ESPNIC GENERAL ASSEMBLY Minutes 7 June 2017, 17:30 – 19:30, Room 5a

Item By Estimated time

1. Welcome/Opening of the meeting Joe BrierleyBarbara Gradel

17:30

2. Approval of minutes of the General Assembly in Geneva in October 2016

All 17:35

P. Rimensberger proposed that the minutes are accepted. M. Kneyber seconded. The minutes are formally accepted.3. Reports of the Presidents Joe Brierley

Barbara Gradel

17:45

A. Medical President- 1. Move to the office from NL to Geneva.

a. The NL should be dissolved by the end of 2017. There are no taxation problems. Effectively, ESPNIC NL is not really in existence except for some paperwork that needs to be sorted out.

b. ESPNIC GE is a legal entity with a bank account. c. We are hoping to have tax exemption granted soon

because tax exemption of societies in Switzerland is standard.

d. The bank balance will be transferred from the Dutch organization to the Swiss organization.

2. Membership is growing. It has started to get more global.3. Baltic States registry. R. Balmak is working in Latvia and trying to

match the Baltic states to work with UK to get a critical care registry started. We have a pilot project and a few meetings with EU officials to discuss funding, but R. Balmaks has also found a private funder that will fund the first year in Latvia.

a. We have a meeting with the EU Commissioner to promote this.

4. Major achievementsa. Established the first intensive care diploma and

credentialing within the speciality. The first beta test of the EPIC diploma has been completed. The program is ready to be launched.

b. Educational activities include Winter school, summer school, BASIC course. We just completed a very successful course in Lisbon with 35 attendees.

c. Successful EAPS 2016 and ESPNIC 2017i. Thanks to Kenes for a conference that ran

smoothly.ii. Thanks to Pierre for his hard work on the

scientific program.iii. We have already received positive feedback.

d. We formally got authorization from UMES paediatric section to set up a multi-disciplinary joint committee of Paediatric intensive care medicine training in UMES European Parliament bodies.

e. Joe handed the position of President to Simon.

B. Nursing Presidenta. Nursing membership is increasing. There are approximate

140 nursing members now.b. ESPNIC delivered sessions around paediatric nursing at

EFCCNA Congress in February in Belfast 2017.c. Nursing science and respiratory section have a joint

publication - VESPER in PCCM (Tume, Blackwood, Kneyber)d. Nursing science and Nutrition sections have undertaken a

study; paper is under review (Tume, Lattne, Valla), also submitted to big UK grant

e. New cardiac, nurse science and nutrition section collaborative project (Tune, da Cruz, Balmaks, verbruggen, Valla) data collection complete and new database of cardiac ICUs across Europe established

f. Input into WFPICCS/ World Congress Singapore 2018- nursing, nutrition and RRS sessions

g. 3rd International Mulitdiciplinary Paediatric Acute and Critical Care Research School in Rome 26 & 27 October hosted by Bambino Gesu hospital - core faculty Tume, Latour, Curley and Ramelet

h. Metacred offered a Nurse-Survey for free, once completed, establish a prototype PICU (then NICU) nurse education online module with exam. First in English then if successful translated

i. Nursing and MEN sections consensus statement on nutrition in critically ill children in development

j. New nursing president Lyvonne Tume, UKk. New President elect Orsola Gawronski, Italy

4. Report of the Secretary Daniele De Luca

18:00

A. Membership statusi. The nursing membership is increasing.

ii. We are approaching 500 medical members.B. Election results-

i. New members, Pierre, Orsola, Frederic, Alberto, Martinii. Thank you to Burkhard, Peter, Odile, Marek

iii. Simon and Lyvonne thanked Joe and Barbara for their contributions.

iv.

5. Medical trainee reporta. The objective is to develop a plan to increase participation of

young professionals and trainees in our society b. With the help of Kenes, we are working on a website rebranding

project and social media, including an interactive PICU and NICU registry. Please use the app to fill out information about your unit and hospital

c. Promotion of ESPNIC activities through national diplomas and other societies

d. Working to introduce a reduced fee for traineesd defined as doctors aged less then 35 years and/or doing a residency/ fellowship/ internship/PhD program;

e. Facebook, LinkedIn, Twitter, please join and stay in contact with us

f. We have a proposal for EAPS 2018 in Paris. We are looking into High Fidelity Simulation, an interesting tool for education and training also in critical care. If you are already running simulation in your hospitals, please join us in helping to build this within our network.

