The early initiation of vasopressors, ideally within the first hour of diagnosing septic shock, is emerging as a preferred strategy. This approach offers a multimodal action with potential benefits, including reduced morbidity and mortality. Prompt vasopressor therapy is crucial for effective management in septic shock patients. To dive deeper into the timing and administration of vasopressors, join us for our next podcast! Michele Chew and Mathieu Jozwiak will guide us through the essentials—don’t miss it!

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) represent sudden and severe declines in airway function and respiratory symptoms in COPD patients. The clinical presentation of AECOPD is diverse, demanding a treatment approach tailored to disease severity—beginning with antibiotic therapy and, in critical cases, advancing to mechanical ventilation for respiratory support. Tune into our next podcast to learn more!

Septic shock triggers a dangerous drop in blood pressure and restricts blood flow to vital organs, making rapid intervention essential to prevent organ failure. This podcast will explore the power of a multimodal treatment approach—combining tailored medications, precise dosing, and supportive therapies—to amplify the body’s response to vasopressors.Don’t miss this insightful discussion!

Autonomic dysfunction and tachycardia are strongly linked to poor outcomes in septic shock, contributing to high mortality rates. In the upcoming podcast, we explore whether β-blockade with landiolol for up to 14 days can reduce organ failure, as measured by the Sequential Organ Failure Assessment (SOFA) score, in critically ill patients with tachycardia and septic shock who have been on high-dose norepinephrine for over 24 hours. Dr. Tony Whitehouse, interviewed by two NEXT representatives, discusses the key findings of the STRESS-L Randomized Clinical Trial.

Aneurysmal subarachnoid hemorrhage (aSAH) is a rare but devastating condition, marked by high global rates of fatality and long-term disability. Key factors influencing patient outcomes include early brain injury, aneurysm rebleeding, and delayed cerebral ischemia. In this podcast, Dr. Chiara Robba and Dr. Laura Galarza explore the epidemiology, treatment strategies, and the identification and management of post-aSAH complications. This exclusive discussion provides valuable insights and practical clinical guidance specifically designed for intensivists.

Esophageal pressure measurement plays a crucial role in estimating transpulmonary pressure, with both its absolute values and variations being key factors in assessing lung injury from mechanical forces during ventilation. To gain deeper insights into esophageal pressure monitoring and the essential equipment required for accurate measurement, tune in to the NEXT podcast. Luigi Zattera, the NEXT representative, conducted an insightful interview with Lise Piquilloud, head of the Acute Respiratory Failure (ARF) section. 

Inspiratory muscle training (IMT) aims to enhance the strength and endurance of respiratory muscles. Numerous clinical trials have explored the effectiveness of IMT using various training protocols, devices, and respiratory assessments. However, its adoption in clinical practice remains limited. The extent to which IMT offers clinical benefits, particularly in conjunction with pulmonary rehabilitation following respiratory failure, is still uncertain.To delve deeper into the subject and gain insights into IMT, we have invited Professor Bernie Bissett. Tune in to our podcast to hear her expert perspective.

To 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 learn more about ARDS from disease understanding to future bedside perspectives.

Cardiogenic 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 outcomes of MCS devices with no MCS and each other and investigate which MCS is the most effective in reducing mortality.To learn more about the findings of this study listen to this podcast.

The 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 more detailed description of ICU diaries from the guests in our next podcast – the first one of 2024 from the ESICM N&AHP group.

Professional 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.

Acute 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 department and remain identifiable over time.To learn more about the methods and findings of this study listen to the next podcast.

Cerebral 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. 

Nutrition 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. 

Sepsis 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.To address this knowledge gap, a study was conducted aiming to determine the concordance between different sub-type labels, outcomes, and biologic pathways of critically ill sepsis patients classified by previously proposed sepsis subtyping methods. Listen to the podcast and learn more about the methodology and findings of this study.

VA-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 learn more about this study listen to the podcast.

Numerous 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 without TDM using an external multicenter dataset to facilitate model selection for MIPD in critically ill patients. Listen to the podcast and learn more about the methodology and findings of this study.

The 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. 

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 Gattinioni and invite you to follow the conversation in the following podcast.

Sepsis‐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.

Transportation 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, peer-reviewed, evidence-based training material, free of charge for ESICM members. Speaker:Michael J LAURIA. Former Pararescueman in the US Air Force and Critical Care/Flight Paramedic. Currently Emergency Medicine Physician, University of New Mexico Health Sciences Center; EMS/Critical Care Fellow, Flight Physician; Associate Medical Director for Lifeguard Air Emergency Services (US).

Intensive 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 results in better patient outcomes and less or better coping with ICU staff burnout. Learn more about the importance of interprofessional teamwork in the ICU in this podcast with Elena Conoscenti and Andreas Xyrichis.Speakers:Andreas XYRICHIS. King's College London (UK). Elena CONOSCENTI. ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo (IT). ESICM Nurses & Allied Healthcare Professionals Committee member.

