Critical Care Medicine最新文献

{"title":"Heterogeneous Treatment Effects of Renal Replacement Therapy in Critically Ill Patients: A Multicenter Observational Study Using a Japanese ICU Registry.","authors":"Sae Nakamura, Kosuke Inoue, Kazunari Takahashi, Shun Maeda, Tomoko Fujii","doi":"10.1097/CCM.0000000000007282","DOIUrl":"10.1097/CCM.0000000000007282","url":null,"abstract":"<p><strong>Objective: </strong>Randomized trials evaluating the timing of renal replacement therapy (RRT) have informed current practice toward more conservative initiation strategies because of the lack of mortality benefit from early initiation. However, the optimal indications for RRT to offer lifesaving benefits remain uncertain. We aimed to estimate heterogeneous treatment effect of RRT and to identify patient groups associated with benefit or harm.</p><p><strong>Design: </strong>Multicenter observational study.</p><p><strong>Setting: </strong>A nationwide intensive care registry in Japan, Japanese Intensive Care Patient Database.</p><p><strong>Patients: </strong>Adult patients who were admitted to the ICUs from 2018 through 2023 were included, excluding those with end-stage kidney disease, early death, readmission, or normal renal function.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>Exposure was RRT during the ICU stay. Hospital mortality was the primary outcome. After 1:1 propensity score matching to adjust for confounding, 18,794 patients (9,397 per group) were analyzed. On average, RRT was associated with higher hospital mortality (risk difference, 6.1% points [95% CI, 3.4-8.7]). However, our machine learning-based causal forest algorithm showed substantial heterogeneity of treatment effects heterogeneity of treatment effects (HTEs) (rank-weighted average treatment effect, -8.2 percentage points [95% CI, -9.7 to -6.7]). Patients characterized by elevated serum creatinine, reduced urine output, and elevated blood urea nitrogen levels showed potential mortality benefit from RRT, whereas relatively preserved renal function was more likely to be associated with harm.</p><p><strong>Conclusions: </strong>Although RRT was associated with an increased risk of hospital mortality overall, HTEs were identified in selected subgroups that may benefit from RRT. These findings support a data-driven approach to defining clinically applicable optimal RRT indications to guide more judicious use of RRT.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":"2590-2600"},"PeriodicalIF":7.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Remote Respiratory Therapy in a Donor Center ICU Using a Telecritical Care Platform.","authors":"Michael Ghio, Heather Pavlichko, Arpit Patel, Jamie Ann Acero-Webb, Brianna Howley, Elizabeth Brown, Kathleen O'Neill, Jose L Pascual, Niels D Martin","doi":"10.1097/CCM.0000000000007231","DOIUrl":"10.1097/CCM.0000000000007231","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the feasibility, safety, and operational impact of delivering comprehensive remote telecritical care respiratory therapy (eRT), including full ventilator management, in a dedicated brain-dead donor care ICU.</p><p><strong>Design: </strong>Prospective observational study conducted over a 12-month period (from October 2023 to October 2024).</p><p><strong>Setting: </strong>An eight-bed brain-dead donor care ICU utilizing a telecritical care platform with real-time audiovisual monitoring and remote ventilator interface capability.</p><p><strong>Subjects: </strong>Organ donors ( n = 182) managed during the study period.</p><p><strong>Interventions: </strong>All respiratory therapy (RT) care, including ventilator management and procedural support, was delivered remotely. In-person RT support was available as needed.</p><p><strong>Measurements and main results: </strong>Procedural workload, in-person RT utilization, safety events, donor outcomes, and full-time equivalent (FTE) labor requirements were recorded. eRT completed 3872 respiratory procedures, totaling 1782 hours of remote care. In-person RT support was required for 119 hours (6.1%), primarily for transport and advanced airway interventions. No airway losses, emergency RT activations, cardiac arrests, or delays in care occurred. Remote RT support resulted in an estimated savings of 2.2 FTEs and $306,952 in avoided labor costs. A total of 520 organs were procured, with an observed-to-expected recovery ratio of 1.19.