6. Report of the Treasurer Burkhard Simma

18:15

a. Approval of Financial Statements 2016a. The main difference in income is with the conference

numbers and it is because the numbers from 2015 include both Barcelona and Vilnuis

b. The main difference in expenses is due to the educational activities (including investing in the EPIC diploma, and the ESPNIC Academy)

c. Jan Hazelzet proposed accepting the budget and Sophie Skellet seconded.

d. We purposely spent a lot of money in the last few years due to issues with the Dutch tax authority.

e. From this point on, the EPIC diploma program will be financially self sustainable.s

b. Burkhard Simma will handover the position of treasurer to Frederic Valla.

7. Report of the Chair of Scientific Affairs Pierre Tissières

18:30

a. ESPNIC 20171. 1160 registered participants2. 73 countries 3. 496 Abstract speakers4. Pierre Tisseres thanks the section chairs and deputy chairs for

their contributions to the scientific programb. Upcoming elections in 2017- many chair and deputy chair positions will be open. The call for candidates June – August. Voting will be open for 4 weeks. The positions will start in October 2017. Please help in recruitment of new members and chairs. The term is for 3 years and is renewable once. We will distribute the Roles and Duties of section chairs and deputy chairs. Please make sure that your response corresponds to the request put forth.

8. Report of the Sections Section Chairs 18:40Cardiac ICU and Mechanical Circulatory Support

1. Aims and Goals, Mission and Vision 2016-2017 To promote quality improvement, safety, effectiveness and

stewardship To advocate for, implement and audit initiatives, algorithms,

guidelines and recommendations that will decrease variability in practice and increase evidence-based and goal-oriented performance

To envision high level and trans-disciplinary transitional care for adults with congenital heart disease

To implement a “twinning concept” within the ESPNIC and inter-societal in Europe and globally

To energetically support trainees and junior intensivists in their career development

2. Accomplishments 2016-2017 Multiple sessions at ESPNIC 2017 (many collaborative) Workshop on Pediatric Heart Failure and MCS – 06 June 2017 AEPC/EACTS TGA guidelines published in 2017; writing ESPNIC supporting statement AEPC and EACTS Councils have approved collaboration

3. Future recommendations Re-editing AEPC Training Guidelines (Cardiol Young 2011) as the AEPC/ESPNIC Training guidelines (EACTS-endorsed) TEXTBOOK OF INTENSIVE CARE FOR THE ADULT WITH

CONGENITAL HEART DISEASE, Eduardo da Cruz, Duncan Macrae, Gary Webb Eds.,Springer-Verlag London. Endorsed by the AEPC (ACHD book series); mid-2017

Two ongoing European surveys (TRANS-SECTION COLLABORATIVES): Enteral feeding practices in CHD patients Demographics of European CICU research

practices/platform4. To come in the foreseeable future:

EUROPEAN QUALITY& SAFETY CARDIAC INTENSIVE CARE SCORE CARD

(seeking collaboration Health Services research, Administration, education, information technology and Long term outcome, Nursing section, etc.)

Eduardo Da Cruz

EUROPEAN MANUAL OF CARDIAC AND CONGENITAL INTENSIVE CARE

CLINICAL GUIDELINES FOR ECHOCARDIOGRAPHY JUNIOR ENDOWMENT COLLABORATION WITH ACHD SOCIETIES AND TASK FORCES WEBSITE

5. SINE QUA NON CONDITION FOR GROWTH AND SUCCESS: MORE TRANS-SECTION AND TRANS-SOCIETAL

COLLABORATION (IPTA-EACTA-EAPA) WELCOMING IDEAS AND SAMURAI WARRIORS TO JOIN THIS

FIGHTCardiovascular Dynamics

1. Goals and mission statement of the section have been determined with important input from members Consensus statement of HD monitoring has highest priority.

All authors are gathered. Business meeting in Lisbon scheduled.

To support education, research and development of guidelines in hemodynamic physiology, monitoring and treatment in critically ill children of all ages. It is the ambition of the section to be a reference point for pediatric intensivists with an interest in cardiovascular dynamics and to increase collaboration with others

2. Membership Still no deputy found Members have vanished from the list???? Input from members is limited to suggestions or ideas, no

active involvement 2018 will be my last year as chairman

3. Achievements Successful meeting with several members in Geneva 2016 Successful meeting working group microcirculation in Geneva

2016 Some input for EAPS 2018 Contribution to the annual ESPNIC meetings Guideline development An index of guidelines will be developed. The first guideline to be developed will concern

hemodynamic monitoring Others might be: Fluid therapy or the use of vasoactive

drugs4. Education (with emphasis on the European diploma)

Contribute to the ESPNIC winter (and summer) school Contribute to the basic course at annual ESPNIC meetings Organize and participate in specific educational sessions at

ESPNIC annual meetings Organize an integrated simulation course of hemodynamic

alterations in critically ill children.

