ESICM Talk ESICM

To date, no specific pharmacotherapy has proven effective against acute respiratory distress syndrome ARDS. Results on the research domain have been ineffective in human trials, a gap attributed in part to clinical and biological heterogeneity in human ARDS. Therefore, a precision medicine approach is intended to address explicitly how such underlying heterogeneity influences response to therapy among different patients with the same diagnosis. “You can find treatment for the disease but not for syndromes and ICU is a syndrome-forward approach to patient care” says Dr Pratik Sinha who is working on ARDS phenotyping.
Listen to his interview and learn more about ARDS from disease understanding to future bedside perspectives.

Cardiogenic shock accounts for up to 5% of acute heart failure presentations and around 14–16% of patients reported in cardiac intensive care datasets. It complicates up to 15% of all myocardial infarctions and is the leading cause of death post-infarction. Using pharmacological agents alone may increase left ventricular afterload and myocardial oxygen demand, resulting in complications. Thus, mechanical circulatory support (MCS) devices have emerged as important therapeutic options. As evidence remains uncertain, MCS selection depends on clinician preference and local availability.
An updated systematic review and meta-analysis of high-quality RCTs and propensity score-matched studies (PSMs) was performed to compare the outcomes of MCS devices with no MCS and each other and investigate which MCS is the most effective in reducing mortality.
To learn more about the findings of this study listen to this podcast.

The communication between families of critically ill patients who manifest prolonged disturbances in the consciousness such as patients under sedation, in a coma, or delirium, and the caregivers became very difficult during the stay of the patient in the ICU.
On the other side, the memories of the patients are distressing and confusing and make the ICU experience for this patient very unpleasant.
To overcome these difficulties and to bridge the communication, written diaries by nurses and families for and to the patients are recommended during the ICU stay.
You will get a more detailed description of ICU diaries from the guests in our next podcast – the first one of 2024 from the ESICM N&AHP group.

Professional burnout has been described by WHO as a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed. Intensive care unit (ICU) professionals are at high risk of experiencing burnout due to the presence of patients with life-threatening illnesses, the observed discrepancies in job demands, responsibility overload, workload, end-of-life issues, perception of futility and other constituting potential stressors. To talk about the prevalence, outcomes, ethical implications and management strategies of ICU professional burnout we have interviewed Dr. Michalsen. Listen to the interview in the following podcast.

Acute respiratory distress syndrome (ARDS) remains a life-threatening syndrome, resulting in high morbidity and mortality. In ARDS patients and mechanically ventilated critically ill patients, two distinct subphenotypes, presenting hyper- and non-hyperinflammatory characteristics, have been identified.
Studies show that early identification of the inflammatory subphenotypes in patients at risk of ARDS could serve as a predictive or prognostic strategy that will lead to an early intervention and individualization of care.
A study has been carried out to prove the hypothesis that the inflammatory subphenotypes are present before ARDS development in at-risk patients presenting to the emergency department and remain identifiable over time.
To learn more about the methods and findings of this study listen to the next podcast.