Multiple 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. Listen to Joanna Shepherd's interview in the following podcast to learn more about the study's results. Original article: Safety and efficacy of artesunate treatment in severely injured patients with traumatic haemorrhage. The TOP-ART randomised clinical trialSpeakers:Joanna SHEPHERD. Centre for Trauma Sciences, The Blizard Institute, Queen Mary University of London (UK). Rahul COSTA-PINTO. Austin Hospital, Melbourne (AU). ESICM NEXT Committee Member.

Sepsis 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 happens in adult and paediatric patients who survived sepsis. Speakers:Elsa AFONSO. Anglia Ruskin University, Cambridge (UK). Laura Maria ALBERTO. Universidad del Salvador (AR). Elena CONOSCENTI. ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo (IT). ESICM Nurses & Allied Healthcare Professionals Committee member.

Central 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 patients with severe meningoencephalitis requiring care in the ICU. We discuss its findings in this episode. Help us review our educational podcasts! Complete this short survey here. Speakers:Romain SONNEVILLE. Bichat Claude Bernard University Hospital, APHP, Université Paris Cité (FR). Laura GALARZA. Laura Galarza Hospital Universitari General de Castellón (ES). Chair, ESICM NEXT Committee.

Several 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. SpeakersTimo MAYERHÖFER. Medical University Innsbruck (AT). Kristina FUEST. Technische Universität München (DE). ESICM NEXT Committee member.

International 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 adults with coma who had been resuscitated after out-of-hospital cardiac arrest.Listen to the podcast for more insight into the hypothesis, methodology and findings from the TAME study. Original paper: Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac ArrestSpeakersClaudio SANDRONI. Policlinico Universitario Agostino Gemelli, Rome (IT). Markus SKRIFVARS. University of Helsinki (FI). Chair, ESICM Trauma & Emergency Medicine (TEM) Section. Chiara ROBBA. University of Genova (IT). ESICM Neuro-Intensive Care (NIC) Section.

Severe 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 European Society of Intensive Care Medicine (ESICM), the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), and the Latin American Thoracic Association (ALAT).Original paper: ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumoniaSpeakersIgnacio MARTIN-LOECHES. Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organisation (MICRO), St James’s Hospital, Dublin (IE). Antoni TORRES. CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid (ES). Pedro PÓVOA. NOVA Medical School, CHRC, New University of Lisbon (PT).

Preclinical 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 AKI Section.SpeakersLakhmir S. CHAWLA. Chief Medical Officer, Silver Creek Pharmaceuticals. Recipient of the International Vicenza Award for Critical Care Nephrology.Eric HOSTE. UZ Gent (BE). AKI Section Representative, ESICM Social Media & Digital Content Committee.Marc ROMAIN. Hadassah Medical Center, Jerusalem (IL).

Coagulopathy 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 SpeakersJulie HELMS. Université de Strasbourg (UNISTRA), Faculté de Médecine, Hôpitaux Universitaires de Strasbourg (FR). Ahmed ZAHER. Oxford University Hospitals (UK). NEXT Committee member, ESICM.

End-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 Committee member, ESICM.

The 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 minimise 28-day all-cause mortality.Original paper: Machine-learning-derived sepsis bundle of careSpeakersRomain PIRRACCHIO. Department of Anesthesia and Perioperative Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco (US). Ana-Maria IOAN. Fundacion Jimenez Diaz University Hospital, Madrid (ES). Spain. NEXT Committe member, ESICM.

Sepsis 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 sepsis at the bedside: guide to cliniciansSpeakersPedro PÓVOA.  NOVA Medical School, New University of Lisbon (PT). Laura BORGSTEDT. Department of Anesthesiology and Intensive Care Medicine, Klinikum rechts der Isar, Technical University Munich (DE). NEXT Committe member, ESICM.

Individualising 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 ciprofloxacin. Original paper: Model‑informed precision dosing of beta‑lactam antibiotics and ciprofloxacin in critically ill patients: a multicentre randomised clinical trialSpeakersTim M. J. EWOLDT. Department Hospital Pharmacy, Erasmus University Medical Center, Rotterdam (NL).Alan ABDULLA. Department Hospital Pharmacy, Erasmus University Medical Center, Rotterdam (NL).Ana-Maria IOAN. Intensive Care Medicine Unit, Fundación "Jiménez Díaz" University Hospital, Madrid (ES). NEXT Committe member, ESICM.

Bronchiolitis 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 guidelines: management of severe bronchiolitis in infants under 12 months old admitted to a paediatric critical care unitSpeakersChristophe MILÉSI. Pediatric Intensive Care Unit, Montpellier University Hospital (FR).Mariangela PELLEGRINI. Dept. of Surgical Sciences, Uppsala University (SE).

The 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 preventive interventions. Listen to Dr Sviri and Dr Beil to learn about the final findings of this study. Original paper: Clustering analysis of geriatric and acute characteristics in a cohort of very old patients on admission to ICUSpeakersMichael BEIL. Hebrew University and Hadassah University Medical Center, Jerusalem (IL).Sigal SVIRI. Hebrew University and Hadassah University Medical Center, Jerusalem, (IL). Rahul COSTA-PINTO. Austin Hospital, Victoria and the University of Melbourne (AU). ESICM Next Committee member.