Joris Lemson

5. Research It is our ambition to establishing a pan-European

hemodynamic research group. The first study will be a “snapshot” like study resembling

Vesper. This study could gather information concerning the various

use of hemodynamic monitoring, use of ultrasound, vasoactive drugs, fluid therapy etc

CRRT/Renal section1. Achievements

ESPNIC endorsed CRRT workshop in the WFPICCS Conference in Toronto – very well attended and good reviews

Contributed presentations to the EPIC curriculum ESPNIC endorsed survey on CRRT practices across Europe ,

approved by EC – will be circulated soon to all CRRT lead medics/nurses

MARS versus CRRT in liver failure – 3 centre analysis looking at safety and efficacy of the 2 modalities – ONGOING

Akash Deep

Ethics1.Achievements• At Geneva meeting new interested members showed up• In a communication process by e-mail the gave some input in what

they are interested in• There is still some conflict ongoing on which topics the section

should focus on: more everyday problems in the interaction of physicians, nurses and parents in different fields of pediatric intensive care (how to communicate end of life question, intercultural aspects etc.) or

• Provide statements and conclusions on principal ethical questions as organ transplantation and allocation, end of life question in a culturally changing environment, economic restraints

• These topics are too many and during this session we have to prioritize and look for new chair(wo)men

2.For the future• For the 2018 meeting several proposals have been made• As here in Lisbon we should focus predominantly on European

colleagues• The North American influence is very important, however, the

complexity in the different European countries has to be reflected• A balance of medical and nursing aspects has to be enforced as• A balance between very practical and principal questions

Jens Möller

Improvement, Quality&Safety and PICU outcome section1. Achievements

Jan Hazelzet

Outcome after critical illness in childhood Based on the Dutch national guideline (2017) Core group Draft of recommendations (April 2017) Delphi round; panel of experts, ESPNIC chairs and co-chair

(summer 2017) Improvement, Quality & Safety and PICU outcome Section Meeting: Thursday June 8th 12.10 h Room 0.04 Elections

Infection, systemic inflammation and sepsis1. Mission statement:

To facilitate research and organize education to improve outcome in treatment and prevention of critically ill children and neonates with infection, systemic inflammation and sepsis

We invite all ESPNIC members interested in the different aspects of I, I&S to join the I,I&S section and participate in our activities

2. Achievements During EAPS / ESPNIC in October Geneva 2016 there were

many sessions of the section I,I&S especially on sepsis; clearly visible and very successful

Young Investigators award by Raymond Stegeman -Geneva 2016

Many topics from I,I&S are accepted for this 28th ESPNIC congress including an international workshop on Sepsis on the 6th of June

Refractory Septic Shock (RSS) an ESPNIC definition: o Prospective validation of the RSS definition

Effectiveness of IV Immunoglobulins in Toxic Septic Shock (TSS): o Survey monkey is finished o Study is started in France

Participation in the new Sepsis guidelines - Surviving Sepsis Campaign

Editorial about Paediatric Sepsis “Old wine in new bottles” in ICM o Published online in April 2017

Study on Refractory Septic Shock (RSS); o Prospective validation of the RSS definition in

collaboration with the European PICUs o Revision of the septic shock criteria (SSC) in

collaboration with the SSCM /ESICM and ESPNIC Effectiveness of IV Immunoglobulins in Toxic Septic Shock

(TSS): Feasibility of an International RCT at the PICU’s Proposals for sessions and workshops for the 29th ESPNIC

/EAPS congress in Paris 2018 in close collaboration with other sections of the ESPNIC are submitted

Koos Jansen

Review on the role of bundles in sepsis at PICU&NICU 3. Goals

To increase the visibility of the section To get members more involved in activities More research projects with and through the members What do our members want; which questions do we need to

answer in I, I&S? Enhanced cooperation with other sections of the ESPNIC,

especially with education & nursing section, and with different committees in ESPNIC / ESICM

Collaboration with other societies especially, with ESICM / SCCM on Sepsis definitions and research; contact with ESICM Section on systemic inflammation and sepsis

