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1. Family centeredness of care:a cross-sectional study in intensive care units part of the European society of intensive care medicine

Author: Azoulay, Élie, Kentish-Barnes, Nancy, Boulanger, Carole, Mistraletti, Giovanni, van Mol, Margo, Heras-La Calle, Gabriel, Estenssoro, Elisa, van Heerden, Peter Vernon, Delgado, Maria Cruz Martin, Perner, Anders, Arabi, Yaseen M., Myatra, Sheila Nainan, Laake, Jon Henrik, De Waele, Jan J., Darmon, Michael, Cecconi, Maurizio, Azoulay, Élie, Kentish-Barnes, Nancy, Boulanger, Carole, Mistraletti, Giovanni, van Mol, Margo, Heras-La Calle, Gabriel, Estenssoro, Elisa, van Heerden, Peter Vernon, Delgado, Maria Cruz Martin, Perner, Anders, Arabi, Yaseen M., Myatra, Sheila Nainan, Laake, Jon Henrik, De Waele, Jan J., Darmon, Michael, and Cecconi, Maurizio
Abstract: Purpose: To identify key components and variations in family-centered care practices. Methods: A cross-sectional study, conducted across ESICM members. Participating ICUs completed a questionnaire covering general ICU characteristics, visitation policies, team-family interactions, and end-of-life decision-making. The primary outcome, self-rated family-centeredness, was assessed using a visual analog scale. Additionally, respondents completed the Maslach Burnout Inventory and the Ethical Decision Making Climate Questionnaire to capture burnout dimensions and assess the ethical decision-making climate. Results: The response rate was 53% (respondents from 359/683 invited ICUs who actually open the email); participating healthcare professionals (HCPs) were from Europe (62%), Asia (9%), South America (6%), North America (5%), Middle East (4%), and Australia/New Zealand (4%). The importance of family-centeredness was ranked high, median 7 (IQR 6–8) of 10 on VAS. Significant differences were observed across quartiles of family centeredness, including in visitation policies availability of a waiting rooms, family rooms, family information leaflet, visiting hours, night visits, sleep in the ICU, and in team-family interactions, including daily information, routine day-3 conference, and willingness to empower nurses and relatives. Higher family centeredness correlated with family involvement in rounds, participation in patient care and end-of-life practices. Burnout symptoms (41% of respondents) were negatively associated with family-centeredness. Ethical climate and willingness to empower nurses were independent predictors of family centeredness. Conclusions: This study emphasizes the need to prioritize healthcare providers’ mental health for enhanced family-centered care. Further research is warranted to assess the impact of improving the ethical climate on family-centeredness.
Published: 2024

2. Family centeredness of care:a cross-sectional study in intensive care units part of the European society of intensive care medicine

Author: Azoulay, Élie, Kentish-Barnes, Nancy, Boulanger, Carole, Mistraletti, Giovanni, van Mol, Margo, Heras-La Calle, Gabriel, Estenssoro, Elisa, van Heerden, Peter Vernon, Delgado, Maria Cruz Martin, Perner, Anders, Arabi, Yaseen M., Myatra, Sheila Nainan, Laake, Jon Henrik, De Waele, Jan J., Darmon, Michael, Cecconi, Maurizio, Azoulay, Élie, Kentish-Barnes, Nancy, Boulanger, Carole, Mistraletti, Giovanni, van Mol, Margo, Heras-La Calle, Gabriel, Estenssoro, Elisa, van Heerden, Peter Vernon, Delgado, Maria Cruz Martin, Perner, Anders, Arabi, Yaseen M., Myatra, Sheila Nainan, Laake, Jon Henrik, De Waele, Jan J., Darmon, Michael, and Cecconi, Maurizio
Abstract: Purpose To identify key components and variations in family-centered care practices. Methods A cross-sectional study, conducted across ESICM members. Participating ICUs completed a questionnaire covering general ICU characteristics, visitation policies, team-family interactions, and end-of-life decision-making. The primary outcome, self-rated family-centeredness, was assessed using a visual analog scale. Additionally, respondents completed the Maslach Burnout Inventory and the Ethical Decision Making Climate Questionnaire to capture burnout dimensions and assess the ethical decision-making climate. Results The response rate was 53% (respondents from 359/683 invited ICUs who actually open the email); participating healthcare professionals (HCPs) were from Europe (62%), Asia (9%), South America (6%), North America (5%), Middle East (4%), and Australia/New Zealand (4%). The importance of family-centeredness was ranked high, median 7 (IQR 6–8) of 10 on VAS. Significant differences were observed across quartiles of family centeredness, including in visitation policies availability of a waiting rooms, family rooms, family information leaflet, visiting hours, night visits, sleep in the ICU, and in team-family interactions, including daily information, routine day-3 conference, and willingness to empower nurses and relatives. Higher family centeredness correlated with family involvement in rounds, participation in patient care and end-of-life practices. Burnout symptoms (41% of respondents) were negatively associated with family-centeredness. Ethical climate and willingness to empower nurses were independent predictors of family centeredness. Conclusions This study emphasizes the need to prioritize healthcare providers’ mental health for enhanced family-centered care. Further research is warranted to assess the impact of improving the ethical climate on family-centeredness., Purpose: To identify key components and variations in family-centered care practices. Methods: A cross-sectional study, conducted across ESICM members. Participating ICUs completed a questionnaire covering general ICU characteristics, visitation policies, team-family interactions, and end-of-life decision-making. The primary outcome, self-rated family-centeredness, was assessed using a visual analog scale. Additionally, respondents completed the Maslach Burnout Inventory and the Ethical Decision Making Climate Questionnaire to capture burnout dimensions and assess the ethical decision-making climate. Results: The response rate was 53% (respondents from 359/683 invited ICUs who actually open the email); participating healthcare professionals (HCPs) were from Europe (62%), Asia (9%), South America (6%), North America (5%), Middle East (4%), and Australia/New Zealand (4%). The importance of family-centeredness was ranked high, median 7 (IQR 6–8) of 10 on VAS. Significant differences were observed across quartiles of family centeredness, including in visitation policies availability of a waiting rooms, family rooms, family information leaflet, visiting hours, night visits, sleep in the ICU, and in team-family interactions, including daily information, routine day-3 conference, and willingness to empower nurses and relatives. Higher family centeredness correlated with family involvement in rounds, participation in patient care and end-of-life practices. Burnout symptoms (41% of respondents) were negatively associated with family-centeredness. Ethical climate and willingness to empower nurses were independent predictors of family centeredness. Conclusions: This study emphasizes the need to prioritize healthcare providers’ mental health for enhanced family-centered care. Further research is warranted to assess the impact of improving the ethical climate on family-centeredness.
Published: 2024

3. Family centeredness of care:a cross-sectional study in intensive care units part of the European society of intensive care medicine

Author: Azoulay, Élie, Kentish-Barnes, Nancy, Boulanger, Carole, Mistraletti, Giovanni, van Mol, Margo, Heras-La Calle, Gabriel, Estenssoro, Elisa, van Heerden, Peter Vernon, Delgado, Maria Cruz Martin, Perner, Anders, Arabi, Yaseen M., Myatra, Sheila Nainan, Laake, Jon Henrik, De Waele, Jan J., Darmon, Michael, Cecconi, Maurizio, Azoulay, Élie, Kentish-Barnes, Nancy, Boulanger, Carole, Mistraletti, Giovanni, van Mol, Margo, Heras-La Calle, Gabriel, Estenssoro, Elisa, van Heerden, Peter Vernon, Delgado, Maria Cruz Martin, Perner, Anders, Arabi, Yaseen M., Myatra, Sheila Nainan, Laake, Jon Henrik, De Waele, Jan J., Darmon, Michael, and Cecconi, Maurizio
Abstract: Purpose To identify key components and variations in family-centered care practices. Methods A cross-sectional study, conducted across ESICM members. Participating ICUs completed a questionnaire covering general ICU characteristics, visitation policies, team-family interactions, and end-of-life decision-making. The primary outcome, self-rated family-centeredness, was assessed using a visual analog scale. Additionally, respondents completed the Maslach Burnout Inventory and the Ethical Decision Making Climate Questionnaire to capture burnout dimensions and assess the ethical decision-making climate. Results The response rate was 53% (respondents from 359/683 invited ICUs who actually open the email); participating healthcare professionals (HCPs) were from Europe (62%), Asia (9%), South America (6%), North America (5%), Middle East (4%), and Australia/New Zealand (4%). The importance of family-centeredness was ranked high, median 7 (IQR 6–8) of 10 on VAS. Significant differences were observed across quartiles of family centeredness, including in visitation policies availability of a waiting rooms, family rooms, family information leaflet, visiting hours, night visits, sleep in the ICU, and in team-family interactions, including daily information, routine day-3 conference, and willingness to empower nurses and relatives. Higher family centeredness correlated with family involvement in rounds, participation in patient care and end-of-life practices. Burnout symptoms (41% of respondents) were negatively associated with family-centeredness. Ethical climate and willingness to empower nurses were independent predictors of family centeredness. Conclusions This study emphasizes the need to prioritize healthcare providers’ mental health for enhanced family-centered care. Further research is warranted to assess the impact of improving the ethical climate on family-centeredness., Purpose: To identify key components and variations in family-centered care practices. Methods: A cross-sectional study, conducted across ESICM members. Participating ICUs completed a questionnaire covering general ICU characteristics, visitation policies, team-family interactions, and end-of-life decision-making. The primary outcome, self-rated family-centeredness, was assessed using a visual analog scale. Additionally, respondents completed the Maslach Burnout Inventory and the Ethical Decision Making Climate Questionnaire to capture burnout dimensions and assess the ethical decision-making climate. Results: The response rate was 53% (respondents from 359/683 invited ICUs who actually open the email); participating healthcare professionals (HCPs) were from Europe (62%), Asia (9%), South America (6%), North America (5%), Middle East (4%), and Australia/New Zealand (4%). The importance of family-centeredness was ranked high, median 7 (IQR 6–8) of 10 on VAS. Significant differences were observed across quartiles of family centeredness, including in visitation policies availability of a waiting rooms, family rooms, family information leaflet, visiting hours, night visits, sleep in the ICU, and in team-family interactions, including daily information, routine day-3 conference, and willingness to empower nurses and relatives. Higher family centeredness correlated with family involvement in rounds, participation in patient care and end-of-life practices. Burnout symptoms (41% of respondents) were negatively associated with family-centeredness. Ethical climate and willingness to empower nurses were independent predictors of family centeredness. Conclusions: This study emphasizes the need to prioritize healthcare providers’ mental health for enhanced family-centered care. Further research is warranted to assess the impact of improving the ethical climate on family-centeredness.
Published: 2024

4. Clinical features, etiologies, and outcomes in adult patients with meningoencephalitis requiring intensive care (EURECA): an international prospective multicenter cohort study

Author: Sonneville, R, de Montmollin, E, Contou, D, Ferrer, R, Gurjar, M, Klouche, K, Sarton, B, Demeret, S, Bailly, P, da Silva, D, Escudier, E, Le Guennec, L, Chabanne, R, Argaud, L, Ben Hadj Salem, O, Thyrault, M, Frerou, A, Louis, G, De Pascale, G, Horn, J, Helbok, R, Geri, G, Bruneel, F, Martin-Loeches, I, Taccone, F, De Waele, J, Ruckly, S, Staiquly, Q, Citerio, G, Timsit, J, Sonneville, Romain, de Montmollin, Etienne, Contou, Damien, Ferrer, Ricard, Gurjar, Mohan, Klouche, Kada, Sarton, Benjamine, Demeret, Sophie, Bailly, Pierre, da Silva, Daniel, Escudier, Etienne, Le Guennec, Loic, Chabanne, Russel, Argaud, Laurent, Ben Hadj Salem, Omar, Thyrault, Martial, Frerou, Aurélien, Louis, Guillaume, De Pascale, Gennaro, Horn, Janneke, Helbok, Raimund, Geri, Guillaume, Bruneel, Fabrice, Martin-Loeches, Ignacio, Taccone, Fabio Silvio, De Waele, Jan J, Ruckly, Stéphane, Staiquly, Quentin, Citerio, Giuseppe, Timsit, Jean-François, Sonneville, R, de Montmollin, E, Contou, D, Ferrer, R, Gurjar, M, Klouche, K, Sarton, B, Demeret, S, Bailly, P, da Silva, D, Escudier, E, Le Guennec, L, Chabanne, R, Argaud, L, Ben Hadj Salem, O, Thyrault, M, Frerou, A, Louis, G, De Pascale, G, Horn, J, Helbok, R, Geri, G, Bruneel, F, Martin-Loeches, I, Taccone, F, De Waele, J, Ruckly, S, Staiquly, Q, Citerio, G, Timsit, J, Sonneville, Romain, de Montmollin, Etienne, Contou, Damien, Ferrer, Ricard, Gurjar, Mohan, Klouche, Kada, Sarton, Benjamine, Demeret, Sophie, Bailly, Pierre, da Silva, Daniel, Escudier, Etienne, Le Guennec, Loic, Chabanne, Russel, Argaud, Laurent, Ben Hadj Salem, Omar, Thyrault, Martial, Frerou, Aurélien, Louis, Guillaume, De Pascale, Gennaro, Horn, Janneke, Helbok, Raimund, Geri, Guillaume, Bruneel, Fabrice, Martin-Loeches, Ignacio, Taccone, Fabio Silvio, De Waele, Jan J, Ruckly, Stéphane, Staiquly, Quentin, Citerio, Giuseppe, and Timsit, Jean-François
Abstract: Purpose: We aimed to characterize the outcomes of patients with severe meningoencephalitis requiring intensive care. Methods: We conducted a prospective multicenter international cohort study (2017–2020) in 68 centers across 7 countries. Eligible patients were adults admitted to the intensive care unit (ICU) with meningoencephalitis, defined by an acute onset of encephalopathy (Glasgow coma scale (GCS) score ≤ 13), a cerebrospinal fluid pleocytosis ≥ 5 cells/mm3, and at least two of the following criteria: fever, seizures, focal neurological deficit, abnormal neuroimaging, and/or electroencephalogram. The primary endpoint was poor functional outcome at 3 months, defined by a score of three to six on the modified Rankin scale. Multivariable analyses stratified on centers investigated ICU admission variables associated with the primary endpoint. Results: Among 599 patients enrolled, 589 (98.3%) completed the 3-month follow-up and were included. Overall, 591 etiologies were identified in those patients which were categorized into five groups: acute bacterial meningitis (n = 247, 41.9%); infectious encephalitis of viral, subacute bacterial, or fungal/parasitic origin (n = 140, 23.7%); autoimmune encephalitis (n = 38, 6.4%); neoplastic/toxic encephalitis (n = 11, 1.9%); and encephalitis of unknown origin (n = 155, 26.2%). Overall, 298 patients (50.5%, 95% CI 46.6–54.6%) had a poor functional outcome, including 152 deaths (25.8%). Variables independently associated with a poor functional outcome were age > 60 years (OR 1.75, 95% CI 1.22–2.51), immunodepression (OR 1.98, 95% CI 1.27–3.08), time between hospital and ICU admission > 1 day (OR 2.02, 95% CI 1.44–2.99), a motor component on the GCS ≤ 3 (OR 2.23, 95% CI 1.49–3.45), hemiparesis/hemiplegia (OR 2.48, 95% CI 1.47–4.18), respiratory failure (OR 1.76, 95% CI 1.05–2.94), and cardiovascular failure (OR 1.72, 95% CI 1.07–2.75). In contrast, administration of a third-generation cephalosporin (OR 0.54, 95% CI 0.37–0.
Published: 2023

5. The Sequential Organ Failure Assessment (SOFA) Score: has the time come for an update?

Author: Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity, Moreno, Rui, Rhodes, Andrew, Piquilloud, Lise, Hernandez, Glenn, Takala, Jukka, Gershengorn, Hayley B, Tavares, Miguel, Coopersmith, Craig M, Myatra, Sheila N, Singer, Mervyn, Rezende, Ederlon, Prescott, Hallie C, Soares, Márcio, Timsit, Jean-François, de Lange, Dylan W, Jung, Christian, De Waele, Jan J, Martin, Greg S, Summers, Charlotte, Azoulay, Elie, Fujii, Tomoko, McLean, Anthony S, Vincent, Jean-Louis, Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity, Moreno, Rui, Rhodes, Andrew, Piquilloud, Lise, Hernandez, Glenn, Takala, Jukka, Gershengorn, Hayley B, Tavares, Miguel, Coopersmith, Craig M, Myatra, Sheila N, Singer, Mervyn, Rezende, Ederlon, Prescott, Hallie C, Soares, Márcio, Timsit, Jean-François, de Lange, Dylan W, Jung, Christian, De Waele, Jan J, Martin, Greg S, Summers, Charlotte, Azoulay, Elie, Fujii, Tomoko, McLean, Anthony S, and Vincent, Jean-Louis
Published: 2023

6. Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study

Author: Greco, M, De Corte, T, Ercole, A, Antonelli, M, Azoulay, E, Citerio, G, Morris, A, De Pascale, G, Duska, F, Elbers, P, Einav, S, Forni, L, Galarza, L, Girbes, A, Grasselli, G, Gusarov, V, Jubb, A, Kesecioglu, J, Lavinio, A, Delgado, M, Mellinghoff, J, Myatra, S, Ostermann, M, Pellegrini, M, Povoa, P, Schaller, S, Teboul, J, Wong, A, De Waele, J, Cecconi, M, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R J, Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Delgado, Maria Cruz Martin, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J, Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J, Cecconi, Maurizio, Greco, M, De Corte, T, Ercole, A, Antonelli, M, Azoulay, E, Citerio, G, Morris, A, De Pascale, G, Duska, F, Elbers, P, Einav, S, Forni, L, Galarza, L, Girbes, A, Grasselli, G, Gusarov, V, Jubb, A, Kesecioglu, J, Lavinio, A, Delgado, M, Mellinghoff, J, Myatra, S, Ostermann, M, Pellegrini, M, Povoa, P, Schaller, S, Teboul, J, Wong, A, De Waele, J, Cecconi, M, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R J, Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Delgado, Maria Cruz Martin, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J, Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J, and Cecconi, Maurizio
Abstract: Purpose: To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods: Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results: 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%–50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions: ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality.
Published: 2022

7. Variation in communication and family visiting policies in intensive care within and between countries during the Covid-19 pandemic : The COVISIT international survey

Author: Tabah, Alexis, Elhadi, Muhammed, Ballard, Emma, Cortegiani, Andrea, Cecconi, Maurizio, Unoki, Takeshi, Galarza, Laurą, Rosa, Regis Goulart, Barbier, Francois, Azoulay, Elie, Laupland, Kevin B., Ssi Yan Kai, Nathalie, Ostermann, Marlies, Francois, Guy, De Waele, Jan J., Fiest, Kirsten, Spronk, Peter, Benbenishty, Julie, Pellegrini, Mariangela, Rose, Louise, other, and, Tabah, Alexis, Elhadi, Muhammed, Ballard, Emma, Cortegiani, Andrea, Cecconi, Maurizio, Unoki, Takeshi, Galarza, Laurą, Rosa, Regis Goulart, Barbier, Francois, Azoulay, Elie, Laupland, Kevin B., Ssi Yan Kai, Nathalie, Ostermann, Marlies, Francois, Guy, De Waele, Jan J., Fiest, Kirsten, Spronk, Peter, Benbenishty, Julie, Pellegrini, Mariangela, Rose, Louise, and other, and
Abstract: Background: During the COVID-19 pandemic, intensive care units (ICU) introduced restrictions to in-person family visiting to safeguard patients, healthcare personnel, and visitors. Methods: We conducted a web-based survey (March–July 2021) investigating ICU visiting practices before the pandemic, at peak COVID-19 ICU admissions, and at the time of survey response. We sought data on visiting policies and communication modes including use of virtual visiting (videoconferencing). Results: We obtained 667 valid responses representing ICUs in all continents. Before the pandemic, 20% (106/525) had unrestricted visiting hours; 6% (30/525) did not allow in-person visiting. At peak, 84% (558/667) did not allow in-person visiting for patients with COVID-19; 66% for patients without COVID-19. This proportion had decreased to 55% (369/667) at time of survey reporting. A government mandate to restrict hospital visiting was reported by 53% (354/646). Most ICUs (55%, 353/615) used regular telephone updates; 50% (306/667) used telephone for formal meetings and discussions regarding prognosis or end-of-life. Virtual visiting was available in 63% (418/667) at time of survey. Conclusions: Highly restrictive visiting policies were introduced at the initial pandemic peaks, were subsequently liberalized, but without returning to pre-pandemic practices. Telephone became the primary communication mode in most ICUs, supplemented with virtual visits.
Published: 2022

8. Correction to: Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study

Author: Greco, Massimiliano, Greco, M, De Corte, T, Ercole, A, Antonelli, M, Azoulay, E, Citerio, G, Morris, A, De Pascale, G, Duska, F, Elbers, P, Einav, S, Forni, L, Galarza, L, Girbes, A, Grasselli, G, Gusarov, V, Jubb, A, Kesecioglu, J, Lavinio, A, Delgado, M, Mellinghoff, J, Myatra, S, Ostermann, M, Pellegrini, M, Povoa, P, Schaller, S, Teboul, J, Wong, A, De Waele, J, Cecconi, M, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R J, Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Delgado, Maria Cruz Martin, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J, Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J, Cecconi, Maurizio, Greco, Massimiliano, Greco, M, De Corte, T, Ercole, A, Antonelli, M, Azoulay, E, Citerio, G, Morris, A, De Pascale, G, Duska, F, Elbers, P, Einav, S, Forni, L, Galarza, L, Girbes, A, Grasselli, G, Gusarov, V, Jubb, A, Kesecioglu, J, Lavinio, A, Delgado, M, Mellinghoff, J, Myatra, S, Ostermann, M, Pellegrini, M, Povoa, P, Schaller, S, Teboul, J, Wong, A, De Waele, J, Cecconi, M, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R J, Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Delgado, Maria Cruz Martin, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J, Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J, and Cecconi, Maurizio
Abstract: In the original version of this article, the given and family names of Kristina Fuest, Tobias Lahmer, Johannes Herrmann, Patrick Meybohm, Nikolaos Markou, Georgia Vasileiadou were incorrectly structured. The Publisher apologises for this mistake.
Published: 2022

9. Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave : the global UNITE-COVID study

Author: Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R. J., Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Martin Delgado, Maria Cruz, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J., Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J., Cecconi, Maurizio, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R. J., Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Martin Delgado, Maria Cruz, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J., Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J., and Cecconi, Maurizio
Abstract: Purpose To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%-50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality., Correction in: Intensive Care Medicine, vol. 48, issue 8, pages 1130-1131.DOI: 10.1007/s00134-022-06801-2
Published: 2022
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10. Variation in communication and family visiting policies in intensive care within and between countries during the Covid-19 pandemic : The COVISIT international survey

Author: Tabah, Alexis, Elhadi, Muhammed, Ballard, Emma, Cortegiani, Andrea, Cecconi, Maurizio, Unoki, Takeshi, Galarza, Laura, Rosa, Regis Goulart, Barbier, Francois, Azoulay, Elie, Laupland, Kevin B., Kai, Nathalie Ssi Yan, Ostermann, Marlies, Francois, Guy, De Waele, Jan J., Fiest, Kirsten, Spronk, Peter, Benbenishty, Julie, Pellegrini, Mariangela, Rose, Louise, Tabah, Alexis, Elhadi, Muhammed, Ballard, Emma, Cortegiani, Andrea, Cecconi, Maurizio, Unoki, Takeshi, Galarza, Laura, Rosa, Regis Goulart, Barbier, Francois, Azoulay, Elie, Laupland, Kevin B., Kai, Nathalie Ssi Yan, Ostermann, Marlies, Francois, Guy, De Waele, Jan J., Fiest, Kirsten, Spronk, Peter, Benbenishty, Julie, Pellegrini, Mariangela, and Rose, Louise
Abstract: Background: During the COVID-19 pandemic, intensive care units (ICU) introduced restrictions to in-person family visiting to safeguard patients, healthcare personnel, and visitors. Methods: We conducted a web-based survey (March-July 2021) investigating ICU visiting practices before the pandemic, at peak COVID-19 ICU admissions, and at the time of survey response. We sought data on visiting policies and communication modes including use of virtual visiting (videoconferencing). Results: We obtained 667 valid responses representing ICUs in all continents. Before the pandemic, 20% (106/ 525) had unrestricted visiting hours; 6% (30/525) did not allow in-person visiting. At peak, 84% (558/667) did not allow in-person visiting for patients with COVID-19; 66% for patients without COVID-19. This proportion had decreased to 55% (369/667) at time of survey reporting. A government mandate to restrict hospital visiting was reported by 53% (354/646). Most ICUs (55%, 353/615) used regular telephone updates; 50% (306/667) used telephone for formal meetings and discussions regarding prognosis or end-of-life. Virtual visiting was available in 63% (418/667) at time of survey. Conclusions: Highly restrictive visiting policies were introduced at the initial pandemic peaks, were subsequently liberalized, but without returning to pre-pandemic practices. Telephone became the primary communication mode in most ICUs, supplemented with virtual visits. (c) 2022 Elsevier Inc. All rights reserved.
Published: 2022
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11. Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave : the global UNITE-COVID study

Author: Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R. J., Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Martin Delgado, Maria Cruz, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J., Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J., Cecconi, Maurizio, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R. J., Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Martin Delgado, Maria Cruz, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J., Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J., and Cecconi, Maurizio
Abstract: Purpose To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%-50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality., Correction in: Intensive Care Medicine, vol. 48, issue 8, pages 1130-1131.DOI: 10.1007/s00134-022-06801-2
Published: 2022
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12. Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave : the global UNITE-COVID study

Author: Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R. J., Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Martin Delgado, Maria Cruz, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J., Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J., Cecconi, Maurizio, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R. J., Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Martin Delgado, Maria Cruz, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J., Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J., and Cecconi, Maurizio
Abstract: Purpose To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%-50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality., Correction in: Intensive Care Medicine, vol. 48, issue 8, pages 1130-1131.DOI: 10.1007/s00134-022-06801-2
Published: 2022
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13. Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave : the global UNITE-COVID study

Author: Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R. J., Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Martin Delgado, Maria Cruz, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J., Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J., Cecconi, Maurizio, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R. J., Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Martin Delgado, Maria Cruz, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J., Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J., and Cecconi, Maurizio
Abstract: Purpose To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%-50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality., Correction in: Intensive Care Medicine, vol. 48, issue 8, pages 1130-1131.DOI: 10.1007/s00134-022-06801-2
Published: 2022
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14. Correction to: Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study

Author: Greco, Massimiliano, Greco, M, De Corte, T, Ercole, A, Antonelli, M, Azoulay, E, Citerio, G, Morris, A, De Pascale, G, Duska, F, Elbers, P, Einav, S, Forni, L, Galarza, L, Girbes, A, Grasselli, G, Gusarov, V, Jubb, A, Kesecioglu, J, Lavinio, A, Delgado, M, Mellinghoff, J, Myatra, S, Ostermann, M, Pellegrini, M, Povoa, P, Schaller, S, Teboul, J, Wong, A, De Waele, J, Cecconi, M, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R J, Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Delgado, Maria Cruz Martin, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J, Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J, Cecconi, Maurizio, Greco, Massimiliano, Greco, M, De Corte, T, Ercole, A, Antonelli, M, Azoulay, E, Citerio, G, Morris, A, De Pascale, G, Duska, F, Elbers, P, Einav, S, Forni, L, Galarza, L, Girbes, A, Grasselli, G, Gusarov, V, Jubb, A, Kesecioglu, J, Lavinio, A, Delgado, M, Mellinghoff, J, Myatra, S, Ostermann, M, Pellegrini, M, Povoa, P, Schaller, S, Teboul, J, Wong, A, De Waele, J, Cecconi, M, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R J, Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Delgado, Maria Cruz Martin, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J, Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J, and Cecconi, Maurizio
Abstract: In the original version of this article, the given and family names of Kristina Fuest, Tobias Lahmer, Johannes Herrmann, Patrick Meybohm, Nikolaos Markou, Georgia Vasileiadou were incorrectly structured. The Publisher apologises for this mistake.
Published: 2022

15. Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave : the global UNITE-COVID study

Author: Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R. J., Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Martin Delgado, Maria Cruz, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J., Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J., Cecconi, Maurizio, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R. J., Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Martin Delgado, Maria Cruz, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J., Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J., and Cecconi, Maurizio
Abstract: Purpose To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%-50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality., Correction in: Intensive Care Medicine, vol. 48, issue 8, pages 1130-1131.DOI: 10.1007/s00134-022-06801-2
Published: 2022
Full Text: View/download PDF

16. Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study

Author: Greco, M, De Corte, T, Ercole, A, Antonelli, M, Azoulay, E, Citerio, G, Morris, A, De Pascale, G, Duska, F, Elbers, P, Einav, S, Forni, L, Galarza, L, Girbes, A, Grasselli, G, Gusarov, V, Jubb, A, Kesecioglu, J, Lavinio, A, Delgado, M, Mellinghoff, J, Myatra, S, Ostermann, M, Pellegrini, M, Povoa, P, Schaller, S, Teboul, J, Wong, A, De Waele, J, Cecconi, M, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R J, Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Delgado, Maria Cruz Martin, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J, Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J, Cecconi, Maurizio, Greco, M, De Corte, T, Ercole, A, Antonelli, M, Azoulay, E, Citerio, G, Morris, A, De Pascale, G, Duska, F, Elbers, P, Einav, S, Forni, L, Galarza, L, Girbes, A, Grasselli, G, Gusarov, V, Jubb, A, Kesecioglu, J, Lavinio, A, Delgado, M, Mellinghoff, J, Myatra, S, Ostermann, M, Pellegrini, M, Povoa, P, Schaller, S, Teboul, J, Wong, A, De Waele, J, Cecconi, M, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R J, Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Delgado, Maria Cruz Martin, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J, Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J, and Cecconi, Maurizio
Abstract: Purpose: To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods: Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results: 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%–50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions: ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality.
Published: 2022

17. Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey

Author: Lanckohr, Christian, Boeing, Christian, De Waele, Jan J., de Lange, Dylan W., Schouten, Jeroen, Prins, Menno, Nijsten, Maarten, Povoa, Pedro, Morris, Andrew Conway, Bracht, Hendrik, Lanckohr, Christian, Boeing, Christian, De Waele, Jan J., de Lange, Dylan W., Schouten, Jeroen, Prins, Menno, Nijsten, Maarten, Povoa, Pedro, Morris, Andrew Conway, and Bracht, Hendrik
Abstract: BACKGROUND: Severe infections and multidrug-resistant pathogens are common in critically ill patients. Antimicrobial stewardship (AMS) and therapeutic drug monitoring (TDM) are contemporary tools to optimize the use of antimicrobials. The A-TEAMICU survey was initiated to gain contemporary insights into dissemination and structure of AMS programs and TDM practices in intensive care units.METHODS: This study involved online survey of members of ESICM and six national professional intensive care societies.RESULTS: Data of 812 respondents from mostly European high- and middle-income countries were available for analysis. 63% had AMS rounds available in their ICU, where 78% performed rounds weekly or more often. While 82% had local guidelines for treatment of infections, only 70% had cumulative antimicrobial susceptibility reports and 56% monitored the quantity of antimicrobials administered. A restriction of antimicrobials was reported by 62%. TDM of antimicrobial agents was used in 61% of ICUs, mostly glycopeptides (89%), aminoglycosides (77%), carbapenems (32%), penicillins (30%), azole antifungals (27%), cephalosporins (17%), and linezolid (16%). 76% of respondents used prolonged/continuous infusion of antimicrobials. The availability of an AMS had a significant association with the use of TDM.CONCLUSIONS: Many respondents of the survey have AMS in their ICUs. TDM of antimicrobials and optimized administration of antibiotics are broadly used among respondents. The availability of antimicrobial susceptibility reports and a surveillance of antimicrobial use should be actively sought by intensivists where unavailable. Results of this survey may inform further research and educational activities.
Published: 2021

18. Corrigendum to “Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 Era (PPE-SAFE) : An international survey” [Journal of Critical Care, Volume 59, October 2020, Pages 70–75](S088394412030592X)(10.1016/j.jcrc.2020.06.005)

Author: Tabah, Alexis, Ramanan, Mahesh, Laupland, Kevin B., Buetti, Niccolò, Cortegiani, Andrea, Mellinghoff, Johannes, Conway Morris, Andrew, Camporota, Luigi, Zappella, Nathalie, Elhadi, Muhammed, Povoa, Pedro, Amrein, Karin, Vidal, Gabriela, Derde, Lennie, Francois, Guy, Bassetti, Matteo, Ssi Yan Kai, Nathalie, De Waele, Jan J., other, and, Tabah, Alexis, Ramanan, Mahesh, Laupland, Kevin B., Buetti, Niccolò, Cortegiani, Andrea, Mellinghoff, Johannes, Conway Morris, Andrew, Camporota, Luigi, Zappella, Nathalie, Elhadi, Muhammed, Povoa, Pedro, Amrein, Karin, Vidal, Gabriela, Derde, Lennie, Francois, Guy, Bassetti, Matteo, Ssi Yan Kai, Nathalie, De Waele, Jan J., and other, and
Abstract: The authors regret errors were present in the published article. Counts of some of the adverse events were erroneous. Changes to the text include. Last sentence of the abstract should read. Adverse effects of PPE included heat (1266, 51%), thirst (1174, 47%), pressure areas (1088, 44%), headaches (696, 28%), Inability to use the bathroom (661, 27%) and extreme exhaustion (492, 20%). All but pressure areas were associated with longer shift durations. Last sentence of the results section of the manuscript should read. All but pressure areas were associated with longer duration of shifts wearing PPE (Table 4). Table 1 the total number of community/urban type of hospital should read 740 instead of 741. Updated Tables 3 and 4 should read as below: The authors would like to apologise for any inconvenience caused.
Published: 2021

19. The effect of renal replacement therapy and antibiotic dose on antibiotic concentrations in critically ill patients: Data from the multinational SMARRT Study.

