{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T07:40:48Z","timestamp":1769154048392,"version":"3.49.0"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T00:00:00Z","timestamp":1596585600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T00:00:00Z","timestamp":1596585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>There is little evidence to support the management of severe COVID-19 patients.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>To document this variation in practices, we performed an online survey (April 30\u2013May 25, 2020) on behalf of the European Society of Intensive Care Medicine (ESICM). A case vignette was sent to ESICM members. Questions investigated practices for a previously healthy 39-year-old patient presenting with severe hypoxemia from COVID-19 infection.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 1132 ICU specialists (response rate 20%) from 85 countries (12 regions) responded to the survey. The survey provides information on the heterogeneity in patient\u2019s management, more particularly regarding the timing of ICU admission, the first line oxygenation strategy, optimization of management, and ventilatory settings in case of refractory hypoxemia. Practices related to antibacterial, antiviral, and anti-inflammatory therapies are also investigated.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>There are important practice variations in the management of severe COVID-19 patients, including differences at regional and individual levels. Large outcome studies based on multinational registries are warranted.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s13054-020-03194-w","type":"journal-article","created":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T10:03:58Z","timestamp":1596621838000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":57,"title":["International variation in the management of severe COVID-19 patients"],"prefix":"10.1186","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8162-1508","authenticated-orcid":false,"given":"Elie","family":"Azoulay","sequence":"first","affiliation":[]},{"given":"Jan","family":"de Waele","sequence":"additional","affiliation":[]},{"given":"Ricard","family":"Ferrer","sequence":"additional","affiliation":[]},{"given":"Thomas","family":"Staudinger","sequence":"additional","affiliation":[]},{"given":"Marta","family":"Borkowska","sequence":"additional","affiliation":[]},{"given":"Pedro","family":"Povoa","sequence":"additional","affiliation":[]},{"given":"Katerina","family":"Iliopoulou","sequence":"additional","affiliation":[]},{"given":"Antonio","family":"Artigas","sequence":"additional","affiliation":[]},{"given":"Stefan J.","family":"Schaller","sequence":"additional","affiliation":[]},{"given":"Manu","family":"Shankar-Hari","sequence":"additional","affiliation":[]},{"given":"Mariangela","family":"Pellegrini","sequence":"additional","affiliation":[]},{"given":"Michael","family":"Darmon","sequence":"additional","affiliation":[]},{"given":"Jozef","family":"Kesecioglu","sequence":"additional","affiliation":[]},{"given":"Maurizio","family":"Cecconi","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2020,8,5]]},"reference":[{"key":"3194_CR1","doi-asserted-by":"publisher","unstructured":"Alhazzani W, M\u00f8ller MH, Arabi YM, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med Published online March 28, 2020:1\u201334. doi:https:\/\/doi.org\/10.1007\/s00134-020-06022-5.","DOI":"10.1007\/s00134-020-06022-5"},{"key":"3194_CR2","doi-asserted-by":"publisher","unstructured":"Bauchner H, Fontanarosa PB. Randomized clinical trials and COVID-19: managing expectations. JAMA Published online May 4, 2020. doi:https:\/\/doi.org\/10.1001\/jama.2020.8115.","DOI":"10.1001\/jama.2020.8115"},{"issue":"17","key":"3194_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1001\/jama.2019.14608","volume":"322","author":"CL Sprung","year":"2019","unstructured":"Sprung CL, Ricou B, Hartog CS, et al. Changes in end-of-life practices in European intensive care units from 1999 to 2016. JAMA. 2019;322(17):1\u201312. https:\/\/doi.org\/10.1001\/jama.2019.14608.","journal-title":"JAMA."},{"key":"3194_CR4","doi-asserted-by":"publisher","unstructured":"Bhimraj A, Morgan RL, Shumaker AH, et al. Infectious diseases Society of America guidelines on the treatment and management of patients with COVID-19. Clin Infect Dis Off Publ Infect Dis Soc Am Published online April 27, 2020. doi:https:\/\/doi.org\/10.1093\/cid\/ciaa478.","DOI":"10.1093\/cid\/ciaa478"},{"key":"3194_CR5","doi-asserted-by":"publisher","unstructured":"Aziz S, Arabi YM, Alhazzani W, et al. Managing ICU surge during the COVID-19 crisis: rapid guidelines. Intensive Care Med Published online June 8, 2020. doi:https:\/\/doi.org\/10.1007\/s00134-020-06092-5.","DOI":"10.1007\/s00134-020-06092-5"},{"key":"3194_CR6","doi-asserted-by":"publisher","unstructured":"Helms J, Severac F, Merdji H, Angl\u00e9s-Cano E, Meziani F. Prothrombotic phenotype in COVID-19 severe patients. Intensive Care Med. Published online May 20, 2020:1\u20132. doi:https:\/\/doi.org\/10.1007\/s00134-020-06082-7.","DOI":"10.1007\/s00134-020-06082-7"},{"key":"3194_CR7","doi-asserted-by":"publisher","unstructured":"Azoulay E, Zafrani L, Mirouse A, Lenglin\u00e9 E, Darmon M, Chevret S. Clinical phenotypes of critically ill COVID-19 patients. Intensive Care Med Published online May 28, 2020. doi:https:\/\/doi.org\/10.1007\/s00134-020-06120-4.","DOI":"10.1007\/s00134-020-06120-4"}],"container-title":["Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13054-020-03194-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13054-020-03194-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13054-020-03194-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:18:54Z","timestamp":1628122734000},"score":1,"resource":{"primary":{"URL":"https:\/\/ccforum.biomedcentral.com\/articles\/10.1186\/s13054-020-03194-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,5]]},"references-count":7,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["3194"],"URL":"https:\/\/doi.org\/10.1186\/s13054-020-03194-w","relation":{},"ISSN":["1364-8535"],"issn-type":[{"value":"1364-8535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,5]]},"assertion":[{"value":"17 June 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 July 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All participants agreed online to complete the survey.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All participants consented.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no conflict of interest in relation to this survey.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"486"}}