Annual report – Subcommittee 9: Intensive Care Medicine

Annual report – Subcommittee 9: Intensive Care Medicine

  • Issue 79

Cesare Gregoretti

As chairman of the Intensive Care Medicine subcommittee I have first to congratulate with all its members who actively participated in our activities. Among our members we had also a great loss. Prof. Claude Martin recently passed away and we are still mourning his loss. He was a gentleman always keen to participate and to collaborate in new projects  and coming up with new initiatives. Thanks to him we recently published, with also the contribution of our subcommittee, an interesting review on fluids in critically ill patients. This review also involved other persons who were experts in the field. In particular one of them that was part of the e-learning committee tried to help Prof Martin on leading this project.

Prof Martin was also the promoter of our ESA workshop entitled Perioperative Intensive Care. The workshop included lectures and interaction with the audience, aimed at providing practical and updated information on how to take care of critically ill patients in the operating or recovery room. The session focused on resuscitation during sepsis, acute respiratory distress syndrome (ARDS) in surgical patients, trauma, and acute abdomen. It was held for the first time in Euroanaesthesia in Vienna.

We also designed a pre-congress course in Vienna, in collaboration with the Respiration and Airway SC11 lead by Dr. Massimilano Sorbello, on the role of intraoperative mechanical ventilation. This workshop aimed to provide  basic information on respiratory physiology to guide participants to understand and/use perioperative ventilatory support including intraoperative mechanical ventilation. It also aimed to provide basic principles of preoperative pre-oxygenation, apnoeic oxygenation strategies, procedural oxygenation, intubation and mRSI bundles. Again, this appeared for the first time in Vienna.

Both the initiatives were successful and they will be repeated in Euroanaesthesia 2020 in Barcelona.

We also worked on the behalf of the Practice Guidelines Committee of the ESA onthe European ESA/ESICM Guideline on Perioperative Noninvasive Respiratory Support for the Hypoxaemic Patient. This project that involved many persons, coming also from other subcommittes (for example the Respiration and Airway Management Committee ESA SC11), aimed at providing to end-users a pragmatic approach of the management of the hypoxaemic patient during the perioperative period. The final draft of the manuscript was presented in Viennaby Marc Leone who chaired the guidelines.

Last but last least some of us participated in the PROBESE study recently published in JAMA. I was also personally involved in the steering committee of PROBESE as well as of the PROTHOR study. We are also planning on behalf of the e-learning committee a webinar on Algorithm Approach in Septic and Haemorrhagic Shock States which will involve Prof Daniel De Backer, Prof Sharon Einav, myself and Dr Andrea Cortegiani. The target audience will be anaesthesiologists, intensivists and emergency physicians involved in the care of patients with trauma, obstetric anaesthesia and septic shock.

This webinar will be able will enable the delegates to recognise the importance of early shock states, know the risk factors for the development of these different shock states, know how predict where “the patient is going to”, know the importance of following an algorithm and eventually know the adverse effect of different therapeutic strategies to prevent the most important complications associated with these shock states.

Regarding the ESA program in previous years, we tried to focus our attention to topics never handled in previous Euroanaesthesia congresses. Although sepsis still remains an important issue, we tried to cover other fields of interest always in collaboration with the other subcommittees. Among them sleep-related disturbances in the ICU and the use of ECMO in all its aspects,  including knowing when to quit . Sessions on mechanical ventilation and on non-invasive respiratory support were also widely dealt with in collaboration with SC11 . Interestingly, we also tried to involve the other SCs with sessions specifically designed for critical patients in different areas (for example obstetric or thoracic surgery) We also take up new initiatives, and thanks to ESA, have the possibility of making our session interactive.