Author: UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, Roberts, Jason A, Joynt, Gavin, Lee, Anna, Choi, Gordon, Bellomo, Rinaldo, Kanji, Salmaan, Mudaliar, M Yugan, Peake, Sandra L, Stephens, Dianne, Taccone, Fabio Silvio, Ulldemolins, Marta, Valkonen, Miia Maaria, Agbeve, Julius, Baptista, João P, Bekos, Vasileios, Boidin, Clement, Brinkmann, Alexander, Buizen, Luke, Castro, Pedro, Cole, C Louise, Creteur, Jacques, De Waele, Jan J, Deans, Renae, Eastwood, Glenn M, Escobar, Leslie, Gomersall, Charles, Gresham, Rebecca, Jamal, Janattul Ain, Kluge, Stefan, König, Christina, Koulouras, Vasilios P, Lassig-Smith, Melissa, Laterre, Pierre-François, Lei, Katie, Leung, Patricia, Lefrant, Jean-Yves, Llauradó-Serra, Mireia, Martin-Loeches, Ignacio, Mat Nor, Mohd Basri, Ostermann, Marlies, Parker, Suzanne L, Rello, Jordi, Roberts, Darren M, Roberts, Michael S, Richards, Brent, Rodríguez, Alejandro, Roehr, Anka C, Roger, Claire, Seoane, Leonardo, Sinnollareddy, Mahipal, Sousa, Eduardo, Soy, Dolors, Spring, Anna, Starr, Therese, Thomas, Jane, Turnidge, John, Wallis, Steven C, Williams, Tricia, Wittebole, Xavier, Zikou, Xanthi T, Paul, Sanjoy, Lipman, Jeffrey, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, Roberts, Jason A, Joynt, Gavin, Lee, Anna, Choi, Gordon, Bellomo, Rinaldo, Kanji, Salmaan, Mudaliar, M Yugan, Peake, Sandra L, Stephens, Dianne, Taccone, Fabio Silvio, Ulldemolins, Marta, Valkonen, Miia Maaria, Agbeve, Julius, Baptista, João P, Bekos, Vasileios, Boidin, Clement, Brinkmann, Alexander, Buizen, Luke, Castro, Pedro, Cole, C Louise, Creteur, Jacques, De Waele, Jan J, Deans, Renae, Eastwood, Glenn M, Escobar, Leslie, Gomersall, Charles, Gresham, Rebecca, Jamal, Janattul Ain, Kluge, Stefan, König, Christina, Koulouras, Vasilios P, Lassig-Smith, Melissa, Laterre, Pierre-François, Lei, Katie, Leung, Patricia, Lefrant, Jean-Yves, Llauradó-Serra, Mireia, Martin-Loeches, Ignacio, Mat Nor, Mohd Basri, Ostermann, Marlies, Parker, Suzanne L, Rello, Jordi, Roberts, Darren M, Roberts, Michael S, Richards, Brent, Rodríguez, Alejandro, Roehr, Anka C, Roger, Claire, Seoane, Leonardo, Sinnollareddy, Mahipal, Sousa, Eduardo, Soy, Dolors, Spring, Anna, Starr, Therese, Thomas, Jane, Turnidge, John, Wallis, Steven C, Williams, Tricia, Wittebole, Xavier, Zikou, Xanthi T, Paul, Sanjoy, and Lipman, Jeffrey
Abstract: BACKGROUND: The optimal dosing of antibiotics in critically ill patients receiving renal replacement therapy (RRT) remains unclear. In this study, we describe the variability in RRT techniques and antibiotic dosing in critically ill patients receiving RRT and to relate observed trough antibiotic concentrations to optimal targets. METHODS: We performed a prospective, observational, multi-national, pharmacokinetic study in 29 intensive care units from 14 countries. We collected demographic, clinical and RRT data. We measured trough antibiotic concentrations of meropenem, piperacillin-tazobactam and vancomycin and related them to high and low target trough concentrations. RESULTS: We studied 381 patients and obtained 508 trough antibiotic concentrations. There was wide variability (4-8 fold) in antibiotic dosing regimens; RRT prescription, and estimated endogenous renal function. The overall median estimated total renal clearance (eTRCL) was 50 mL/min (interquartile range [IQR] 35-65) and higher eTRCL was associated with lower trough concentrations for all antibiotics (p<0.05). The median (IQR) trough concentration for meropenem was 12.1 mg/L (7.9-18.8), piperacillin 78.6 mg/L (49.5-127.3), tazobactam 9.5 mg/L (6.3-14.2) and vancomycin 14.3 mg/L (11.6-21.8). Trough concentrations failed to meet optimal higher limits in 26%, 36%, 72%, and optimal lower limits in 4%, 4%, and 55% of patients for meropenem, piperacillin and vancomycin respectively. CONCLUSIONS: In critically ill patients treated with RRT, antibiotic dosing regimens, RRT prescription and eTRCL varied markedly and resulted in highly variable antibiotic concentrations that failed to meet therapeutic targets in many patients.
Published: 2021

20. Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey

Author: Lanckohr, Christian, Boeing, Christian, De Waele, Jan J., de Lange, Dylan W., Schouten, Jeroen, Prins, Menno, Nijsten, Maarten, Povoa, Pedro, Morris, Andrew Conway, Bracht, Hendrik, Lanckohr, Christian, Boeing, Christian, De Waele, Jan J., de Lange, Dylan W., Schouten, Jeroen, Prins, Menno, Nijsten, Maarten, Povoa, Pedro, Morris, Andrew Conway, and Bracht, Hendrik
Abstract: BACKGROUND: Severe infections and multidrug-resistant pathogens are common in critically ill patients. Antimicrobial stewardship (AMS) and therapeutic drug monitoring (TDM) are contemporary tools to optimize the use of antimicrobials. The A-TEAMICU survey was initiated to gain contemporary insights into dissemination and structure of AMS programs and TDM practices in intensive care units.METHODS: This study involved online survey of members of ESICM and six national professional intensive care societies.RESULTS: Data of 812 respondents from mostly European high- and middle-income countries were available for analysis. 63% had AMS rounds available in their ICU, where 78% performed rounds weekly or more often. While 82% had local guidelines for treatment of infections, only 70% had cumulative antimicrobial susceptibility reports and 56% monitored the quantity of antimicrobials administered. A restriction of antimicrobials was reported by 62%. TDM of antimicrobial agents was used in 61% of ICUs, mostly glycopeptides (89%), aminoglycosides (77%), carbapenems (32%), penicillins (30%), azole antifungals (27%), cephalosporins (17%), and linezolid (16%). 76% of respondents used prolonged/continuous infusion of antimicrobials. The availability of an AMS had a significant association with the use of TDM.CONCLUSIONS: Many respondents of the survey have AMS in their ICUs. TDM of antimicrobials and optimized administration of antibiotics are broadly used among respondents. The availability of antimicrobial susceptibility reports and a surveillance of antimicrobial use should be actively sought by intensivists where unavailable. Results of this survey may inform further research and educational activities.
Published: 2021

21. Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey

Author: Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity, Lanckohr, Christian, Boeing, Christian, De Waele, Jan J, de Lange, Dylan W, Schouten, Jeroen, Prins, Menno, Nijsten, Maarten, Povoa, Pedro, Morris, Andrew Conway, Bracht, Hendrik, Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity, Lanckohr, Christian, Boeing, Christian, De Waele, Jan J, de Lange, Dylan W, Schouten, Jeroen, Prins, Menno, Nijsten, Maarten, Povoa, Pedro, Morris, Andrew Conway, and Bracht, Hendrik
Published: 2021

22. Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE) : An international survey

Author: Tabah, Alexis, Ramanan, Mahesh, Laupland, Kevin B., Buetti, Niccolò, Cortegiani, Andrea, Mellinghoff, Johannes, Conway Morris, Andrew, Comporota, Luigi, Zappella, Nathalie, Elhadi, Muhammed, Povoa, Pedro, Amrein, Karin, Vidal, Gabriela, Derde, Lennie, Bassetti, Matteo, Francois, Guy, Ssi yan kai, Nathalie, De Waele, Jan J., Tabah, Alexis, Ramanan, Mahesh, Laupland, Kevin B., Buetti, Niccolò, Cortegiani, Andrea, Mellinghoff, Johannes, Conway Morris, Andrew, Comporota, Luigi, Zappella, Nathalie, Elhadi, Muhammed, Povoa, Pedro, Amrein, Karin, Vidal, Gabriela, Derde, Lennie, Bassetti, Matteo, Francois, Guy, Ssi yan kai, Nathalie, and De Waele, Jan J.
Abstract: Purpose: To survey healthcare workers (HCW) on availability and use of personal protective equipment (PPE) caring for COVID-19 patients in the intensive care unit (ICU). Materials and method: A web-based survey distributed worldwide in April 2020. Results: We received 2711 responses from 1797 (67%) physicians, 744 (27%) nurses, and 170 (6%) Allied HCW. For routine care, most (1557, 58%) reportedly used FFP2/N95 masks, waterproof long sleeve gowns (1623; 67%), and face shields/visors (1574; 62%). Powered Air-Purifying Respirators were used routinely and for intubation only by 184 (7%) and 254 (13%) respondents, respectively. Surgical masks were used for routine care by 289 (15%) and 47 (2%) for intubations. At least one piece of standard PPE was unavailable for 1402 (52%), and 817 (30%) reported reusing single-use PPE. PPE was worn for a median of 4 h (IQR 2, 5). Adverse effects of PPE were associated with longer shift durations and included heat (1266, 51%), thirst (1174, 47%), pressure areas (1088, 44%), headaches (696, 28%), Inability to use the bathroom (661, 27%) and extreme exhaustion (492, 20%). Conclusions: HCWs reported widespread shortages, frequent reuse of, and adverse effects related to PPE. Urgent action by healthcare administrators, policymakers, governments and industry is warranted.
Published: 2020

23. Organising international research in critical care medicine : current challenges and potential solutions

Author: De Waele, Jan J, de Lange, Dylan W, De Waele, Jan J, and de Lange, Dylan W
Published: 2020

24. Antimicrobial De-Escalation in the ICU: From Recommendations to Level of Evidence

Author: Lakbar, Ines, De Waele, Jan J., Tabah, Alexis, Einav, Sharon, Martin-Loeches, Ignacio, Leone, Marc, Lakbar, Ines, De Waele, Jan J., Tabah, Alexis, Einav, Sharon, Martin-Loeches, Ignacio, and Leone, Marc
Abstract: Antimicrobial de-escalation (ADE) is a component of antimicrobial stewardship (AMS) aimed to reduce exposure to broad-spectrum antimicrobials. In the intensive care unit, ADE is a strong recommendation that is moderately applied in clinical practice. Following a systematic review of the literature, we assessed the studies identified on the topic which included one randomized controlled trial and 20 observational studies. The literature shows a low level of evidence, although observational studies suggested that this procedure is safe. The effects of ADE on the level of resistance of ecological systems and especially on the microbiota are unclear. The reviewers recommend de-escalating antimicrobial treatment in patients requiring long-term antibiotic therapy and considering de-escalation in short-term treatments.
Published: 2020

25. Prevalence and Outcomes of Infection Among Patients in Intensive Care Units in 2017.

Author: UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, Vincent, Jean-Louis, Sakr, Yasser, Singer, Mervyn, Martin-Loeches, Ignacio, Machado, Flavia R, Marshall, John C, Finfer, Simon, Pelosi, Paolo, Brazzi, Luca, Aditianingsih, Dita, Timsit, Jean-François, Du, Bin, Wittebole, Xavier, Máca, Jan, Kannan, Santhana, Gorordo-Delsol, Luis A, De Waele, Jan J, Mehta, Yatin, Bonten, Marc J M, Khanna, Ashish K, Kollef, Marin, Human, Mariesa, Angus, Derek C, EPIC III Investigators, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, Vincent, Jean-Louis, Sakr, Yasser, Singer, Mervyn, Martin-Loeches, Ignacio, Machado, Flavia R, Marshall, John C, Finfer, Simon, Pelosi, Paolo, Brazzi, Luca, Aditianingsih, Dita, Timsit, Jean-François, Du, Bin, Wittebole, Xavier, Máca, Jan, Kannan, Santhana, Gorordo-Delsol, Luis A, De Waele, Jan J, Mehta, Yatin, Bonten, Marc J M, Khanna, Ashish K, Kollef, Marin, Human, Mariesa, Angus, Derek C, and EPIC III Investigators
Abstract: IMPORTANCE: Infection is frequent among patients in the intensive care unit (ICU). Contemporary information about the types of infections, causative pathogens, and outcomes can aid the development of policies for prevention, diagnosis, treatment, and resource allocation and may assist in the design of interventional studies. OBJECTIVE: To provide information about the prevalence and outcomes of infection and the available resources in ICUs worldwide. DESIGN, SETTING, AND PARTICIPANTS: Observational 24-hour point prevalence study with longitudinal follow-up at 1150 centers in 88 countries. All adult patients (aged ≥18 years) treated at a participating ICU during a 24-hour period commencing at 08:00 on September 13, 2017, were included. The final follow-up date was November 13, 2017. EXPOSURES: Infection diagnosis and receipt of antibiotics. MAIN OUTCOMES AND MEASURES: Prevalence of infection and antibiotic exposure (cross-sectional design) and all-cause in-hospital mortality (longitudinal design). RESULTS: Among 15 202 included patients (mean age, 61.1 years [SD, 17.3 years]; 9181 were men [60.4%]), infection data were available for 15 165 (99.8%); 8135 (54%) had suspected or proven infection, including 1760 (22%) with ICU-acquired infection. A total of 10 640 patients (70%) received at least 1 antibiotic. The proportion of patients with suspected or proven infection ranged from 43% (141/328) in Australasia to 60% (1892/3150) in Asia and the Middle East. Among the 8135 patients with suspected or proven infection, 5259 (65%) had at least 1 positive microbiological culture; gram-negative microorganisms were identified in 67% of these patients (n = 3540), gram-positive microorganisms in 37% (n = 1946), and fungal microorganisms in 16% (n = 864). The in-hospital mortality rate was 30% (2404/7936) in patients with suspected or proven infection. In a multilevel analysis, ICU-acquired infection was independently associated with higher risk of mortality compared with communi
Published: 2020

26. Organising international research in critical care medicine : current challenges and potential solutions

Author: De Waele, Jan J, de Lange, Dylan W, De Waele, Jan J, and de Lange, Dylan W
Published: 2020

27. Organising international research in critical care medicine: current challenges and potential solutions

Author: Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity, De Waele, Jan J, de Lange, Dylan W, Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity, De Waele, Jan J, and de Lange, Dylan W
Published: 2020

28. Developing definitions for invasive fungal diseases in critically ill adult patients in intensive care units. Protocol of the FUNgal infections Definitions in ICU patients (FUNDICU) project

Author: Bassetti, Matteo, Scudeller, Luigia, Giacobbe, Daniele R., Lamoth, Frederic, Righi, Elda, Zuccaro, Valentina, Grecchi, Cecilia, Rebuffi, Chiara, Akova, Murat, Alastruey-Izquierdo, Ana, Arikan-Akdagli, Sevtap, Azoulay, Elie, Blot, Stijn I., Cornely, Oliver A., Lass-Floerl, Cornelia, Koehler, Philipp, Cuenca-Estrella, Manuel, de Lange, Dylan W., De Rosa, Francesco G., De Waele, Jan J., Dimopoulos, George, Garnacho-Montero, Jose, Hoenigl, Martin, Kanj, Souha S., Maertens, Johan, Martin-Loeches, Ignacio, Munoz, Patricia, Kullberg, Bart J., Agvald-Ohman, Christina, Poulakou, Garyphallia, Rello, Jordi, Sanguinetti, Maurizio, Taccone, Fabio S., Timsit, Jean-Francois, Torres, Antoni, Vazquez, Jose A., Calandra, Thierry, Bassetti, Matteo, Scudeller, Luigia, Giacobbe, Daniele R., Lamoth, Frederic, Righi, Elda, Zuccaro, Valentina, Grecchi, Cecilia, Rebuffi, Chiara, Akova, Murat, Alastruey-Izquierdo, Ana, Arikan-Akdagli, Sevtap, Azoulay, Elie, Blot, Stijn I., Cornely, Oliver A., Lass-Floerl, Cornelia, Koehler, Philipp, Cuenca-Estrella, Manuel, de Lange, Dylan W., De Rosa, Francesco G., De Waele, Jan J., Dimopoulos, George, Garnacho-Montero, Jose, Hoenigl, Martin, Kanj, Souha S., Maertens, Johan, Martin-Loeches, Ignacio, Munoz, Patricia, Kullberg, Bart J., Agvald-Ohman, Christina, Poulakou, Garyphallia, Rello, Jordi, Sanguinetti, Maurizio, Taccone, Fabio S., Timsit, Jean-Francois, Torres, Antoni, Vazquez, Jose A., and Calandra, Thierry
Abstract: Background The reliability of diagnostic criteria for invasive fungal diseases (IFD) developed for severely immunocompromised patients is questionable in critically ill adult patients in intensive care units (ICU). Objectives To develop a standard set of definitions for IFD in critically ill adult patients in ICU. Methods Based on a systematic literature review, a list of potential definitions to be applied to ICU patients will be developed by the ESCMID Study Group for Infections in Critically Ill Patients (ESGCIP) and the ESCMID Fungal Infection Study Group (EFISG) chairpersons. The proposed definitions will be evaluated by a panel of 30 experts using the RAND/UCLA appropriateness methods. The panel will rank each of the proposed definitions on a 1-9 scale trough a dedicated questionnaire, in two rounds: one remote and one face-to-face. Based on their median rank and the level of agreement across panel members, selected definitions will be organised in a main consensus document and in an executive summary. The executive summary will be made available online for public comments. Conclusions The present consensus project will seek to provide standard definitions for IFD in critically ill adult patients in ICU, with the ultimate aims of improving their clinical outcome and facilitating the comparison and generalizability of research findings.
Published: 2019

