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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.



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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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.



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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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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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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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.



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.



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.



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 2023

Newsletter July 2023: ESAIC CTN Study - MET: REevaluation for Peri-operative cArdIac Risk (MET-REPAIR)

Giovanna Lurati Buse

ESAIC Clinical Trial Networking of 2016 was dedicated to MET-REPAIR by the chief investigator, by Prof. Giovanna LURATI BUSE. The study was published in April 2023. 

The European Society of Anaesthesiology and Intensive Care established the Clinical Trial Network to foster large research cooperations across Europe in Anaesthesiology, Intensive Care, Peri-Operative Medicine, Emergency Medicine, and Pain Medicine. This support by the ESAIC allowed the successful conduction of several large international trials over the last decade (https://www.esaic.org/research/clinical-trial-network/published-trials/).  

In 2016 the project “MET: REevaluation for Peri-operative cArdIac Risk (MET-REPAIR)” was awarded an ESAIC CTN Grant. Prior to noncardiac surgery, international and national guidelines, including the ESAIC guidelines1-3, recommend the assessment of functional capacity to estimate the risk of adverse events, specifically cardiovascular, after noncardiac surgery. While this approach is broadly and regularly used in clinical practice and is endorsed by multiple guidelines1-3, the evidence for improved prediction was not well established. Therefore, the objective of MET-REPAIR was to assess self-reported measures of effort tolerance for the prediction of major adverse cardiovascular events in a large cohort of noncardiac surgery patients with elevated cardiovascular risk. Patients were asked to complete a questionnaire4 that assessed the following measures of functional capacity: 

  1. self-reported effort tolerance quantified in METs and estimated using a 10-item questionnaire, 
  2. the number of floors climbed without having to rest,  
  3. self-perceived own cardiopulmonary fitness compared to their peers 
  4. the pattern of regular physical activity. 

In addition to the main study, investigators were invited to nest subcohorts in METREPAIR, e.g. substudies on N-terminal brain natriuretic peptide, pre-operative presepsin, or frailty were conducted at the international or national level.  

Over 150 European centres answered the ESAIC call and joined this venture. The joint efforts of around 350 anaesthesiologists from Portugal to Russia from Sweden to Malta achieved the impressive target of recruiting over 15,000 patients between June 2017 and April 2020, reaching 99% follow-up completeness at 30 days. The ESAIC Research team was strongly involved and provided invaluable help supporting centres and managing the nearly 12,000 queries for data cleaning.  

The study results were published in the British Journal of Anaesthesiology 130(6):655-665, in June 2023 under the title “Risk assessment for major adverse cardiovascular events after noncardiac surgery using self-reported functional capacity: an international prospective cohort study”.5 Here we present a summary.  First, with a 2.1% 30-day events rate, major adverse cardiac events and cardiac mortality remain major peri-operative population health problems after noncardiac surgery.  

Second, all self-reported measures of functional capacity were independently associated with adverse events. This means that each self-reported functional capacity in METs, floor climbing ability, self-perceived level of fitness compared to peers, or pattern of regular physical activity were prognostic factors. Of note, the assessment of prognosis addresses the question: How does self-reported functional capacity influence the risk of the specific outcome? More interesting from a clinical point of view is the question of prediction, i.e., how far does self-reported functional capacity contribute to the differentiation of patients that will or will not suffer the specific outcome? And, of course, clinicians are interested in the additional predictive value, i.e., in improving prediction over clinical risk factors or established clinical risk scores.  

The answer to this question requires a more detailed description of the results and leads us to the third main finding of the METREPAIR study. In the study, self-reported measures of functional capacity were added to either 1) a study baseline model that included age, sex, American Society of Anaesthesiologists (ASA) physical status class, glomerular filtration rate, active cancer, type of surgery, diabetes mellitus, hypertension, congestive heart failure, coronary artery disease, chronic obstructive pulmonary disease, peripheral vascular disease, and stroke; 2) the Revised Cardiac Risk Index;6 or 3) National Surgical Quality Improvement Program, Risk calculator for Myocardial Infarction and Cardiac Arrest (NSQIP MICA).7 Only the level of regular physical activity statistically improved discrimination over the study baseline model. However, the gain was very limited and, while statistically significant, probably not clinically relevant. All self-reported functional capacity measures statistically improved discrimination over the Revised Cardiac Risk Index, six a validated and widely used clinical risk score; however, again, the effect size was so limited that its clinical relevance was questionable. Discrimination over the NSQIP MICA7 was not improved. In other words, the data from METREPAIR do not support the widely used approach of adding self-reported functional capacity information to clinical risk assessments to predict major adverse cardiac events. As such, the united efforts of anaesthesiologists from all over Europe and of the ESAIC Clinical Trial Network contributed to providing the answer to clinical questions that affects our daily clinical practice.  


  1. De Hert S, Staender S, Fritsch G, et al. Pre-operative evaluation of adults undergoing elective noncardiac surgery: An updated guideline from the European Society of Anaesthesiology. European Journal of Anaesthesiology. 2018;35(6):407-465. 
  2. Fleisher LA, Fleischmann KE, Auerbach AD, et al. 2014 ACC/AHA guideline on peri-operative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Journal of the American College of Cardiology. 2014;64(22):e77-137. 
  3. Halvorsen S, Mehilli J, Cassese S, et al. 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing noncardiac surgery. European heart journal. 2022. 
  4. 4 Jaeger C, Burkard T, Kamber F, et al. Quantification of metabolic equivalents (METs) by the MET-REPAIR questionnaire: A validation study in patients with a high cardiovascular burden. Journal of clinical anaesthesia. 2021;76:110559. 
  5. Lurati Buse GA, Mauermann E, Ionescu D, et al. Risk assessment for major adverse cardiovascular events after noncardiac surgery using self-reported functional capacity: international prospective cohort study. British Journal of Anaesthesia. 2023;130(6):655-665. 
  6. Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999;100(10):1043-1049. 
  7. Gupta PK, Gupta H, Sundaram A, et al. Development and validation of a risk calculator for prediction of cardiac risk after surgery. Circulation. 2011;124(4):381-387. 

Funding: This study is financially supported by the European Society of Anaesthesiology and Intensive Care (ESAIC) in terms of an ESAIC Research Group. 




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