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The ESAIC is dedicated to supporting professionals in anaesthesiology and intensive care by serving as the hub for development and dissemination of valuable educational, scientific, research, and networking resources.


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Congresses

The ESAIC hosts the Euroanaesthesia and Focus Meeting congresses that serve as platforms for cutting-edge science and innovation in the field. These events bring together experts, foster networking, and facilitate knowledge exchange in anaesthesiology, intensive care, pain management, and perioperative medicine. Euroanaesthesia is one of the world’s largest and most influential scientific congresses for anaesthesia professionals. Held annually throughout Europe, our congress is a contemporary event geared towards education, knowledge exchange and innovation in anaesthesia, intensive care, pain and perioperative medicine, as well as a platform for immense international visibility for scientific research.


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Professional Growth

The ESAIC's mission is to foster and provide exceptional training and educational opportunities. The ESAIC ensures the provision of robust and standardised examination and certification systems to support the professional development of anaesthesiologists and to ensure outstanding future doctors in the field of anaesthesiology and intensive care.


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Research

The ESAIC aims to advance patient outcomes and contribute to the progress of anaesthesiology and intensive care evidence-based practice through research. The ESAIC Clinical Trial Network (CTN), the Academic Contract Research Organisation (A-CRO), the Research Groups and Grants all contribute to the knowledge and clinical advances in the peri-operative setting.


Learn more about the ESAIC Clinical Trial Network (CTN) and the associated studies.

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EU Projects

The ESAIC is actively involved as a consortium member in numerous EU funded projects. Together with healthcare leaders and practitioners, the ESAIC's involvement as an EU project partner is another way that it is improving patient outcomes and ensuring the best care for every patient.


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Patient Safety

The ESAIC aims to promote the professional role of anaesthesiologists and intensive care physicians and enhance perioperative patient outcomes by focusing on quality of care and patient safety strategies. The Society is committed to implementing the Helsinki Declaration and leading patient safety projects.


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Sustainability

To ESAIC is committed to implementing the Glasgow Declaration and drive initiatives towards greater environmental sustainability across anaesthesiology and intensive care in Europe.


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Partnerships

The ESAIC works in collaboration with industry, national societies, and specialist societies to promote advancements in anaesthesia and intensive care. The Industry Partnership offers visibility and engagement opportunities for industry participants with ESAIC members, facilitating understanding of specific needs in anaesthesiology and in intensive care. This partnership provides resources for education and avenues for collaborative projects enhancing science, education, and patient safety. The Specialist Societies contribute to high-quality educational opportunities for European anaesthesiologists and intensivists, fostering discussion and sharing, while the National Societies, through NASC, maintain standards, promote events and courses, and facilitate connections. All partnerships collectively drive dialogue, learning, and growth in the anaesthesiology and intensive care sector.


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Guidelines

Guidelines play a crucial role in delivering evidence-based recommendations to healthcare professionals. Within the fields of anaesthesia and intensive care, guidelines are instrumental in standardizing clinical practices and enhancing patient outcomes. For many years, the ESAIC has served as a pivotal platform for facilitating continuous advancements, improving care standards and harmonising clinical management practices across Europe.


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Publications

With over 40 years of publication history, the EJA (European Journal of Anaesthesiology) has established itself as a highly respected and influential journal in its field. It covers a wide range of topics related to anaesthesiology and intensive care medicine, including perioperative medicine, pain management, critical care, resuscitation, and patient safety.


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Membership

Becoming a member of ESAIC implies becoming a part of a vibrant community of nearly 8,000 professionals who exchange best practices and stay updated on the latest developments in anaesthesiology, intensive care and perioperative medicine. ESAIC membership equips you with the tools and resources necessary to enhance your daily professional routine, nurture your career growth, and play an active role in advancing anaesthesiology, intensive care and perioperative medicine.


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Newsletter 2021

Newsletter August 2021: Robotic Anaesthesia

Chief editor note: we continue our tradition of inserting, here and in the next issues, some abstracts of paper to be presented at the next Euroanaesthesia, December 2021

Sean Coeckelenbergh, M.D.1, Alexandre Joosten, M.D. Ph.D.1,2
joosten-alexandre@hotmail.com

Automatisation and robotics are all around us. Self-driving cars are a reality, aeroplane autopilot has been the norm for years, and even the thermostats in our operating rooms use a closed-loop circuit to maintain an often freezing cold predetermined temperature. Nonetheless, the majority of our medical monitoring systems have no function beyond displaying data to clinicians. If computer systems can drive cars and fly planes safely surely there is more they can be doing for patient care than just displaying numbers on a screen!

Intensive care or operating room patients often require constant assessment and optimisation for considerable periods of time (from hours to weeks). Anaesthetics, vasopressors, fluids and other therapies are useful, but also dangerous, drugs that need to be delivered effectively. This remains today a challenge in perioperative and intensive care medicine. As Peter Pronovost from Johns Hopkins Hospital said:

The fundamental problem with the quality of medicine is that we’ve failed to view delivery of health care as a science. The tasks of medical science fall into three buckets. One is understanding disease biology. One is finding effective therapies. And one is ensuring those therapies are delivered effectively. That third bucket has been almost totally ignored by research funders, government, and academia. It’s viewed as the art of medicine. That’s a mistake, a huge mistake. And from a taxpayer’s perspective it’s outrageous.”