29. Developing definitions for invasive fungal diseases in critically ill adult patients in intensive care units. Protocol of the FUNgal infections Definitions in ICU patients (FUNDICU) project

Author: Bassetti, Matteo, Scudeller, Luigia, Giacobbe, Daniele R., Lamoth, Frederic, Righi, Elda, Zuccaro, Valentina, Grecchi, Cecilia, Rebuffi, Chiara, Akova, Murat, Alastruey-Izquierdo, Ana, Arikan-Akdagli, Sevtap, Azoulay, Elie, Blot, Stijn I., Cornely, Oliver A., Lass-Floerl, Cornelia, Koehler, Philipp, Cuenca-Estrella, Manuel, de Lange, Dylan W., De Rosa, Francesco G., De Waele, Jan J., Dimopoulos, George, Garnacho-Montero, Jose, Hoenigl, Martin, Kanj, Souha S., Maertens, Johan, Martin-Loeches, Ignacio, Munoz, Patricia, Kullberg, Bart J., Agvald-Ohman, Christina, Poulakou, Garyphallia, Rello, Jordi, Sanguinetti, Maurizio, Taccone, Fabio S., Timsit, Jean-Francois, Torres, Antoni, Vazquez, Jose A., Calandra, Thierry, Bassetti, Matteo, Scudeller, Luigia, Giacobbe, Daniele R., Lamoth, Frederic, Righi, Elda, Zuccaro, Valentina, Grecchi, Cecilia, Rebuffi, Chiara, Akova, Murat, Alastruey-Izquierdo, Ana, Arikan-Akdagli, Sevtap, Azoulay, Elie, Blot, Stijn I., Cornely, Oliver A., Lass-Floerl, Cornelia, Koehler, Philipp, Cuenca-Estrella, Manuel, de Lange, Dylan W., De Rosa, Francesco G., De Waele, Jan J., Dimopoulos, George, Garnacho-Montero, Jose, Hoenigl, Martin, Kanj, Souha S., Maertens, Johan, Martin-Loeches, Ignacio, Munoz, Patricia, Kullberg, Bart J., Agvald-Ohman, Christina, Poulakou, Garyphallia, Rello, Jordi, Sanguinetti, Maurizio, Taccone, Fabio S., Timsit, Jean-Francois, Torres, Antoni, Vazquez, Jose A., and Calandra, Thierry
Abstract: Background The reliability of diagnostic criteria for invasive fungal diseases (IFD) developed for severely immunocompromised patients is questionable in critically ill adult patients in intensive care units (ICU). Objectives To develop a standard set of definitions for IFD in critically ill adult patients in ICU. Methods Based on a systematic literature review, a list of potential definitions to be applied to ICU patients will be developed by the ESCMID Study Group for Infections in Critically Ill Patients (ESGCIP) and the ESCMID Fungal Infection Study Group (EFISG) chairpersons. The proposed definitions will be evaluated by a panel of 30 experts using the RAND/UCLA appropriateness methods. The panel will rank each of the proposed definitions on a 1-9 scale trough a dedicated questionnaire, in two rounds: one remote and one face-to-face. Based on their median rank and the level of agreement across panel members, selected definitions will be organised in a main consensus document and in an executive summary. The executive summary will be made available online for public comments. Conclusions The present consensus project will seek to provide standard definitions for IFD in critically ill adult patients in ICU, with the ultimate aims of improving their clinical outcome and facilitating the comparison and generalizability of research findings.
Published: 2019

30. ESICM/ESCMID task force on practical management of invasive candidiasis in critically ill patients

Author: Martín-Loeches, Ignacio, Antonelli, Massimo, Cuenca-Estrella, Manuel, Dimopoulos, George, Einav, Sharon, De Waele, Jan J., Garnacho-Montero, José, Kanj, Souha S., Machado, Flavia R., Montravers, Philippe, Sakr, Yasser, Sanguinetti, Maurizio, Timsit, Jean-François, Bassetti, Matteo, Martín-Loeches, Ignacio, Antonelli, Massimo, Cuenca-Estrella, Manuel, Dimopoulos, George, Einav, Sharon, De Waele, Jan J., Garnacho-Montero, José, Kanj, Souha S., Machado, Flavia R., Montravers, Philippe, Sakr, Yasser, Sanguinetti, Maurizio, Timsit, Jean-François, and Bassetti, Matteo
Abstract: [Introduction] The term invasive candidiasis (IC) refers to both bloodstream and deep-seated invasive infections, such as peritonitis, caused by Candida species. Several guidelines on the management of candidemia and invasive infection due to Candida species have recently been published, but none of them focuses specifically on critically ill patients admitted to intensive care units (ICUs)., [Material and Methods] In the absence of available scientific evidence, the resulting recommendations are based solely on epidemiological and clinical evidence in conjunction with expert opinion. The task force used the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach to evaluate the recommendations and assign levels of evidence. The recommendations and their strength were decided by consensus and, if necessary, by vote (modified Delphi process). Descriptive statistics were used to analyze the results of the Delphi process. Statements obtaining > 80% agreement were considered to have achieved consensus., [Conclusions] The heterogeneity of this patient population necessitated the creation of a mixed working group comprising experts in clinical microbiology, infectious diseases and intensive care medicine, all chosen on the basis of their expertise in the management of IC and/or research methodology. The working group’s main goal was to provide clinicians with clear and practical recommendations to optimize microbiological diagnosis and treatment of IC. The Systemic Inflammation and Sepsis and Infection sections of the European Society of Intensive Care Medicine (ESICM) and the Critically Ill Patients Study Group of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) therefore decided to develop a set of recommendations for application in non-immunocompromised critically ill patients.
Published: 2019

31. Antimicrobial resistance and antibiotic stewardship programs in the ICU : insistence and persistence in the fight against resistance. A position statement from ESICM/ESCMID/WAAAR round table on multi-drug resistance

Author: De Waele, Jan J, Akova, Murat, Antonelli, Massimo, Canton, Rafael, Carlet, Jean, De Backer, Daniel, Dimopoulos, George, Garnacho-Montero, José, Kesecioglu, Jozef, Lipman, Jeffrey, Mer, Mervyn, Paiva, José-Artur, Poljak, Mario, Roberts, Jason A, Rodriguez Bano, Jesus, Timsit, Jean-François, Zahar, Jean-Ralph, Bassetti, Matteo, De Waele, Jan J, Akova, Murat, Antonelli, Massimo, Canton, Rafael, Carlet, Jean, De Backer, Daniel, Dimopoulos, George, Garnacho-Montero, José, Kesecioglu, Jozef, Lipman, Jeffrey, Mer, Mervyn, Paiva, José-Artur, Poljak, Mario, Roberts, Jason A, Rodriguez Bano, Jesus, Timsit, Jean-François, Zahar, Jean-Ralph, and Bassetti, Matteo
Published: 2018

32. Antimicrobial resistance and antibiotic stewardship programs in the ICU : insistence and persistence in the fight against resistance. A position statement from ESICM/ESCMID/WAAAR round table on multi-drug resistance

Author: De Waele, Jan J, Akova, Murat, Antonelli, Massimo, Canton, Rafael, Carlet, Jean, De Backer, Daniel, Dimopoulos, George, Garnacho-Montero, José, Kesecioglu, Jozef, Lipman, Jeffrey, Mer, Mervyn, Paiva, José-Artur, Poljak, Mario, Roberts, Jason A, Rodriguez Bano, Jesus, Timsit, Jean-François, Zahar, Jean-Ralph, Bassetti, Matteo, De Waele, Jan J, Akova, Murat, Antonelli, Massimo, Canton, Rafael, Carlet, Jean, De Backer, Daniel, Dimopoulos, George, Garnacho-Montero, José, Kesecioglu, Jozef, Lipman, Jeffrey, Mer, Mervyn, Paiva, José-Artur, Poljak, Mario, Roberts, Jason A, Rodriguez Bano, Jesus, Timsit, Jean-François, Zahar, Jean-Ralph, and Bassetti, Matteo
Published: 2018

33. Antimicrobial resistance and antibiotic stewardship programs in the ICU : insistence and persistence in the fight against resistance. A position statement from ESICM/ESCMID/WAAAR round table on multi-drug resistance

Author: De Waele, Jan J, Akova, Murat, Antonelli, Massimo, Canton, Rafael, Carlet, Jean, De Backer, Daniel, Dimopoulos, George, Garnacho-Montero, José, Kesecioglu, Jozef, Lipman, Jeffrey, Mer, Mervyn, Paiva, José-Artur, Poljak, Mario, Roberts, Jason A, Rodriguez Bano, Jesus, Timsit, Jean-François, Zahar, Jean-Ralph, Bassetti, Matteo, De Waele, Jan J, Akova, Murat, Antonelli, Massimo, Canton, Rafael, Carlet, Jean, De Backer, Daniel, Dimopoulos, George, Garnacho-Montero, José, Kesecioglu, Jozef, Lipman, Jeffrey, Mer, Mervyn, Paiva, José-Artur, Poljak, Mario, Roberts, Jason A, Rodriguez Bano, Jesus, Timsit, Jean-François, Zahar, Jean-Ralph, and Bassetti, Matteo
Published: 2018

34. Antimicrobial resistance and antibiotic stewardship programs in the ICU: insistence and persistence in the fight against resistance. A position statement from ESICM/ESCMID/WAAAR round table on multi-drug resistance

Author: Management Vitale Functies, Medische Staf Intensive Care, Brain, Infection & Immunity, De Waele, Jan J, Akova, Murat, Antonelli, Massimo, Canton, Rafael, Carlet, Jean, De Backer, Daniel, Dimopoulos, George, Garnacho-Montero, José, Kesecioglu, Jozef, Lipman, Jeffrey, Mer, Mervyn, Paiva, José-Artur, Poljak, Mario, Roberts, Jason A, Rodriguez Bano, Jesus, Timsit, Jean-François, Zahar, Jean-Ralph, Bassetti, Matteo, Management Vitale Functies, Medische Staf Intensive Care, Brain, Infection & Immunity, De Waele, Jan J, Akova, Murat, Antonelli, Massimo, Canton, Rafael, Carlet, Jean, De Backer, Daniel, Dimopoulos, George, Garnacho-Montero, José, Kesecioglu, Jozef, Lipman, Jeffrey, Mer, Mervyn, Paiva, José-Artur, Poljak, Mario, Roberts, Jason A, Rodriguez Bano, Jesus, Timsit, Jean-François, Zahar, Jean-Ralph, and Bassetti, Matteo
Published: 2018

35. Developing definitions for invasive fungal diseases in critically ill adult patients in intensive care units. Protocol of the FUNgal infections Definitions in ICU patients (FUNDICU) project

Author: Bassetti, Matteo, Scudeller, Luigia, Giacobbe, Daniele R., Lamoth, Frederic, Righi, Elda, Zuccaro, Valentina, Grecchi, Cecilia, Rebuffi, Chiara, Akova, Murat, Alastruey-Izquierdo, Ana, Arikan-Akdagli, Sevtap, Azoulay, Elie, Blot, Stijn I., Cornely, Oliver A., Lass-Flörl, Cornelia, Koehler, Philipp, Cuenca-Estrella, Manuel, de Lange, Dylan W., De Rosa, Francesco G., De Waele, Jan J., Dimopoulos, George, Garnacho-Montero, José, Hoenigl, Martin, Kanj, Souha S., Maertens, Johan, Martin-Loeches, Ignacio, Muñoz, Patricia, Kullberg, Bart J., Agvald-Ohman, Christina, Poulakou, Garyphallia, Rello, Jordi, Sanguinetti, Maurizio, Taccone, Fabio S., Timsit, Jean-Françoi, Torres, Antoni, Vazquez, Jose A., Calandra, Thierry, Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059), Bassetti, Matteo, Scudeller, Luigia, Giacobbe, Daniele R., Lamoth, Frederic, Righi, Elda, Zuccaro, Valentina, Grecchi, Cecilia, Rebuffi, Chiara, Akova, Murat, Alastruey-Izquierdo, Ana, Arikan-Akdagli, Sevtap, Azoulay, Elie, Blot, Stijn I., Cornely, Oliver A., Lass-Flörl, Cornelia, Koehler, Philipp, Cuenca-Estrella, Manuel, de Lange, Dylan W., De Rosa, Francesco G., De Waele, Jan J., Dimopoulos, George, Garnacho-Montero, José, Hoenigl, Martin, Kanj, Souha S., Maertens, Johan, Martin-Loeches, Ignacio, Muñoz, Patricia, Kullberg, Bart J., Agvald-Ohman, Christina, Poulakou, Garyphallia, Rello, Jordi, Sanguinetti, Maurizio, Taccone, Fabio S., Timsit, Jean-Françoi, Torres, Antoni, Vazquez, Jose A., Calandra, Thierry, and Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059)
Abstract: Background: The reliability of diagnostic criteria for invasive fungal diseases (IFD) developed for severely immunocompromised patients is questionable in critically ill adult patients in intensive care units (ICU). Objectives: To develop a standard set of definitions for IFD in critically ill adult patients in ICU. Methods: Based on a systematic literature review, a list of potential definitions to be applied to ICU patients will be developed by the ESCMID Study Group for Infections in Critically Ill Patients (ESGCIP) and the ESCMID Fungal Infection Study Group (EFISG) chairpersons. The proposed definitions will be evaluated by a panel of 30 experts using the RAND/UCLA appropriateness methods. The panel will rank each of the proposed definitions on a 1-9 scale trough a dedicated questionnaire, in two rounds: one remote and one face-to-face. Based on their median rank and the level of agreement across panel members, selected definitions will be organised in a main consensus document and in an executive summary. The executive summary will be made available online for public comments. Conclusions: The present consensus project will seek to provide standard definitions for IFD in critically ill adult patients in ICU, with the ultimate aims of improving their clinical outcome and facilitating the comparison and generalizability of research findings.
Published: 2018

