Intersociety projects

SC 9 has also been working on intersociety projects such as the European ESA/ESICM Guideline on Perioperative Noninvasive Respiratory Support for the Hypoxemic Patient.

SC 9 also planned joint ESA-ESICM sessions to be included in the Euroanaesthesia Scientific programme in Copenhagen 2018 as well as the ESICM Congress in Vienna 2017.

ESA SC 9 is open to all of you that want to attend our SC meeting in Copenhagen. Your presence will be very welcome.