Metabolism, endocrinology and nutrition Collaboration with ESPGHAN PN guidelines Collaboration with ESPGHAN nutritional course Paris Collaboration with special interest group pediatrics ESPEN Participation with Sepsis guideline Develop European PICU consensus multidisciplinair: Nutrition

o Working group: finish 2018o Koen Joosten, Frederic Valla, Sascha

Verbruggen, Nazima Patan, Shancy Rooze, Rosan Meyer, Lynne Latten, Lyvonne Tume

Koen Joosten

Neuro Critical Care3. Accomplishments

Neuro critical care lectures and the workshop were well attended

Geneva 2016 in Neuro critical care was very successful Topics for 2018 in Paris are proposed Enquiry among section members regrading refractory status

epilepticus- 1 member answered to be interested besides Barney , Robert and myself (needs improvement)

We have the possibility to join the adult European Registry. Global Audit of Treatment of Refractory and Super-Refractory Status Epilepticus (Sarah Hocker)

4. For the Future Needs to be decided whether that is wanted by the members How to activate members - not solved To join the CPR registry and Resuscitation section regarding treatment after CPR and neurologic outcome and in addition Longterm outcome ??? To motivate more members to become active in the section Decision: Refractory status epilepticus Study ?!

Hannelore Ringe

Nursing Science Group1. Goals

Increasing nursing membership

Erwin Ista

o Undertake planned roadmap activities Plans (deliverables ) of the Study groups

o Family Centred Care o Deteriorating child/PEWS subgroup o Nutritiono Pain, Sedation, IWS, Deliriumo Ventilation

2. Achievements Communication with members Implementation Position Statement

o Translation recommendation Communication:

o Twitter #ESPNICNursingScienceo 2nd News letter

Membership increased Links between Nursing Science other sections to facilitate

inter-section research collaboration, e.g.o The GrApHIc study of GRV measurement

between Nursing Science section and Nutrition section (Tume, Valla)

Consensus statement long-term outcome o Health Services and Long-term outcomes

Section (leading: Buysse, Knoester) &Nursing Science section (Latour, Manning, Ista)

3. For the future Plan to map paediatric critical care nursing education

programmes across Europe; in collaboration with NICU/PICU Nursing section

Preconference day EAPS Paris Study groups: FCC: multi-national study implementation FCC in NICUs Pain & Sedation: European Point prevalence of Delirium and

Early Mobilisation PEWS: Development of Position Statement

Paediatric and Neonatal Intensive Care Nursing1. Achievements

• Increased Nurse Membership • Current 138 Nurse members• Increase 47 new members from 2016

• Contribution to development of ESPNIC Diploma • Collaborate with Nurse Science - Nursing sessions for

ESPNIC/EAPS 2018 Paris• Focus on increasing local nurse attendance at

meetings/cost/language issues• Survey of PICU/NICU nurse training needs, staffing and scope of

Andy Darbyshire

nursing practice across Europe future nursing strand of ESPNIC Diploma and ‘best practice’ guidelines

• Survey educational preparation for NICU & PICU• ESPNIC Nursing Diploma

2. For the future• Review the differing requirements of NICU & PICU nurses within the

society – try to get a ‘better fit’• Target differing groups within nursing – managers &

leaders / educators / practitioners?• More collaboration with other ESPNIC sections for congress content

and collaborative projects

Pharmacology1. Achievements

Integral part of the 2016 and 2017 scientific programs of the Geneva and Lisbon meetings

Number of proposals submitted to the scientific board of the EAPS 2018 meeting in Paris aiming at intersectional activities and sharing with the other scientific societies contributing to the EAPS 2018 meeting

Enquiry distributed amongst the members of the pharmacology section to determine the future goals and collaborative initiatives of our section

Active connection with ESPA to contribute to their meeting in Glasgow September 2017 (arranged and supported by the EC)

Participation in EU supported grants to enhance the level of evidence based pharmacotherapy in Europe

Active role in the EU project IMI2 an international collaboration aiming to enhance pharmacotherapeutic studies in children and building on an infrastructure in EU countries representing ESPNIC

Active collaboration with ESPA for mutual research exchange of ideas and initiatives such as the T-REX study incorporating the pharma section and the long term outcome section of ESPNIC

Taking the lead in the ungoing discussion and scientific uncertainty about optimal (anti)coagulation in patients treated with ECMO or VAD’s to come to international consensus and prospective studies with the European Society of Thrombosis and Hemostasis (Berlin conference July 2017) through the formation of an international study group

Pharmacology section of ESPNIC Small but Beautiful

Dick Tibboel

Respiratory failure Martin

1. Achievements European mechanical ventilation consensus guideline –

submitted to Intensive Care Medicine (May 2017) European ventilation database – data analysis pending European survey role and responsibilities during weaning –

collaboration with Nursing section. Paper published in PCCM

Neonatal ARDS Montreux definition – paper accepted Lancet Respir Med

Neonatal ARDS project – inclusion ongoing for data validation Survey lung transplantation – ongoing Paediatric WIND studies – under construction (Jesus Lopez