36. The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey

Author: Sartelli, Massimo, Labricciosa, Francesco M., Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian J., Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Di Saverio, Salomone, May, Addison K., Viale, Pierluigi, Watkins, Richard R., Scudeller, Luigia, Abbo, Lilian M., Abu-Zidan, FikriM., Adesunkanmi, Abdulrashid K., Al-Dahir, Sara, Al-Hasan, Majdi N., Alis, Halil, Alves, Carlos, Araujo da Silva, Andre R., Augustin, Goran, Bala, Miklosh, Barie, Philip S., Beltran, Marcelo A., Bhangu, Aneel, Bouchra, Belefquih, Brecher, Stephen M., Cainzos, Miguel A., Camacho-Ortiz, Adrian, Catani, Marco, Chandy, Sujith J., Jusoh, Asri Che, Cherry-Bukowiec, Jill R., Chiara, Osvaldo, Colak, Elif, Cornely, Oliver A., Cui, Yunfeng, Demetrashvili, Zaza, De Simone, Belinda, De Waele, Jan J., Dhingra, Sameer, Di Marzo, Francesco, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, ThereseM., Elmangory, Mutasim M., Enani, Mushira A., Ferrada, Paula, Foianini, J. Esteban, Gachabayov, Mahir, Gandhi, Chinmay, Ghnnam, Wagih Mommtaz, Giamarellou, Helen, Gkiokas, Georgios, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen A., Guerra Gronerth, Rosio I., Haidamus Monteiro, Julio C., Hardcastle, Timothy C., Hecker, Andreas, Hodonou, Adrien M., Ioannidis, Orestis, Isik, Arda, Iskandar, Katia A., Kafil, Hossein S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar R., Kenig, Jakub, Kerschaever, Ivan, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong B., Ko, Wen-Chien, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae G., Lee, Young R., Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Lowman, Warren, Machain, Gustavo M., Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasios, Martinez Casas, Isidro, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael E., Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, ShyamK., Moore, Ernest E., Munyika, Akutu, Mylonakis, Eleftherios, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica D., Nicolau, David P., Omari, Abdelkarim H., Ordonez, Carlos A., Paiva, Jose-Artur, Pant, Narayan D., Parreira, Jose G., Pedziwiatr, Michal, Pereira, BrunoM., Ponce-de-Leon, Alfredo, Poulakou, Garyphallia, Preller, Jacobus, Pulcini, Celine, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy M., Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno Rocha, Rodriguez-Bano, Jesus, Sakakushev, Boris, Sanders, James, Santos, Natalia, Sato, Norio, Sawyer, Robert G., Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Shelat, Vishalkumar, Sifri, Costi D., Siribumrungwong, Boonying, Soreide, Kjetil, Soto, Rodolfo, de Souza, Hamilton P., Talving, Peep, Trung, Ngo Tat, Tessier, Jeffrey M., Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Van Goor, Harry, Vereczkei, Andras, Wagenlehner, Floriann, Xiao, Yonghong, Yuan, Kuo-Ching, Wechsler-Foerdoes, Agnes, Zahar, Jean-Ralph, Zakrison, Tanya L., Zuckerbraun, Brian, Zuidema, Wietse P., Catena, Fausto, Sartelli, Massimo, Labricciosa, Francesco M., Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian J., Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Di Saverio, Salomone, May, Addison K., Viale, Pierluigi, Watkins, Richard R., Scudeller, Luigia, Abbo, Lilian M., Abu-Zidan, FikriM., Adesunkanmi, Abdulrashid K., Al-Dahir, Sara, Al-Hasan, Majdi N., Alis, Halil, Alves, Carlos, Araujo da Silva, Andre R., Augustin, Goran, Bala, Miklosh, Barie, Philip S., Beltran, Marcelo A., Bhangu, Aneel, Bouchra, Belefquih, Brecher, Stephen M., Cainzos, Miguel A., Camacho-Ortiz, Adrian, Catani, Marco, Chandy, Sujith J., Jusoh, Asri Che, Cherry-Bukowiec, Jill R., Chiara, Osvaldo, Colak, Elif, Cornely, Oliver A., Cui, Yunfeng, Demetrashvili, Zaza, De Simone, Belinda, De Waele, Jan J., Dhingra, Sameer, Di Marzo, Francesco, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, ThereseM., Elmangory, Mutasim M., Enani, Mushira A., Ferrada, Paula, Foianini, J. Esteban, Gachabayov, Mahir, Gandhi, Chinmay, Ghnnam, Wagih Mommtaz, Giamarellou, Helen, Gkiokas, Georgios, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen A., Guerra Gronerth, Rosio I., Haidamus Monteiro, Julio C., Hardcastle, Timothy C., Hecker, Andreas, Hodonou, Adrien M., Ioannidis, Orestis, Isik, Arda, Iskandar, Katia A., Kafil, Hossein S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar R., Kenig, Jakub, Kerschaever, Ivan, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong B., Ko, Wen-Chien, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae G., Lee, Young R., Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Lowman, Warren, Machain, Gustavo M., Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasios, Martinez Casas, Isidro, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael E., Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, ShyamK., Moore, Ernest E., Munyika, Akutu, Mylonakis, Eleftherios, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica D., Nicolau, David P., Omari, Abdelkarim H., Ordonez, Carlos A., Paiva, Jose-Artur, Pant, Narayan D., Parreira, Jose G., Pedziwiatr, Michal, Pereira, BrunoM., Ponce-de-Leon, Alfredo, Poulakou, Garyphallia, Preller, Jacobus, Pulcini, Celine, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy M., Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno Rocha, Rodriguez-Bano, Jesus, Sakakushev, Boris, Sanders, James, Santos, Natalia, Sato, Norio, Sawyer, Robert G., Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Shelat, Vishalkumar, Sifri, Costi D., Siribumrungwong, Boonying, Soreide, Kjetil, Soto, Rodolfo, de Souza, Hamilton P., Talving, Peep, Trung, Ngo Tat, Tessier, Jeffrey M., Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Van Goor, Harry, Vereczkei, Andras, Wagenlehner, Floriann, Xiao, Yonghong, Yuan, Kuo-Ching, Wechsler-Foerdoes, Agnes, Zahar, Jean-Ralph, Zakrison, Tanya L., Zuckerbraun, Brian, Zuidema, Wietse P., and Catena, Fausto
Abstract: Background: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. Methods: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. Results: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). Conclusion: T
Published: 2017

37. The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey

Author: Sartelli, Massimo, Labricciosa, Francesco M., Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian J., Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Di Saverio, Salomone, May, Addison K., Viale, Pierluigi, Watkins, Richard R., Scudeller, Luigia, Abbo, Lilian M., Abu-Zidan, FikriM., Adesunkanmi, Abdulrashid K., Al-Dahir, Sara, Al-Hasan, Majdi N., Alis, Halil, Alves, Carlos, Araujo da Silva, Andre R., Augustin, Goran, Bala, Miklosh, Barie, Philip S., Beltran, Marcelo A., Bhangu, Aneel, Bouchra, Belefquih, Brecher, Stephen M., Cainzos, Miguel A., Camacho-Ortiz, Adrian, Catani, Marco, Chandy, Sujith J., Jusoh, Asri Che, Cherry-Bukowiec, Jill R., Chiara, Osvaldo, Colak, Elif, Cornely, Oliver A., Cui, Yunfeng, Demetrashvili, Zaza, De Simone, Belinda, De Waele, Jan J., Dhingra, Sameer, Di Marzo, Francesco, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, ThereseM., Elmangory, Mutasim M., Enani, Mushira A., Ferrada, Paula, Foianini, J. Esteban, Gachabayov, Mahir, Gandhi, Chinmay, Ghnnam, Wagih Mommtaz, Giamarellou, Helen, Gkiokas, Georgios, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen A., Guerra Gronerth, Rosio I., Haidamus Monteiro, Julio C., Hardcastle, Timothy C., Hecker, Andreas, Hodonou, Adrien M., Ioannidis, Orestis, Isik, Arda, Iskandar, Katia A., Kafil, Hossein S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar R., Kenig, Jakub, Kerschaever, Ivan, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong B., Ko, Wen-Chien, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae G., Lee, Young R., Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Lowman, Warren, Machain, Gustavo M., Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasios, Martinez Casas, Isidro, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael E., Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, ShyamK., Moore, Ernest E., Munyika, Akutu, Mylonakis, Eleftherios, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica D., Nicolau, David P., Omari, Abdelkarim H., Ordonez, Carlos A., Paiva, Jose-Artur, Pant, Narayan D., Parreira, Jose G., Pedziwiatr, Michal, Pereira, BrunoM., Ponce-de-Leon, Alfredo, Poulakou, Garyphallia, Preller, Jacobus, Pulcini, Celine, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy M., Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno Rocha, Rodriguez-Bano, Jesus, Sakakushev, Boris, Sanders, James, Santos, Natalia, Sato, Norio, Sawyer, Robert G., Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Shelat, Vishalkumar, Sifri, Costi D., Siribumrungwong, Boonying, Soreide, Kjetil, Soto, Rodolfo, de Souza, Hamilton P., Talving, Peep, Trung, Ngo Tat, Tessier, Jeffrey M., Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Van Goor, Harry, Vereczkei, Andras, Wagenlehner, Floriann, Xiao, Yonghong, Yuan, Kuo-Ching, Wechsler-Foerdoes, Agnes, Zahar, Jean-Ralph, Zakrison, Tanya L., Zuckerbraun, Brian, Zuidema, Wietse P., Catena, Fausto, Sartelli, Massimo, Labricciosa, Francesco M., Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian J., Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Di Saverio, Salomone, May, Addison K., Viale, Pierluigi, Watkins, Richard R., Scudeller, Luigia, Abbo, Lilian M., Abu-Zidan, FikriM., Adesunkanmi, Abdulrashid K., Al-Dahir, Sara, Al-Hasan, Majdi N., Alis, Halil, Alves, Carlos, Araujo da Silva, Andre R., Augustin, Goran, Bala, Miklosh, Barie, Philip S., Beltran, Marcelo A., Bhangu, Aneel, Bouchra, Belefquih, Brecher, Stephen M., Cainzos, Miguel A., Camacho-Ortiz, Adrian, Catani, Marco, Chandy, Sujith J., Jusoh, Asri Che, Cherry-Bukowiec, Jill R., Chiara, Osvaldo, Colak, Elif, Cornely, Oliver A., Cui, Yunfeng, Demetrashvili, Zaza, De Simone, Belinda, De Waele, Jan J., Dhingra, Sameer, Di Marzo, Francesco, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, ThereseM., Elmangory, Mutasim M., Enani, Mushira A., Ferrada, Paula, Foianini, J. Esteban, Gachabayov, Mahir, Gandhi, Chinmay, Ghnnam, Wagih Mommtaz, Giamarellou, Helen, Gkiokas, Georgios, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen A., Guerra Gronerth, Rosio I., Haidamus Monteiro, Julio C., Hardcastle, Timothy C., Hecker, Andreas, Hodonou, Adrien M., Ioannidis, Orestis, Isik, Arda, Iskandar, Katia A., Kafil, Hossein S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar R., Kenig, Jakub, Kerschaever, Ivan, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong B., Ko, Wen-Chien, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae G., Lee, Young R., Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Lowman, Warren, Machain, Gustavo M., Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasios, Martinez Casas, Isidro, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael E., Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, ShyamK., Moore, Ernest E., Munyika, Akutu, Mylonakis, Eleftherios, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica D., Nicolau, David P., Omari, Abdelkarim H., Ordonez, Carlos A., Paiva, Jose-Artur, Pant, Narayan D., Parreira, Jose G., Pedziwiatr, Michal, Pereira, BrunoM., Ponce-de-Leon, Alfredo, Poulakou, Garyphallia, Preller, Jacobus, Pulcini, Celine, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy M., Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno Rocha, Rodriguez-Bano, Jesus, Sakakushev, Boris, Sanders, James, Santos, Natalia, Sato, Norio, Sawyer, Robert G., Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Shelat, Vishalkumar, Sifri, Costi D., Siribumrungwong, Boonying, Soreide, Kjetil, Soto, Rodolfo, de Souza, Hamilton P., Talving, Peep, Trung, Ngo Tat, Tessier, Jeffrey M., Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Van Goor, Harry, Vereczkei, Andras, Wagenlehner, Floriann, Xiao, Yonghong, Yuan, Kuo-Ching, Wechsler-Foerdoes, Agnes, Zahar, Jean-Ralph, Zakrison, Tanya L., Zuckerbraun, Brian, Zuidema, Wietse P., and Catena, Fausto
Abstract: Background: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. Methods: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. Results: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). Conclusion: T
Published: 2017

38. Management of intra-abdominal infections: Recommendations by the WSES 2016 consensus conference

Author: Sartelli, Massimo, Catena, Fausto, Abu-Zidan, Fikri M., Ansaloni, Luca, Biffl, Walter L., Boermeester, Marja A., Ceresoli, Marco, Chiara, Osvaldo, Coccolini, Federico, De Waele, Jan J., Di Saverio, Salomone, Eckmann, Christian, Fraga, Gustavo P., Giannella, Maddalena, Girardis, Massimo, Griffiths, Ewen A., Kashuk, Jeffry, Kirkpatrick, Andrew W., Khokha, Vladimir, Kluger, Yoram, Labricciosa, Francesco M., Leppaniemi, Ari, Maier, Ronald V., May, Addison K., Malangoni, Mark, Martin-Loeches, Ignacio, Mazuski, John, Montravers, Philippe, Peitzman, Andrew, Pereira, Bruno M., Reis, Tarcisio, Sakakushev, Bori, Sganga, Gabriele, Soreide, Kjetil, Sugrue, Michael, Ulrych, Jan, Vincent, Jean-Loui, Viale, Pierluigi, Moore, Ernest E., Sganga, Gabriele (ORCID:0000-0001-5079-0395), Sartelli, Massimo, Catena, Fausto, Abu-Zidan, Fikri M., Ansaloni, Luca, Biffl, Walter L., Boermeester, Marja A., Ceresoli, Marco, Chiara, Osvaldo, Coccolini, Federico, De Waele, Jan J., Di Saverio, Salomone, Eckmann, Christian, Fraga, Gustavo P., Giannella, Maddalena, Girardis, Massimo, Griffiths, Ewen A., Kashuk, Jeffry, Kirkpatrick, Andrew W., Khokha, Vladimir, Kluger, Yoram, Labricciosa, Francesco M., Leppaniemi, Ari, Maier, Ronald V., May, Addison K., Malangoni, Mark, Martin-Loeches, Ignacio, Mazuski, John, Montravers, Philippe, Peitzman, Andrew, Pereira, Bruno M., Reis, Tarcisio, Sakakushev, Bori, Sganga, Gabriele, Soreide, Kjetil, Sugrue, Michael, Ulrych, Jan, Vincent, Jean-Loui, Viale, Pierluigi, Moore, Ernest E., and Sganga, Gabriele (ORCID:0000-0001-5079-0395)
Abstract: This paper reports on the consensus conference on the management of intra-abdominal infections (IAIs) which was held on July 23, 2016, in Dublin, Ireland, as a part of the annual World Society of Emergency Surgery (WSES) meeting. This document covers all aspects of the management of IAIs. The Grading of Recommendations Assessment, Development and Evaluation recommendation is used, and this document represents the executive summary of the consensus conference findings.
Published: 2017

39. Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA).