Why do planes have autopilot? Why does our thermostat operate using a closed-loop system? Why do countless other contemporary tools depend on robotic systems? The answer is simple: for repetitive tasks that require constant assessment, automated systems work better than humans. In other words, for therapies that require constant evaluation and modification, robotic systems are more effective at ensuring therapeutic delivery with less under-and over-treatment.1,2 While we get bored very quickly with such tasks, a robot will never get bored. It’s the same in aeronautics, engineering, medicine, anaesthesia, and intensive care. Time after time automated robotic systems have been shown to have higher compliance to a predetermined protocol, and compliance is essential. We can have access to all the monitors and therapies in the world, but if we do not apply a clear protocol with high compliance, we won’t have any conclusive results.

Closed-loop robotic systems have been available for several decades. 3 Many of today’s anaesthesia machines can maintain a predetermined gas concentration (oxygen, nitrous oxide, halogenated ethers) using closed-loop systems. Titration of propofol and remifentanil using robotic technology that assesses electroencephalographic changes to then infuse the anaesthetics and maintain a steady-state was an early step in introducing such systems in the operating room. Even a closed-loop vasodilator system was developed over 20 years ago to avoid hypertension during cardiac surgery. More recently, a renewed effort to couple goal-directed haemodynamic therapy to closed-loop robotic systems has gained substantial ground.4-7

Over the past decade, several key studies have shown the potential of using robotically controlled (i.e., automated) haemodynamic closed-loop systems in the operating room and intensive care setting.8-12 Initial studies focused on the development of a closed-loop robotic system capable of interpreting the patient’s fluid status and administering fluid boluses when necessary.11,12 This tool, which was validated in silico and in vivo with both crystalloids and colloids, was found to maintain patients longer in a fluid-independent state than clinicians and was linked to the improved postoperative outcome and shorter hospital length of stay when compared to standard care fluid therapy in patients undergoing major abdominal surgery.13 The next step was to develop a robotic closed-loop vasopressor system. 9,14-16Again, tested both in silico and in vivo this system was shown to maintain blood pressure in target more often and with less variation than when vasopressors were administered by a physician or intensive care nurse.17,18 In other words, these systems are able to more consistently apply the predetermined therapy in order to optimise the patient’s hemodynamics.

Haemodynamics, though essential, is not the only component of perioperative and intensive care medicine. The future lies in integrating all these robotic systems with one mother controller (i.e., a coordinator controller/robot) that can interpret the input and output from all systems. Although combining different robotic systems that work independently during anaesthesia for major abdominal surgery was shown to be feasible19 and even beneficial for postoperative cognitive function when compared to standard care non-robotic anaesthesia,20,21 a centralized robotic controller is yet to be developed. Nonetheless, although still considered as research tools, robotic systems in anaesthesia are here!22 These independent systems can now be implemented at the bedside.3 It is up to us to move forward with their implementation while developing systems that allow fully-fledged coordination of therapies to administer them as effectively as possible.

 

References

  1. Pasin L, Nardelli P, Pintaudi M, et al. Anesth Analg. 2017;124(2): 456-464.
  2. Brogi E, Cyr S, Kazan R, et al. Anesth Analg. 2017;124(2): 446-455.
  3. Zaouter C, Joosten A, Rinehart J, et al. Anesth Analg. 2020;130(5): 1120-1132.
  4. Alexander B, Rinehart J, Cannesson M, et al. Best Pract Res Clin Anaesthesiol. 2019;33(2): 199-209.
  5. Coeckelenbergh S, Zaouter C, Alexander B, et al. J Anesth. 2020;34(1): 104-114.
  6. Joosten A, Alexander B, Delaporte A, et al. Anaesthesiol Intensive Ther. 2015;47(5): 517-523.
  7. Rinehart J, Lee S, Saugel B, et al. Semin Respir Crit Care Med. 2021;42(1): 47-58.
  8. Joosten A, Alexander B, Duranteau J, et al.. Br J Anaesth. 2019;123(4): 430-438.
  9. Joosten A, Delaporte A, Alexander B, et al. Anesthesiology. 2019;130(3): 394-403.
  10. Joosten A, Hafiane R, Pustetto M, et al. J Clin Monit Comput. 2019;33(1): 15-24.
  11. Rinehart J, Lilot M, Lee C, et al. Crit Care. 2015;19(1): 94.
  12. Joosten A, Huynh T, Suehiro K, et al. Br J Anaesth. 2015;114(6): 886-892.
  13. Joosten A, Coeckelenbergh S, Delaporte A, et al. Eur J Anaesthesiol. 2018;35(9): 650-658.
  14. Rinehart J, Joosten A, Ma M, et al. J Clin Monit Comput. 2019;33(5): 795-802.
  15. Rinehart J, Cannesson M, Weeraman S, et al. J Cardiothorac Vasc Anesth. 2020;34(11): 3081-3085.
  16. Joosten A, Coeckelenbergh S, Alexander B, et al. Anaesth Crit Care Pain Med. 2020;39(5): 623-624.
  17. Joosten A, Chirnoaga D, Van der Linden P, et al. Br J Anaesth. 2021;126(1): 210-218.
  18. Joosten A, Rinehart J, Van der Linden P, et al. Anesthesiology. 2021;135(2): 258-272.
  19. Joosten A, Jame V, Alexander B, et al. Anesth Analg. 2019;128(6): e88-e92.
  20. Joosten A, Rinehart J, Bardaji A, et al. Anesthesiology. 2020;132(2): 253-266.
  21. Cotoia A, Mirabella L, Beck R, et al. Minerva Anestesiol. 2018;84(4): 437-446.
  22. Joosten A, Rinehart J. Anesth Analg. 2017;125(1): 20-22.

 

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