Herce) Paediatric proning/HFOV trial – under construction (Martin

Kneyber, Peter Rimensberger) Sessions EAPS2016, ESPNIC2017 Proposals for EAPS2018 Non-invasive ventilation courses – Marti Pons

Kneyber

Resuscitation1. Activities

Section Meeting Geneva October 2016 Discussions around the need to determine paediatric cardiac

arrest management in Europe Feasibilty of European Cardiac arrest registry Survey to ESPNIC members to gauge practice and interest Subsequent small section group meeting in London

December 2016 Cross section working with outcomes group and joint

meeting this year with neurocritical care section The section proposed topics for this congress which were

adopted and have also put forward a full programme for next year

Review ESPNIC academy material relevant to resuscitation to ensure current for EPIC diploma students

Working to encourage section membership and attendance2. Plans

Elections lead position section moved to during ESPNIC 2017 meeting

Involvement members increasing? Ongoing discussions education and research

Dominique Biarent

Transport1. Summary

One year old Paediatric and neonatal transport professionals (medical,

nursing and allied health) Current membership 20 people total representing: UK,

Serbia, France, Spain, Switzerland, and Italy2. Activities

Padmanabhan Ramnarayan

European survey of current practice in PIC/NIC transporto Organisational differences, practice differences

Unit based team, dedicated regional team, combined neonatal and paediatric

Team composition (doctor, advanced nurse practitioner, respiratory therapist, critical care paramedic)

Mode of transport (road, air) Interventions (basic intensive care, advanced

intensive care) Contact list of transport services being

generated through contacts Draft survey completed, ready for dissemination

through ESPNIC membership + contactso OUTPUT: summary of current practice across

Europe ESPNIC

o ESPNIC 2017: 4 sessions on transporto EAPS/ESPNIC 2018: Proposal for workshop, lectures

and educational sessions COLLABORATIVE

o Transport of the High Risk Neonate conference (Oxford, 2017)

Educational sessions Program planning Discussions for closer collaboration 2018

Development of common minimum dataseto Discussions at section meeting tomorrowo Draft set of data items to be discussed based on

PICANet (UK) and GAMUT (US) as well as draft Canadian dataset (Canada)

o Challenging due to lack of awareness of all transport services in Europe and different models of care

o Data collection platform to be discussed and finalized

Working Groups- we are working on developing working groups that work across all sections- we have just developed two more: the echo and the oncology. Both new groups are looking for new members. The newly formed oncology group hopes to generate a database for oncology PICU patients to identify better outcomes and risk factors.Journal- Mark PetersThe journal is very healthyMore than 2000 submissions for the first time.Reads, downloads and cites continue to increase - impact factor now greater than 10 (actually new one just released Impact factor 12.1!)Paeds submissions down however only 40-45 this year rather than 80 in previous years. Journal is specifically supportive of paediatric submissions - and we have a

favourable acceptance rate in comparison to other sections.But please help us by sending us your best work - especially prospective multiple centre studies.As a journal of ESPNIC we are also interested in outputs from the scientific sections - some e.g. sepsis have recently contributed short consensus pieces and others e.g. Resuscitation are expectedMark is always prepared to make an informal comment about potential submissions: mark.peters@ucl.ac.uk9. Report Chair of Professional Development Affairs & Chair of European

Board of Paediatric & Neonatal Intensive CareMarek Migdal/Joe Brierley

19:00

Over the last three years, we have invested a lot of money and time into the EPIC diploma.

We have completed the development phase and are now pursuing appraisal of the program by the UEMS Council of European Specialist Medical Assessments (CESMA).”

Even during the preparation phase, there were hundreds of applications. There was a special information session at the conference that was very well attended. There are more than 800 locations for candidates to take the exam for the diploma.

We need people to help write questions for the exam. David Rosza will email the section chairs and deputy chairs for help.

10. Members agenda items All 19:05

11. Welcome to the New Presidents & Trainee Rep Joe Brierley & Barbara Grädel

19:10

Simon Nadel and Lyvonne Tume were welcomed as new presidents of the society. Simon thanked Joe for his achievements and hard work and expressed that he is excited for the future and continuing to strengthen the society. Simon also thanked everyone who has made this congress a success. Simon presented Joe with a gift to thank him. Joe thanked Ella Nkanagu for her help in moving the society forward. He then welcomed Corie Leifer to the team. Lyvonne presented Barbara a gift to thank her as well.12. Close of Meeting 19:15