Author: UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, Sartelli, Massimo, Weber, Dieter G, Ruppé, Etienne, Bassetti, Matteo, Wright, Brian J, Ansaloni, Luca, Catena, Fausto, Coccolini, Federico, Abu-Zidan, Fikri M, Coimbra, Raul, Moore, Ernest E, Moore, Frederick A, Maier, Ronald V, De Waele, Jan J, Kirkpatrick, Andrew W, Griffiths, Ewen A, Eckmann, Christian, Brink, Adrian J, Mazuski, John E, May, Addison K, Sawyer, Rob G, Mertz, Dominik, Montravers, Philippe, Kumar, Anand, Roberts, Jason A, Vincent, Jean-Louis, Watkins, Richard R, Lowman, Warren, Spellberg, Brad, Abbott, Iain J, Adesunkanmi, Abdulrashid Kayode, Al-Dahir, Sara, Al-Hasan, Majdi N, Agresta, Ferdinando, Althani, Asma A, Ansari, Shamshul, Ansumana, Rashid, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J, Baraket, Oussama, Bhangu, Aneel, Beltrán, Marcelo A, Bernhard, Michael, Biffl, Walter L, Boermeester, Marja A, Brecher, Stephen M, Cherry-Bukowiec, Jill R, Buyne, Otmar R, Cainzos, Miguel A, Cairns, Kelly A, Camacho-Ortiz, Adrian, Chandy, Sujith J, Che Jusoh, Asri, Chichom-Mefire, Alain, Colijn, Caroline, Corcione, Francesco, Cui, Yunfeng, Curcio, Daniel, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, Dhingra, Sameer, Diaz, José J, Di Carlo, Isidoro, Dillip, Angel, Di Saverio, Salomone, Doyle, Michael P, Dorj, Gereltuya, Dogjani, Agron, Dupont, Hervé, Eachempati, Soumitra R, Enani, Mushira Abdulaziz, Egiev, Valery N, Elmangory, Mutasim M, Ferrada, Paula, Fitchett, Joseph R, Fraga, Gustavo P, Guessennd, Nathalie, Giamarellou, Helen, Ghnnam, Wagih, Gkiokas, George, Goldberg, Staphanie R, Gomes, Carlos Augusto, Gomi, Harumi, Guzmán-Blanco, Manuel, Haque, Mainul, Hansen, Sonja, Hecker, Andreas, Heizmann, Wolfgang R, Herzog, Torsten, Hodonou, Adrien Montcho, Hong, Suk-Kyung, Kafka-Ritsch, Reinhold, Kaplan, Lewis J, Kapoor, Garima, Karamarkovic, Aleksandar, Kees, Martin G, Kenig, Jakub, Kiguba, Ronald, Kim, Peter K, Kluger, Yoram, Khokha, Vladimir, Koike, Kaoru, Kok, Kenneth Y Y, Kong, Victory, Knox, Matthew C, Inaba, Kenji, Isik, Arda, Iskandar, Katia, Ivatury, Rao R, Labbate, Maurizio, Labricciosa, Francesco M, Laterre, Pierre-François, Latifi, Rifat, Lee, Jae Gil, Lee, Young Ran, Leone, Marc, Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y, Loho, Tonny, Maegele, Marc, Malama, Sydney, Marei, Hany E, Martin-Loeches, Ignacio, Marwah, Sanjay, Massele, Amos, McFarlane, Michael, Melo, Renato Bessa, Negoi, Ionut, Nicolau, David P, Nord, Carl Erik, Ofori-Asenso, Richard, Omari, AbdelKarim H, Ordonez, Carlos A, Ouadii, Mouaqit, Pereira Júnior, Gerson Alves, Piazza, Diego, Pupelis, Guntars, Rawson, Timothy Miles, Rems, Miran, Rizoli, Sandro, Rocha, Claudio, Sakakhushev, Boris, Sanchez-Garcia, Miguel, Sato, Norio, Segovia Lohse, Helmut A, Sganga, Gabriele, Siribumrungwong, Boonying, Shelat, Vishal G, Soreide, Kjetil, Soto, Rodolfo, Talving, Peep, Tilsed, Jonathan V, Timsit, Jean-Francois, Trueba, Gabriel, Trung, Ngo Tat, Ulrych, Jan, van Goor, Harry, Vereczkei, Andras, Vohra, Ravinder S, Wani, Imtiaz, Uhl, Waldemar, Xiao, Yonghong, Yuan, Kuo-Ching, Zachariah, Sanoop K, Zahar, Jean-Ralph, Zakrison, Tanya L, Corcione, Antonio, Melotti, Rita M, Viscoli, Claudio, Viale, Perluigi, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, Sartelli, Massimo, Weber, Dieter G, Ruppé, Etienne, Bassetti, Matteo, Wright, Brian J, Ansaloni, Luca, Catena, Fausto, Coccolini, Federico, Abu-Zidan, Fikri M, Coimbra, Raul, Moore, Ernest E, Moore, Frederick A, Maier, Ronald V, De Waele, Jan J, Kirkpatrick, Andrew W, Griffiths, Ewen A, Eckmann, Christian, Brink, Adrian J, Mazuski, John E, May, Addison K, Sawyer, Rob G, Mertz, Dominik, Montravers, Philippe, Kumar, Anand, Roberts, Jason A, Vincent, Jean-Louis, Watkins, Richard R, Lowman, Warren, Spellberg, Brad, Abbott, Iain J, Adesunkanmi, Abdulrashid Kayode, Al-Dahir, Sara, Al-Hasan, Majdi N, Agresta, Ferdinando, Althani, Asma A, Ansari, Shamshul, Ansumana, Rashid, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J, Baraket, Oussama, Bhangu, Aneel, Beltrán, Marcelo A, Bernhard, Michael, Biffl, Walter L, Boermeester, Marja A, Brecher, Stephen M, Cherry-Bukowiec, Jill R, Buyne, Otmar R, Cainzos, Miguel A, Cairns, Kelly A, Camacho-Ortiz, Adrian, Chandy, Sujith J, Che Jusoh, Asri, Chichom-Mefire, Alain, Colijn, Caroline, Corcione, Francesco, Cui, Yunfeng, Curcio, Daniel, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, Dhingra, Sameer, Diaz, José J, Di Carlo, Isidoro, Dillip, Angel, Di Saverio, Salomone, Doyle, Michael P, Dorj, Gereltuya, Dogjani, Agron, Dupont, Hervé, Eachempati, Soumitra R, Enani, Mushira Abdulaziz, Egiev, Valery N, Elmangory, Mutasim M, Ferrada, Paula, Fitchett, Joseph R, Fraga, Gustavo P, Guessennd, Nathalie, Giamarellou, Helen, Ghnnam, Wagih, Gkiokas, George, Goldberg, Staphanie R, Gomes, Carlos Augusto, Gomi, Harumi, Guzmán-Blanco, Manuel, Haque, Mainul, Hansen, Sonja, Hecker, Andreas, Heizmann, Wolfgang R, Herzog, Torsten, Hodonou, Adrien Montcho, Hong, Suk-Kyung, Kafka-Ritsch, Reinhold, Kaplan, Lewis J, Kapoor, Garima, Karamarkovic, Aleksandar, Kees, Martin G, Kenig, Jakub, Kiguba, Ronald, Kim, Peter K, Kluger, Yoram, Khokha, Vladimir, Koike, Kaoru, Kok, Kenneth Y Y, Kong, Victory, Knox, Matthew C, Inaba, Kenji, Isik, Arda, Iskandar, Katia, Ivatury, Rao R, Labbate, Maurizio, Labricciosa, Francesco M, Laterre, Pierre-François, Latifi, Rifat, Lee, Jae Gil, Lee, Young Ran, Leone, Marc, Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y, Loho, Tonny, Maegele, Marc, Malama, Sydney, Marei, Hany E, Martin-Loeches, Ignacio, Marwah, Sanjay, Massele, Amos, McFarlane, Michael, Melo, Renato Bessa, Negoi, Ionut, Nicolau, David P, Nord, Carl Erik, Ofori-Asenso, Richard, Omari, AbdelKarim H, Ordonez, Carlos A, Ouadii, Mouaqit, Pereira Júnior, Gerson Alves, Piazza, Diego, Pupelis, Guntars, Rawson, Timothy Miles, Rems, Miran, Rizoli, Sandro, Rocha, Claudio, Sakakhushev, Boris, Sanchez-Garcia, Miguel, Sato, Norio, Segovia Lohse, Helmut A, Sganga, Gabriele, Siribumrungwong, Boonying, Shelat, Vishal G, Soreide, Kjetil, Soto, Rodolfo, Talving, Peep, Tilsed, Jonathan V, Timsit, Jean-Francois, Trueba, Gabriel, Trung, Ngo Tat, Ulrych, Jan, van Goor, Harry, Vereczkei, Andras, Vohra, Ravinder S, Wani, Imtiaz, Uhl, Waldemar, Xiao, Yonghong, Yuan, Kuo-Ching, Zachariah, Sanoop K, Zahar, Jean-Ralph, Zakrison, Tanya L, Corcione, Antonio, Melotti, Rita M, Viscoli, Claudio, and Viale, Perluigi
Abstract: Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.
Published: 2016

40. Antimicrobials

Author: University of Helsinki, II kirurgian klinikka, Sartelli, Massimo, Weber, Dieter G., Ruppe, Etienne, Bassetti, Matteo, Wright, Brian J., Ansaloni, Luca, Catena, Fausto, Coccolini, Federico, Abu-Zidan, Fikri M., Coimbra, Raul, Moore, Ernest E., Moore, Frederick A., Maier, Ronald V., De Waele, Jan J., Kirkpatrick, Andrew W., Griffiths, Ewen A., Eckmann, Christian, Brink, Adrian J., Mazuski, John E., May, Addison K., Sawyer, Rob G., Mertz, Dominik, Montravers, Philippe, Kumar, Anand, Roberts, Jason A., Vincent, Jean-Louis, Watkins, Richard R., Lowman, Warren, Spellberg, Brad, Abbott, Iain J., Adesunkanmi, Abdulrashid Kayode, Al-Dahir, Sara, Al-Hasan, Majdi N., Agresta, Ferdinando, Althani, Asma A., Ansari, Shamshul, Ansumana, Rashid, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J., Baraket, Oussama, Bhangu, Aneel, Beltran, Marcelo A., Bernhard, Michael, Biffl, Walter L., Boermeester, Marja A., Brecher, Stephen M., Cherry-Bukowiec, Jill R., Buyne, Otmar R., Cainzos, Miguel A., Cairns, Kelly A., Camacho-Ortiz, Adrian, Chandy, Sujith J., Jusoh, Asri Che, Chichom-Mefire, Alain, Colijn, Caroline, Corcione, Francesco, Cui, Yunfeng, Curcio, Daniel, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, Dhingra, Sameer, Diaz, Jose J., Di Carlo, Isidoro, Dillip, Angel, Di Saverio, Salomone, Doyle, Michael P., Dorj, Gereltuya, Dogjani, Agron, Dupont, Herve, Eachempati, Soumitra R., Enani, Mushira Abdulaziz, Egiev, Valery N., Elmangory, Mutasim M., Ferrada, Paula, Fitchett, Joseph R., Fraga, Gustavo P., Guessennd, Nathalie, Giamarellou, Helen, Ghnnam, Wagih, Gkiokas, George, Goldberg, Staphanie R., Gomes, Carlos Augusto, Gomi, Harumi, Guzman-Blanco, Manuel, Haque, Mainul, Hansen, Sonja, Hecker, Andreas, Heizmann, Wolfgang R., Herzog, Torsten, Hodonou, Adrien Montcho, Hong, Suk-Kyung, Kafka-Ritsch, Reinhold, Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar, Kees, Martin G., Kenig, Jakub, Kiguba, Ronald, Kim, Peter K., Kluger, Yoram, Khokha, Vladimir, Koike, Kaoru, Kok, Kenneth Y. Y., Kong, Victory, Knox, Matthew C., Inaba, Kenji, Isik, Arda, Iskandar, Katia, Ivatury, Rao R., Labbate, Maurizio, Labricciosa, Francesco M., Laterre, Pierre-Francois, Latifi, Rifat, Lee, Jae Gil, Lee, Young Ran, Leone, Marc, Leppäniemi, Ari, Li, Yousheng, Liang, Stephen Y., Loho, Tonny, Maegele, Marc, Malama, Sydney, Marei, Hany E., Martin-Loeches, Ignacio, Marwah, Sanjay, Massele, Amos, McFarlane, Michael, Melo, Renato Bessa, Negoi, Ionut, Nicolau, David P., Nord, Carl Erik, Ofori-Asenso, Richard, Omari, AbdelKarim H., Ordonez, Carlos A., Ouadii, Mouaqit, Pereira Junior, Gerson Alves, Piazza, Diego, Pupelis, Guntars, Rawson, Timothy Miles, Rems, Miran, Rizoli, Sandro, Rocha, Claudio, Sakakhushev, Boris, Sanchez-Garcia, Miguel, Sato, Norio, Lohse, Helmut A. Segovia, Sganga, Gabriele, Siribumrungwong, Boonying, Shelat, Vishal G., Soreide, Kjetil, Soto, Rodolfo, Talving, Peep, Tilsed, Jonathan V., Timsit, Jean-Francois, Trueba, Gabriel, Trung, Ngo Tat, Ulrych, Jan, van Goor, Harry, Vereczkei, Andras, Vohra, Ravinder S., Wani, Imtiaz, Uhl, Waldemar, Xiao, Yonghong, Yuan, Kuo-Ching, Zachariah, Sanoop K., Zahar, Jean-Ralph, Zakrison, Tanya L., Corcione, Antonio, Melotti, Rita M., Viscoli, Claudio, Viale, Perluigi, University of Helsinki, II kirurgian klinikka, Sartelli, Massimo, Weber, Dieter G., Ruppe, Etienne, Bassetti, Matteo, Wright, Brian J., Ansaloni, Luca, Catena, Fausto, Coccolini, Federico, Abu-Zidan, Fikri M., Coimbra, Raul, Moore, Ernest E., Moore, Frederick A., Maier, Ronald V., De Waele, Jan J., Kirkpatrick, Andrew W., Griffiths, Ewen A., Eckmann, Christian, Brink, Adrian J., Mazuski, John E., May, Addison K., Sawyer, Rob G., Mertz, Dominik, Montravers, Philippe, Kumar, Anand, Roberts, Jason A., Vincent, Jean-Louis, Watkins, Richard R., Lowman, Warren, Spellberg, Brad, Abbott, Iain J., Adesunkanmi, Abdulrashid Kayode, Al-Dahir, Sara, Al-Hasan, Majdi N., Agresta, Ferdinando, Althani, Asma A., Ansari, Shamshul, Ansumana, Rashid, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J., Baraket, Oussama, Bhangu, Aneel, Beltran, Marcelo A., Bernhard, Michael, Biffl, Walter L., Boermeester, Marja A., Brecher, Stephen M., Cherry-Bukowiec, Jill R., Buyne, Otmar R., Cainzos, Miguel A., Cairns, Kelly A., Camacho-Ortiz, Adrian, Chandy, Sujith J., Jusoh, Asri Che, Chichom-Mefire, Alain, Colijn, Caroline, Corcione, Francesco, Cui, Yunfeng, Curcio, Daniel, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, Dhingra, Sameer, Diaz, Jose J., Di Carlo, Isidoro, Dillip, Angel, Di Saverio, Salomone, Doyle, Michael P., Dorj, Gereltuya, Dogjani, Agron, Dupont, Herve, Eachempati, Soumitra R., Enani, Mushira Abdulaziz, Egiev, Valery N., Elmangory, Mutasim M., Ferrada, Paula, Fitchett, Joseph R., Fraga, Gustavo P., Guessennd, Nathalie, Giamarellou, Helen, Ghnnam, Wagih, Gkiokas, George, Goldberg, Staphanie R., Gomes, Carlos Augusto, Gomi, Harumi, Guzman-Blanco, Manuel, Haque, Mainul, Hansen, Sonja, Hecker, Andreas, Heizmann, Wolfgang R., Herzog, Torsten, Hodonou, Adrien Montcho, Hong, Suk-Kyung, Kafka-Ritsch, Reinhold, Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar, Kees, Martin G., Kenig, Jakub, Kiguba, Ronald, Kim, Peter K., Kluger, Yoram, Khokha, Vladimir, Koike, Kaoru, Kok, Kenneth Y. Y., Kong, Victory, Knox, Matthew C., Inaba, Kenji, Isik, Arda, Iskandar, Katia, Ivatury, Rao R., Labbate, Maurizio, Labricciosa, Francesco M., Laterre, Pierre-Francois, Latifi, Rifat, Lee, Jae Gil, Lee, Young Ran, Leone, Marc, Leppäniemi, Ari, Li, Yousheng, Liang, Stephen Y., Loho, Tonny, Maegele, Marc, Malama, Sydney, Marei, Hany E., Martin-Loeches, Ignacio, Marwah, Sanjay, Massele, Amos, McFarlane, Michael, Melo, Renato Bessa, Negoi, Ionut, Nicolau, David P., Nord, Carl Erik, Ofori-Asenso, Richard, Omari, AbdelKarim H., Ordonez, Carlos A., Ouadii, Mouaqit, Pereira Junior, Gerson Alves, Piazza, Diego, Pupelis, Guntars, Rawson, Timothy Miles, Rems, Miran, Rizoli, Sandro, Rocha, Claudio, Sakakhushev, Boris, Sanchez-Garcia, Miguel, Sato, Norio, Lohse, Helmut A. Segovia, Sganga, Gabriele, Siribumrungwong, Boonying, Shelat, Vishal G., Soreide, Kjetil, Soto, Rodolfo, Talving, Peep, Tilsed, Jonathan V., Timsit, Jean-Francois, Trueba, Gabriel, Trung, Ngo Tat, Ulrych, Jan, van Goor, Harry, Vereczkei, Andras, Vohra, Ravinder S., Wani, Imtiaz, Uhl, Waldemar, Xiao, Yonghong, Yuan, Kuo-Ching, Zachariah, Sanoop K., Zahar, Jean-Ralph, Zakrison, Tanya L., Corcione, Antonio, Melotti, Rita M., Viscoli, Claudio, and Viale, Perluigi
Abstract: Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.
Published: 2016

41. Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Author: Sartelli, Massimo, Weber, Dieter G., Ruppe, Etienne, Bassetti, Matteo, Wright, Brian J., Ansaloni, Luca, Catena, Fausto, Coccolini, Federico, Abu-Zidan, Fikri M., Coimbra, Raul, Moore, Ernest E., Moore, Frederick A., Maier, Ronald V., De Waele, Jan J., Kirkpatrick, Andrew W., Griffiths, Ewen A., Eckmann, Christian, Brink, Adrian J., Mazuski, John E., May, Addison K., Sawyer, Rob G., Mertz, Dominik, Montravers, Philippe, Kumar, Anand, Roberts, Jason A., Vincent, Jean-Louis, Watkins, Richard R., Lowman, Warren, Spellberg, Brad, Abbott, Iain J., Adesunkanmi, Abdulrashid Kayode, Al-Dahir, Sara, Al-Hasan, Majdi N., Agresta, Ferdinando, Althani, Asma A., Ansari, Shamshul, Ansumana, Rashid, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J., Baraket, Oussama, Bhangu, Aneel, Beltran, Marcelo A., Bernhard, Michael, Biffl, Walter L., Boermeester, Marja A., Brecher, Stephen M., Cherry-Bukowiec, Jill R., Buyne, Otmar R., Cainzos, Miguel A., Cairns, Kelly A., Camacho-Ortiz, Adrian, Chandy, Sujith J., Jusoh, Asri Che, Chichom-Mefire, Alain, Colijn, Caroline, Corcione, Francesco, Cui, Yunfeng, Curcio, Daniel, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, Dhingra, Sameer, Diaz, Jose J., Di Carlo, Isidoro, Dillip, Angel, Di Saverio, Salomone, Doyle, Michael P., Dorj, Gereltuya, Dogjani, Agron, Dupont, Herve, Eachempati, Soumitra R., Enani, Mushira Abdulaziz, Egiev, Valery N., Elmangory, Mutasim M., Ferrada, Paula, Fitchett, Joseph R., Fraga, Gustavo P., Guessennd, Nathalie, Giamarellou, Helen, Ghnnam, Wagih, Gkiokas, George, Goldberg, Staphanie R., Gomes, Carlos Augusto, Gomi, Harumi, Guzman-Blanco, Manuel, Haque, Mainul, Hansen, Sonja, Hecker, Andreas, Heizmann, Wolfgang R., Herzog, Torsten, Hodonou, Adrien Montcho, Hong, Suk-Kyung, Kafka-Ritsch, Reinhold, Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar, Kees, Martin G., Kenig, Jakub, Kiguba, Ronald, Kim, Peter K., Kluger, Yoram, Khokha, Vladimir, Koike, Kaoru, Kok, Kenneth Y. Y., Kong, Victory, Knox, Matthew C., Inaba, Kenji, Isik, Arda, Iskandar, Katia, Ivatury, Rao R., Labbate, Maurizio, Labricciosa, Francesco M., Laterre, Pierre-Francois, Latifi, Rifat, Lee, Jae Gil, Lee, Young Ran, Leone, Marc, Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Loho, Tonny, Maegele, Marc, Malama, Sydney, Marei, Hany E., Martin-Loeches, Ignacio, Marwah, Sanjay, Massele, Amos, McFarlane, Michael, Melo, Renato Bessa, Negoi, Ionut, Nicolau, David P., Nord, Carl Erik, Ofori-Asenso, Richard, Omari, AbdelKarim H., Ordonez, Carlos A., Ouadii, Mouaqit, Pereira Junior, Gerson Alves, Piazza, Diego, Pupelis, Guntars, Rawson, Timothy Miles, Rems, Miran, Rizoli, Sandro, Rocha, Claudio, Sakakhushev, Boris, Sanchez-Garcia, Miguel, Sato, Norio, Lohse, Helmut A. Segovia, Sganga, Gabriele, Siribumrungwong, Boonying, Shelat, Vishal G., Soreide, Kjetil, Soto, Rodolfo, Talving, Peep, Tilsed, Jonathan V., Timsit, Jean-Francois, Trueba, Gabriel, Trung, Ngo Tat, Ulrych, Jan, van Goor, Harry, Vereczkei, Andras, Vohra, Ravinder S., Wani, Imtiaz, Uhl, Waldemar, Xiao, Yonghong, Yuan, Kuo-Ching, Zachariah, Sanoop K., Zahar, Jean-Ralph, Zakrison, Tanya L., Corcione, Antonio, Melotti, Rita M., Viscoli, Claudio, Viale, Perluigi, Sartelli, Massimo, Weber, Dieter G., Ruppe, Etienne, Bassetti, Matteo, Wright, Brian J., Ansaloni, Luca, Catena, Fausto, Coccolini, Federico, Abu-Zidan, Fikri M., Coimbra, Raul, Moore, Ernest E., Moore, Frederick A., Maier, Ronald V., De Waele, Jan J., Kirkpatrick, Andrew W., Griffiths, Ewen A., Eckmann, Christian, Brink, Adrian J., Mazuski, John E., May, Addison K., Sawyer, Rob G., Mertz, Dominik, Montravers, Philippe, Kumar, Anand, Roberts, Jason A., Vincent, Jean-Louis, Watkins, Richard R., Lowman, Warren, Spellberg, Brad, Abbott, Iain J., Adesunkanmi, Abdulrashid Kayode, Al-Dahir, Sara, Al-Hasan, Majdi N., Agresta, Ferdinando, Althani, Asma A., Ansari, Shamshul, Ansumana, Rashid, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J., Baraket, Oussama, Bhangu, Aneel, Beltran, Marcelo A., Bernhard, Michael, Biffl, Walter L., Boermeester, Marja A., Brecher, Stephen M., Cherry-Bukowiec, Jill R., Buyne, Otmar R., Cainzos, Miguel A., Cairns, Kelly A., Camacho-Ortiz, Adrian, Chandy, Sujith J., Jusoh, Asri Che, Chichom-Mefire, Alain, Colijn, Caroline, Corcione, Francesco, Cui, Yunfeng, Curcio, Daniel, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, Dhingra, Sameer, Diaz, Jose J., Di Carlo, Isidoro, Dillip, Angel, Di Saverio, Salomone, Doyle, Michael P., Dorj, Gereltuya, Dogjani, Agron, Dupont, Herve, Eachempati, Soumitra R., Enani, Mushira Abdulaziz, Egiev, Valery N., Elmangory, Mutasim M., Ferrada, Paula, Fitchett, Joseph R., Fraga, Gustavo P., Guessennd, Nathalie, Giamarellou, Helen, Ghnnam, Wagih, Gkiokas, George, Goldberg, Staphanie R., Gomes, Carlos Augusto, Gomi, Harumi, Guzman-Blanco, Manuel, Haque, Mainul, Hansen, Sonja, Hecker, Andreas, Heizmann, Wolfgang R., Herzog, Torsten, Hodonou, Adrien Montcho, Hong, Suk-Kyung, Kafka-Ritsch, Reinhold, Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar, Kees, Martin G., Kenig, Jakub, Kiguba, Ronald, Kim, Peter K., Kluger, Yoram, Khokha, Vladimir, Koike, Kaoru, Kok, Kenneth Y. Y., Kong, Victory, Knox, Matthew C., Inaba, Kenji, Isik, Arda, Iskandar, Katia, Ivatury, Rao R., Labbate, Maurizio, Labricciosa, Francesco M., Laterre, Pierre-Francois, Latifi, Rifat, Lee, Jae Gil, Lee, Young Ran, Leone, Marc, Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Loho, Tonny, Maegele, Marc, Malama, Sydney, Marei, Hany E., Martin-Loeches, Ignacio, Marwah, Sanjay, Massele, Amos, McFarlane, Michael, Melo, Renato Bessa, Negoi, Ionut, Nicolau, David P., Nord, Carl Erik, Ofori-Asenso, Richard, Omari, AbdelKarim H., Ordonez, Carlos A., Ouadii, Mouaqit, Pereira Junior, Gerson Alves, Piazza, Diego, Pupelis, Guntars, Rawson, Timothy Miles, Rems, Miran, Rizoli, Sandro, Rocha, Claudio, Sakakhushev, Boris, Sanchez-Garcia, Miguel, Sato, Norio, Lohse, Helmut A. Segovia, Sganga, Gabriele, Siribumrungwong, Boonying, Shelat, Vishal G., Soreide, Kjetil, Soto, Rodolfo, Talving, Peep, Tilsed, Jonathan V., Timsit, Jean-Francois, Trueba, Gabriel, Trung, Ngo Tat, Ulrych, Jan, van Goor, Harry, Vereczkei, Andras, Vohra, Ravinder S., Wani, Imtiaz, Uhl, Waldemar, Xiao, Yonghong, Yuan, Kuo-Ching, Zachariah, Sanoop K., Zahar, Jean-Ralph, Zakrison, Tanya L., Corcione, Antonio, Melotti, Rita M., Viscoli, Claudio, and Viale, Perluigi
Abstract: Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.
Published: 2016

42. Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Author: Sartelli, Massimo, Weber, Dieter G., Ruppe, Etienne, Bassetti, Matteo, Wright, Brian J., Ansaloni, Luca, Catena, Fausto, Coccolini, Federico, Abu-Zidan, Fikri M., Coimbra, Raul, Moore, Ernest E., Moore, Frederick A., Maier, Ronald V., De Waele, Jan J., Kirkpatrick, Andrew W., Griffiths, Ewen A., Eckmann, Christian, Brink, Adrian J., Mazuski, John E., May, Addison K., Sawyer, Rob G., Mertz, Dominik, Montravers, Philippe, Kumar, Anand, Roberts, Jason A., Vincent, Jean-Louis, Watkins, Richard R., Lowman, Warren, Spellberg, Brad, Abbott, Iain J., Adesunkanmi, Abdulrashid Kayode, Al-Dahir, Sara, Al-Hasan, Majdi N., Agresta, Ferdinando, Althani, Asma A., Ansari, Shamshul, Ansumana, Rashid, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J., Baraket, Oussama, Bhangu, Aneel, Beltran, Marcelo A., Bernhard, Michael, Biffl, Walter L., Boermeester, Marja A., Brecher, Stephen M., Cherry-Bukowiec, Jill R., Buyne, Otmar R., Cainzos, Miguel A., Cairns, Kelly A., Camacho-Ortiz, Adrian, Chandy, Sujith J., Jusoh, Asri Che, Chichom-Mefire, Alain, Colijn, Caroline, Corcione, Francesco, Cui, Yunfeng, Curcio, Daniel, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, Dhingra, Sameer, Diaz, Jose J., Di Carlo, Isidoro, Dillip, Angel, Di Saverio, Salomone, Doyle, Michael P., Dorj, Gereltuya, Dogjani, Agron, Dupont, Herve, Eachempati, Soumitra R., Enani, Mushira Abdulaziz, Egiev, Valery N., Elmangory, Mutasim M., Ferrada, Paula, Fitchett, Joseph R., Fraga, Gustavo P., Guessennd, Nathalie, Giamarellou, Helen, Ghnnam, Wagih, Gkiokas, George, Goldberg, Staphanie R., Gomes, Carlos Augusto, Gomi, Harumi, Guzman-Blanco, Manuel, Haque, Mainul, Hansen, Sonja, Hecker, Andreas, Heizmann, Wolfgang R., Herzog, Torsten, Hodonou, Adrien Montcho, Hong, Suk-Kyung, Kafka-Ritsch, Reinhold, Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar, Kees, Martin G., Kenig, Jakub, Kiguba, Ronald, Kim, Peter K., Kluger, Yoram, Khokha, Vladimir, Koike, Kaoru, Kok, Kenneth Y. Y., Kong, Victory, Knox, Matthew C., Inaba, Kenji, Isik, Arda, Iskandar, Katia, Ivatury, Rao R., Labbate, Maurizio, Labricciosa, Francesco M., Laterre, Pierre-Francois, Latifi, Rifat, Lee, Jae Gil, Lee, Young Ran, Leone, Marc, Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Loho, Tonny, Maegele, Marc, Malama, Sydney, Marei, Hany E., Martin-Loeches, Ignacio, Marwah, Sanjay, Massele, Amos, McFarlane, Michael, Melo, Renato Bessa, Negoi, Ionut, Nicolau, David P., Nord, Carl Erik, Ofori-Asenso, Richard, Omari, AbdelKarim H., Ordonez, Carlos A., Ouadii, Mouaqit, Pereira Junior, Gerson Alves, Piazza, Diego, Pupelis, Guntars, Rawson, Timothy Miles, Rems, Miran, Rizoli, Sandro, Rocha, Claudio, Sakakhushev, Boris, Sanchez-Garcia, Miguel, Sato, Norio, Lohse, Helmut A. Segovia, Sganga, Gabriele, Siribumrungwong, Boonying, Shelat, Vishal G., Soreide, Kjetil, Soto, Rodolfo, Talving, Peep, Tilsed, Jonathan V., Timsit, Jean-Francois, Trueba, Gabriel, Trung, Ngo Tat, Ulrych, Jan, van Goor, Harry, Vereczkei, Andras, Vohra, Ravinder S., Wani, Imtiaz, Uhl, Waldemar, Xiao, Yonghong, Yuan, Kuo-Ching, Zachariah, Sanoop K., Zahar, Jean-Ralph, Zakrison, Tanya L., Corcione, Antonio, Melotti, Rita M., Viscoli, Claudio, Viale, Perluigi, Sartelli, Massimo, Weber, Dieter G., Ruppe, Etienne, Bassetti, Matteo, Wright, Brian J., Ansaloni, Luca, Catena, Fausto, Coccolini, Federico, Abu-Zidan, Fikri M., Coimbra, Raul, Moore, Ernest E., Moore, Frederick A., Maier, Ronald V., De Waele, Jan J., Kirkpatrick, Andrew W., Griffiths, Ewen A., Eckmann, Christian, Brink, Adrian J., Mazuski, John E., May, Addison K., Sawyer, Rob G., Mertz, Dominik, Montravers, Philippe, Kumar, Anand, Roberts, Jason A., Vincent, Jean-Louis, Watkins, Richard R., Lowman, Warren, Spellberg, Brad, Abbott, Iain J., Adesunkanmi, Abdulrashid Kayode, Al-Dahir, Sara, Al-Hasan, Majdi N., Agresta, Ferdinando, Althani, Asma A., Ansari, Shamshul, Ansumana, Rashid, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J., Baraket, Oussama, Bhangu, Aneel, Beltran, Marcelo A., Bernhard, Michael, Biffl, Walter L., Boermeester, Marja A., Brecher, Stephen M., Cherry-Bukowiec, Jill R., Buyne, Otmar R., Cainzos, Miguel A., Cairns, Kelly A., Camacho-Ortiz, Adrian, Chandy, Sujith J., Jusoh, Asri Che, Chichom-Mefire, Alain, Colijn, Caroline, Corcione, Francesco, Cui, Yunfeng, Curcio, Daniel, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, Dhingra, Sameer, Diaz, Jose J., Di Carlo, Isidoro, Dillip, Angel, Di Saverio, Salomone, Doyle, Michael P., Dorj, Gereltuya, Dogjani, Agron, Dupont, Herve, Eachempati, Soumitra R., Enani, Mushira Abdulaziz, Egiev, Valery N., Elmangory, Mutasim M., Ferrada, Paula, Fitchett, Joseph R., Fraga, Gustavo P., Guessennd, Nathalie, Giamarellou, Helen, Ghnnam, Wagih, Gkiokas, George, Goldberg, Staphanie R., Gomes, Carlos Augusto, Gomi, Harumi, Guzman-Blanco, Manuel, Haque, Mainul, Hansen, Sonja, Hecker, Andreas, Heizmann, Wolfgang R., Herzog, Torsten, Hodonou, Adrien Montcho, Hong, Suk-Kyung, Kafka-Ritsch, Reinhold, Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar, Kees, Martin G., Kenig, Jakub, Kiguba, Ronald, Kim, Peter K., Kluger, Yoram, Khokha, Vladimir, Koike, Kaoru, Kok, Kenneth Y. Y., Kong, Victory, Knox, Matthew C., Inaba, Kenji, Isik, Arda, Iskandar, Katia, Ivatury, Rao R., Labbate, Maurizio, Labricciosa, Francesco M., Laterre, Pierre-Francois, Latifi, Rifat, Lee, Jae Gil, Lee, Young Ran, Leone, Marc, Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Loho, Tonny, Maegele, Marc, Malama, Sydney, Marei, Hany E., Martin-Loeches, Ignacio, Marwah, Sanjay, Massele, Amos, McFarlane, Michael, Melo, Renato Bessa, Negoi, Ionut, Nicolau, David P., Nord, Carl Erik, Ofori-Asenso, Richard, Omari, AbdelKarim H., Ordonez, Carlos A., Ouadii, Mouaqit, Pereira Junior, Gerson Alves, Piazza, Diego, Pupelis, Guntars, Rawson, Timothy Miles, Rems, Miran, Rizoli, Sandro, Rocha, Claudio, Sakakhushev, Boris, Sanchez-Garcia, Miguel, Sato, Norio, Lohse, Helmut A. Segovia, Sganga, Gabriele, Siribumrungwong, Boonying, Shelat, Vishal G., Soreide, Kjetil, Soto, Rodolfo, Talving, Peep, Tilsed, Jonathan V., Timsit, Jean-Francois, Trueba, Gabriel, Trung, Ngo Tat, Ulrych, Jan, van Goor, Harry, Vereczkei, Andras, Vohra, Ravinder S., Wani, Imtiaz, Uhl, Waldemar, Xiao, Yonghong, Yuan, Kuo-Ching, Zachariah, Sanoop K., Zahar, Jean-Ralph, Zakrison, Tanya L., Corcione, Antonio, Melotti, Rita M., Viscoli, Claudio, and Viale, Perluigi
Abstract: Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.
Published: 2016

43. A Systematic Review of the Definitions, Determinants, and Clinical Outcomes of Antimicrobial De-escalation in the Intensive Care Unit

Author: European Society of Intensive Care Medicine, National Health and Medical Research Council (Australia), Tabah, Alexis, Osbert Cotta, Menino, Garnacho-Montero, José, Schouten, Jeroen, Roberts, Jason A., Lipman, Jeffrey, Tacey, Mark, Timsit, Jean-François, Leone, Marc, Zahar, Jean Ralph, De Waele, Jan J., European Society of Intensive Care Medicine, National Health and Medical Research Council (Australia), Tabah, Alexis, Osbert Cotta, Menino, Garnacho-Montero, José, Schouten, Jeroen, Roberts, Jason A., Lipman, Jeffrey, Tacey, Mark, Timsit, Jean-François, Leone, Marc, Zahar, Jean Ralph, and De Waele, Jan J.
Abstract: Antimicrobial de-escalation (ADE) is a strategy to reduce the spectrum of antimicrobials and aims to prevent the emergence of bacterial resistance. We present a systematic review describing the definitions, determinants and outcomes associated with ADE. We included 2 randomized controlled trials and 12 cohort studies. There was considerable variability in the definition of ADE. It was more frequently performed in patients with broad-spectrum and/or appropriate antimicrobial therapy (P = .05 to .002), when more agents were used (P = .002), and in the absence of multidrug-resistant pathogens (P < .05). Where investigated, lower or improving severity scores were consistently associated with ADE (P = .04 to <.001). The pooled effect of ADE on mortality is protective (relative risk, 0.68; 95% confidence interval, .52–.88). Because the determinants of ADE are markers of clinical improvement and/or of lower risk of treatment failure this effect on mortality cannot be retained as evidence. None of the studies were designed to investigate the effect of ADE on antimicrobial resistance.
Published: 2016