Nutrition 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 short survey here. SpeakersJanja TARCUKOVIC. Department of Anaesthesiology, Intensive Care and Pain Medicine Clinical Hospital Centre Rijeka, Rijeka (HR).Kristina FUEST. Technische Universität München (DE). ESICM NEXT Committee member.

Pregnant 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 of pregnant women admitted to intensive care unit for severe pneumonia related to SARS-CoV-2 infection: the multicenter and international COVIDPREG studySpeakersMathieu JOZWIAK. Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nice (FR).Mariangela PELLEGRINI. Intensive Care Unit, AnOpIVA, Hedenstierna Laboratory, Dept. of Surgical Sciences, Uppsala University (SE).

Intensive 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 paper: Evolution of sedation management in the ICUSpeakersJoanna STOLLINGS. Vanderbilt University Medical Center, Nashville (USA). Rahul COSTA-PINTO. Austin Hospital, Victoria (AU). ESICM Next Committee member.

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 our educational podcasts! Complete this short survey here. SpeakersAntoine SCHNEIDER. Lausanne University Hospital (CH). Chair, ESICM Acute Kidney Injury Section.Eric HOSTE. Universitair Ziekenhuis Ghent (BE).Sean BAGSGAW. University of Alberta Hospital (CA); Mazankowski Alberta Health Institute (CA).Silvia DE ROSA. San Bortolo Hospital, Vicenza (IT). ESICM Next Committee member.

Over 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 podcasts! Complete this short survey here. SpeakersChristian JUNG. Heinrich-Heine-University Duesseldorf (DE). Chair, ESICM Health Services Research & Outcome (HSRO) Section.Kristina FUEST. Technische Universität München (DE). ESICM NEXT Committee member.

A 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 Dhawan, and Dr Verma relating their experience with this novel hepatitis. Original article: Outbreak of hepatitis in children: clinical course of children with acute liver failure admitted to the intensive care unit.SpeakersAkash DEEP. Paediatric Intensive Care Unit, King’s College Hospital NHS Foundation Trust, Denmark Hill, London (UK).Anil DHAWAN. Paediatric Liver, GI and Nutrition Centre and Mowatlabs, King’s College Hospital NHS Foundation Trust, London (UK).Anita VERMA. Department of Microbiology, King’s College Hospital NHS Foundation Trust, London (UK).Inès Lakbar. Service Anesthésie - Réanimation Pr LEONE AP-HM - Hôpital Nord - Marseille (FR).

The 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 findings and conclusions. Original article: Echocardiography findings in COVID-19 patients admitted to intensive care units: a multi-national observational study (the ECHO-COVID study)SpeakersAntoine VIEILLARD-BARON. Service de Médecine Intensive Réanimation, Assistance Publique‑Hôpitaux de Paris, University Hospital Ambroise Paré, 92100 Boulogne‑Billancourt, France /INSERM, UMR 1018, Clinical Epidemiology Team, CESP, Université de Paris Saclay, Villejuif (FR).Ahmed ZAHER. Oxford Critical care, Oxford University hospitals (UK)

The 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 of this comprehensive study with Prof Jan De Waele.Original article: Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID studySpeakersJan DE WAELE. Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University (BE).Emilio RODRIGUEZ-RUIZ. Intensive Care Medicine Department, University Clinic Hospital of Santiago de Compostela (ES).

The 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. Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France.Ahmed ZAHER. Oxford University Hospitals (UK). ESICM Next Committee member.Xavier MONNET. Bicêtre Hospital, Paris-South University Hospitals (FR).Michelle CHEW. Linköping University Hospital (SE).

The 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 critical care: unique aspects of assessment, monitoring, investigations, and follow up Speakers Kate BROWN. Biomedical Research Centre, Great Ormond Street Hospital for Children, London (UK). Institute of Cardiovascular, Science University College London, London (UK).Robert TASKER. Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts (USA). Selwyn College, Cambridge University, Cambridge (UK).Rahul COSTA-PINTO. Department of Intensive Care, Austin Hospital, 145 Studley Road, Heidelberg, Victoria (AU). Department of Critical Care, Department of Medicine, the University of Melbourne, Parkville, Victoria (AU).

Recent 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 physiology in patients mechanically ventilated for ARDS: a systematic review and meta-analysis.Speakers:Armand MEKONTSO DESSAP. AP-HP, Hôpitaux Universitaires Henri-Mondor, Service de Médecine Intensive-Réanimation, 94010 Créteil (FR).Mariangela PELLEGRINI. Department of Surgical Sciences, Uppsala University Hospital (SE). ESICM NEXT member.

Sepsis 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 subsequent major cardiovascular events during long-term follow-up. Dr Angriman explains the findings of this recent study. Original paper: Sepsis hospitalization and risk of subsequent cardiovascular events in adults: a population-based matched cohort studySpeakers:Federico ANGRIMAN. Sunnybrook Health Sciences Centre, Toronto, ON (CA); Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON (CA). Mehmet YILDIRIM. Health Science University, Diskapi Training and Research Hospital, Ankara (TR). ESICM NEXT member.