44. Antimicrobials: A global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Author: Sartelli, Massimo, Weber, Dieter G., Ruppé, Etienne, Bassetti, Matteo, Wright, Brian J., Ansaloni, Luca, Catena, Fausto, Coccolini, Federico, Abu Zidan, Fikri M., Coimbra, Raul, Moore, Ernest E., Moore, Frederick A., Maier, Ronald V., De Waele, Jan J., Kirkpatrick, Andrew W., Griffiths, Ewen A., Eckmann, Christian, Brink, Adrian J., Mazuski, John E., May, Addison K., Sawyer, Rob G., Mertz, Dominik, Montravers, Philippe, Kumar, Anand, Roberts, Jason A., Vincent, Jean Loui, Watkins, Richard R., Lowman, Warren, Spellberg, Brad, Abbott, Iain J., Adesunkanmi, Abdulrashid Kayode, Al Dahir, Sara, Al Hasan, Majdi N., Agresta, Ferdinando, Althani, Asma A., Ansari, Shamshul, Ansumana, Rashid, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J., Baraket, Oussama, Bhangu, Aneel, Beltrán, Marcelo A., Bernhard, Michael, Biffl, Walter L., Boermeester, Marja A., Brecher, Stephen M., Cherry Bukowiec, Jill R., Buyne, Otmar R., Cainzos, Miguel A., Cairns, Kelly A., Camacho Ortiz, Adrian, Chandy, Sujith J., Che Jusoh, Asri, Chichom Mefire, Alain, Colijn, Caroline, Corcione, Francesco, Cui, Yunfeng, Curcio, Daniel, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, Dhingra, Sameer, Diaz, José J., Di Carlo, Isidoro, Dillip, Angel, Di Saverio, Salomone, Doyle, Michael P., Dorj, Gereltuya, Dogjani, Agron, Dupont, Hervé, Eachempati, Soumitra R., Enani, Mushira Abdulaziz, Egiev, Valery N., Elmangory, Mutasim M., Ferrada, Paula, Fitchett, Joseph R., Fraga, Gustavo P., Guessennd, Nathalie, Giamarellou, Helen, Ghnnam, Wagih, Gkiokas, George, Goldberg, Staphanie R., Gomes, Carlos Augusto, Gomi, Harumi, Guzmán Blanco, Manuel, Haque, Mainul, Hansen, Sonja, Hecker, Andrea, Heizmann, Wolfgang R., Herzog, Torsten, Hodonou, Adrien Montcho, Hong, Suk Kyung, Kafka Ritsch, Reinhold, Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar, Kees, Martin G., Kenig, Jakub, Kiguba, Ronald, Kim, Peter K., Kluger, Yoram, Khokha, Vladimir, Koike, Kaoru, Kok, Kenneth Y. Y., Kong, Victory, Knox, Matthew C., Inaba, Kenji, Isik, Arda, Iskandar, Katia, Ivatury, Rao R., Labbate, Maurizio, Labricciosa, Francesco M., Laterre, Pierre Françoi, Latifi, Rifat, Lee, Jae Gil, Lee, Young Ran, Leone, Marc, Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Loho, Tonny, Maegele, Marc, Malama, Sydney, Marei, Hany E., Martin Loeches, Ignacio, Marwah, Sanjay, Massele, Amo, Mcfarlane, Michael, Melo, Renato Bessa, Negoi, Ionut, Nicolau, David P., Nord, Carl Erik, Ofori Asenso, Richard, Omari, AbdelKarim H., Ordonez, Carlos A., Ouadii, Mouaqit, Pereira Júnior, Gerson Alve, Piazza, Diego, Pupelis, Guntar, Rawson, Timothy Mile, Rems, Miran, Rizoli, Sandro, Rocha, Claudio, Sakakhushev, Bori, Sanchez Garcia, Miguel, Sato, Norio, Segovia Lohse, Helmut A., Sganga, Gabriele, Siribumrungwong, Boonying, Shelat, Vishal G., Soreide, Kjetil, Soto, Rodolfo, Talving, Peep, Tilsed, Jonathan V., Timsit, Jean Francoi, Trueba, Gabriel, Trung, Ngo Tat, Ulrych, Jan, van Goor, Harry, Vereczkei, Andra, Vohra, Ravinder S., Wani, Imtiaz, Uhl, Waldemar, Xiao, Yonghong, Yuan, Kuo Ching, Zachariah, Sanoop K., Zahar, Jean Ralph, Zakrison, Tanya L., Corcione, Antonio, Melotti, Rita M., Viscoli, Claudio, Viale, Perluigi, Sganga, Gabriele (ORCID:0000-0001-5079-0395), Sartelli, Massimo, Weber, Dieter G., Ruppé, Etienne, Bassetti, Matteo, Wright, Brian J., Ansaloni, Luca, Catena, Fausto, Coccolini, Federico, Abu Zidan, Fikri M., Coimbra, Raul, Moore, Ernest E., Moore, Frederick A., Maier, Ronald V., De Waele, Jan J., Kirkpatrick, Andrew W., Griffiths, Ewen A., Eckmann, Christian, Brink, Adrian J., Mazuski, John E., May, Addison K., Sawyer, Rob G., Mertz, Dominik, Montravers, Philippe, Kumar, Anand, Roberts, Jason A., Vincent, Jean Loui, Watkins, Richard R., Lowman, Warren, Spellberg, Brad, Abbott, Iain J., Adesunkanmi, Abdulrashid Kayode, Al Dahir, Sara, Al Hasan, Majdi N., Agresta, Ferdinando, Althani, Asma A., Ansari, Shamshul, Ansumana, Rashid, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J., Baraket, Oussama, Bhangu, Aneel, Beltrán, Marcelo A., Bernhard, Michael, Biffl, Walter L., Boermeester, Marja A., Brecher, Stephen M., Cherry Bukowiec, Jill R., Buyne, Otmar R., Cainzos, Miguel A., Cairns, Kelly A., Camacho Ortiz, Adrian, Chandy, Sujith J., Che Jusoh, Asri, Chichom Mefire, Alain, Colijn, Caroline, Corcione, Francesco, Cui, Yunfeng, Curcio, Daniel, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, Dhingra, Sameer, Diaz, José J., Di Carlo, Isidoro, Dillip, Angel, Di Saverio, Salomone, Doyle, Michael P., Dorj, Gereltuya, Dogjani, Agron, Dupont, Hervé, Eachempati, Soumitra R., Enani, Mushira Abdulaziz, Egiev, Valery N., Elmangory, Mutasim M., Ferrada, Paula, Fitchett, Joseph R., Fraga, Gustavo P., Guessennd, Nathalie, Giamarellou, Helen, Ghnnam, Wagih, Gkiokas, George, Goldberg, Staphanie R., Gomes, Carlos Augusto, Gomi, Harumi, Guzmán Blanco, Manuel, Haque, Mainul, Hansen, Sonja, Hecker, Andrea, Heizmann, Wolfgang R., Herzog, Torsten, Hodonou, Adrien Montcho, Hong, Suk Kyung, Kafka Ritsch, Reinhold, Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar, Kees, Martin G., Kenig, Jakub, Kiguba, Ronald, Kim, Peter K., Kluger, Yoram, Khokha, Vladimir, Koike, Kaoru, Kok, Kenneth Y. Y., Kong, Victory, Knox, Matthew C., Inaba, Kenji, Isik, Arda, Iskandar, Katia, Ivatury, Rao R., Labbate, Maurizio, Labricciosa, Francesco M., Laterre, Pierre Françoi, Latifi, Rifat, Lee, Jae Gil, Lee, Young Ran, Leone, Marc, Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Loho, Tonny, Maegele, Marc, Malama, Sydney, Marei, Hany E., Martin Loeches, Ignacio, Marwah, Sanjay, Massele, Amo, Mcfarlane, Michael, Melo, Renato Bessa, Negoi, Ionut, Nicolau, David P., Nord, Carl Erik, Ofori Asenso, Richard, Omari, AbdelKarim H., Ordonez, Carlos A., Ouadii, Mouaqit, Pereira Júnior, Gerson Alve, Piazza, Diego, Pupelis, Guntar, Rawson, Timothy Mile, Rems, Miran, Rizoli, Sandro, Rocha, Claudio, Sakakhushev, Bori, Sanchez Garcia, Miguel, Sato, Norio, Segovia Lohse, Helmut A., Sganga, Gabriele, Siribumrungwong, Boonying, Shelat, Vishal G., Soreide, Kjetil, Soto, Rodolfo, Talving, Peep, Tilsed, Jonathan V., Timsit, Jean Francoi, Trueba, Gabriel, Trung, Ngo Tat, Ulrych, Jan, van Goor, Harry, Vereczkei, Andra, Vohra, Ravinder S., Wani, Imtiaz, Uhl, Waldemar, Xiao, Yonghong, Yuan, Kuo Ching, Zachariah, Sanoop K., Zahar, Jean Ralph, Zakrison, Tanya L., Corcione, Antonio, Melotti, Rita M., Viscoli, Claudio, Viale, Perluigi, and Sganga, Gabriele (ORCID:0000-0001-5079-0395)
Abstract: Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.
Published: 2016

45. WSACS--The Abdominal Compartment Society. A Society dedicated to the study of the physiology and pathophysiology of the abdominal compartment and its interactions with all organ systems.

Author: Kirkpatrick, Andrew W, De Waele, Jan J, De Laet, Inneke, De Keulenaer, Bart L, D'Amours, Scott, Björck, Martin, Balogh, Zsolt J, Leppäniemi, Ari, Kaplan, Mark, Chiaka Ejike, Janeth, Reintam Blaser, Annika, Sugrue, Michael, Ivatury, Rao R, Malbrain, Manu L N G, Kirkpatrick, Andrew W, De Waele, Jan J, De Laet, Inneke, De Keulenaer, Bart L, D'Amours, Scott, Björck, Martin, Balogh, Zsolt J, Leppäniemi, Ari, Kaplan, Mark, Chiaka Ejike, Janeth, Reintam Blaser, Annika, Sugrue, Michael, Ivatury, Rao R, and Malbrain, Manu L N G
Published: 2015
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46. How to deal with an open abdomen?

Author: De Waele, Jan J, Kaplan, Mark, Sugrue, Michael, Sibaja, Pablo, Björck, Martin, De Waele, Jan J, Kaplan, Mark, Sugrue, Michael, Sibaja, Pablo, and Björck, Martin
Abstract: Appropriate open abdomen treatment is one of the key elements in the management of patients who require decompressive laparotomy or in whom the abdomen is left open prophylactically. Apart from fluid control and protection from external injury, fluid evacuation and facilitation of early closure are now the goals of open abdomen treatment. Abdominal negative pressure therapy has emerged as the most appropriate method to reach these goals. Especially when combined with strategies that allow progressive approximation of the fascial edges, high closure rates can be obtained. Intra-abdominal pressure measurement can be used to guide the surgical strategy and continued attention to intra-abdominal hypertension is necessary. This paper reviews recent advances as well as identifying the remaining challenges in patients requiring open abdomen treatment. The new classification system of the open abdomen is an important tool to use when comparing the efficacy of different strategies, as well as different systems of temporary abdominal closure.
Published: 2015
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47. 'Piece' of mind: End of life in the intensive care unit Statement of the Belgian Society of Intensive Care Medicine

Author: UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, UCL - (SLuc) Service de soins intensifs, UCL - (MGD) Services des soins intensifs, Vincent, Jean-Louis, Schetz, Miet, De Waele, Jan J., Clément de Cléty, Stéphan, Michaux, Isabelle, Sottiaux, Thierry, Hoste, Eric, Ledoux, Didier, De Weerdt, Annick, Wilmer, Alexander, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, UCL - (SLuc) Service de soins intensifs, UCL - (MGD) Services des soins intensifs, Vincent, Jean-Louis, Schetz, Miet, De Waele, Jan J., Clément de Cléty, Stéphan, Michaux, Isabelle, Sottiaux, Thierry, Hoste, Eric, Ledoux, Didier, De Weerdt, Annick, and Wilmer, Alexander
Published: 2014

48. Intra-abdominal pressure measurement using a U-tube technique : caveat emptor!

Author: De Waele, Jan J., Cheatham, Michael L., Balogh, Zsolt, Björck, Martin, D'Amours, Scott, De Keulenaer, Bart, Ivatury, Rao, Kirkpatrick, Andrew W, Leppaniemi, Ari, Malbrain, Manu, Sugrue, Michael, De Waele, Jan J., Cheatham, Michael L., Balogh, Zsolt, Björck, Martin, D'Amours, Scott, De Keulenaer, Bart, Ivatury, Rao, Kirkpatrick, Andrew W, Leppaniemi, Ari, Malbrain, Manu, and Sugrue, Michael
Published: 2010
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49. Clinical review: Intra-abdominal hypertension: Does it influence the physiology of prone ventilation?

Author: Kirkpatrick, Andrew W., Pelosi, Paolo, De Waele, Jan J., Malbrain, Manu L.N.G., Ball, Chad G., Meade, Maureen O., Stelfox, Henry T., Laupland, Kevin B., Kirkpatrick, Andrew W., Pelosi, Paolo, De Waele, Jan J., Malbrain, Manu L.N.G., Ball, Chad G., Meade, Maureen O., Stelfox, Henry T., and Laupland, Kevin B.
Abstract: Prone ventilation (PV) is a ventilatory strategy that frequently improves oxygenation and lung mechanics in critical illness, yet does not consistently improve survival. While the exact physiologic mechanisms related to these benefits remain unproven, one major theoretical mechanism relates to reducing the abdominal encroachment upon the lungs. Concurrent to this experience is increasing recognition of the ubiquitous role of intra-abdominal hypertension (IAH) in critical illness, of the relationship between IAH and intra-abdominal volume or thus the compliance of the abdominal wall, and of the potential difference in the abdominal influences between the extrapulmonary and pulmonary forms of acute respiratory distress syndrome. The present paper reviews reported data concerning intra-abdominal pressure (IAP) in association with the use of PV to explore the potential influence of IAH. While early authors stressed the importance of gravitationally unloading the abdominal cavity to unencumber the lung bases, this admonition has not been consistently acknowledged when PV has been utilized. Basic data required to understand the role of IAP/IAH in the physiology of PV have generally not been collected and/or reported. No randomized controlled trials or meta-analyses considered IAH in design or outcome. While the act of proning itself has a variable reported effect on IAP, abundant clinical and laboratory data confirm that the thoracoabdominal cavities are intimately linked and that IAH is consistently transmitted across the diaphragm - although the transmission ratio is variable and is possibly related to the compliance of the abdominal wall. Any proning-related intervention that secondarily influences IAP/IAH is likely to greatly influence respiratory mechanics and outcomes. Further study of the role of IAP/IAH in the physiology and outcomes of PV in hypoxemic respiratory failure is thus required. Theories relating inter-relations between prone positioning and the abdo
Published: 2010

50. An international, multicentre survey of β-lactam antibiotic therapeutic drug monitoring practice in intensive care units

Author: Wong, Gloria, Brinkman, Alexander, Benefield, Russell J., Carlier, Mieke, De Waele, Jan J., El Helali, Najoua, Frey, Otto, Harbarth, Stephan, Huttner, Angela, McWhinney, Brett, Misset, Benoit, Pea, Federico, Preisenberger, Judit, Roberts, Michael S., Robertson, Thomas A., Roehr, Anka, Sime, Fekade Bruck, Taccone, Fabio Silvio, Ungerer, Jacobus P. J., Lipman, Jeffrey, Roberts, Jason A., Wong, Gloria, Brinkman, Alexander, Benefield, Russell J., Carlier, Mieke, De Waele, Jan J., El Helali, Najoua, Frey, Otto, Harbarth, Stephan, Huttner, Angela, McWhinney, Brett, Misset, Benoit, Pea, Federico, Preisenberger, Judit, Roberts, Michael S., Robertson, Thomas A., Roehr, Anka, Sime, Fekade Bruck, Taccone, Fabio Silvio, Ungerer, Jacobus P. J., Lipman, Jeffrey, and Roberts, Jason A.
Abstract: Objectives Emerging evidence supports the use of therapeutic drug monitoring (TDM) of β-lactams for intensive care unit (ICU) patients to optimize drug exposure, although limited detail is available on how sites run this service in practice. This multicentre survey study was performed to describe the various approaches used for β-lactam TDM in ICUs. Methods A questionnaire survey was developed to describe various aspects relating to the conduct of β-lactam TDM in an ICU setting. Data sought included: β-lactams chosen for TDM, inclusion criteria for selecting patients, blood sampling strategy, analytical methods, pharmacokinetic (PK)/pharmacodynamic (PD) targets and dose adjustment strategies. Results Nine ICUs were included in this survey. Respondents were either ICU or infectious disease physicians, pharmacists or clinical pharmacologists. Piperacillin (co-formulated with tazobactam) and meropenem (100% of units surveyed) were the β-lactams most commonly subject to TDM, followed by ceftazidime (78%), ceftriaxone (43%) and cefazolin (43%). Different chromatographic and microbiological methods were used for assay of β-lactam concentrations in blood and other biological fluids (e.g. CSF). There was significant variation in the PK/PD targets (100% fT>MIC up to 100% fT>4×MIC) and dose adjustment strategies used by each of the sites. Conclusions Large variations were found in the type of β-lactams tested, the patients selected for TDM and drug assay methods. Significant variation observed in the PK/PD targets and dose adjustment strategies used supports the need for further studies that robustly define PK/PD targets for ICU patients to ensure a greater consistency of practice for dose adjustment strategies for optimizing β-lactam dosing with TDM

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