</p><p><strong>Conclusions: </strong>Comprehensive remote RT, including full ventilator management, was safely and effectively implemented in a donor care ICU. This model substantially reduced bedside staffing requirements while maintaining favorable donor outcomes, supporting broader adoption and highlighting the need for regulatory pathways enabling secure remote ventilator access.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":"2536-2542"},"PeriodicalIF":7.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Net Ultrafiltration Rate and Mortality in Critically Ill Patients: A Multicenter Cohort Study With Analysis of Fluid Balance Changes.","authors":"Nadine C Monai, Carmen A Pfortmueller, Joerg C Schefold, Luca Cioccari, Martin Faltys","doi":"10.1097/CCM.0000000000007289","DOIUrl":"10.1097/CCM.0000000000007289","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between net ultrafiltration (NUF) rate and fluid balance changes with 28-day mortality in critically ill patients receiving continuous renal replacement therapy (CRRT).</p><p><strong>Design: </strong>Multicenter retrospective observational study.</p><p><strong>Setting: </strong>Data from two European mixed medical-surgical ICUs: University Hospital Bern, Switzerland, and Amsterdam University Medical Center, the Netherlands.</p><p><strong>Patients: </strong>Adult critically ill patients receiving CRRT for at least 24 hours.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>We studied 973 critically ill adults undergoing a total of 6914 days of CRRT. NUF rates and fluid balance changes were calculated from hourly data and categorized into four predefined groups. NUF rates were classified as no NUF, low (< 1.01 mL/kg/h), moderate (1.01-1.75 mL/kg/h), or high (> 1.75 mL/kg/h). Fluid balance change was stratified as negative (< -1.5 L/day), moderate negative (-1.5 to -0.5 L/day), neutral (-0.5 to 0.5 L/day), or positive (> 0.5 L/day). Using multivariable regression, random forest modeling, and mediation analysis, we observed no independent association between NUF rate and 28-day mortality after accounting for fluid balance. Mediation analysis suggested that the apparent survival advantage observed among patients with higher NUF rates was largely mediated through achievement of a more negative fluid balance, rather than a direct effect of NUF rate itself. In contrast, more positive fluid balance changes were linked to adverse clinical outcomes including 28-day mortality.</p><p><strong>Conclusions: </strong>In this two-center cohort of CRRT patients, NUF rate was not independently associated with mortality. Instead, the key determinant of outcome was fluid balance change. These findings suggest clinicians should not make NUF decisions in isolation, but rather should be using NUF as a means to achieve patient-specific fluid balance targets.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":"2648-2659"},"PeriodicalIF":7.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"H3.1 Nucleosomes to Predict Renal Replacement Therapy and Mortality in Sepsis-A Secondary Analysis of the SISPCT Randomized Control Trial.","authors":"Caroline Neumann, Frank Bloos, Teddy Tun Win Hla, Thomas Bygott, Holger Bogatsch, Michael Kiehntopf, Friedemann Börner, Adrian T Press, Michael Bauer, Andrew Retter","doi":"10.1097/CCM.0000000000007270","DOIUrl":"10.1097/CCM.0000000000007270","url":null,"abstract":"<p><strong>Objectives: </strong>The release of neutrophil extracellular traps is a key immune host defense mechanism that can contribute to organ damage during sepsis if excessive. We evaluated presentation H3.1 nucleosome levels in patients with sepsis, septic shock, and sepsis-associated acute kidney injury (AKI). We sought to determine if plasma H3.1 nucleosome levels could serve as predictive biomarkers for both renal replacement therapy (RRT) requirements and 28-day mortality.</p><p><strong>Design: </strong>A secondary analysis of prospectively collected samples from the large multicenter Effect of Sodium Selenite Administration and Procalcitonin-Guided Therapy on Mortality in Patients with Severe Sepsis or Septic Shock (SISPCT) trial.</p><p><strong>Setting: </strong>Patients from 33 ICUs in Germany recruited between November 6, 2009, and June 6, 2013, including a 90-day follow-up period.</p><p><strong>Patients: </strong>A total of 971 patients with complete data on plasma H3.1 admission levels with sepsis and septic shock, and 927 patients with complete data on RRT requirements.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>We evaluated associations between H3.1 levels and mortality and the time to commencement of RRT using multivariable Cox regression. A total of 443 patients (45.6%) presented with sepsis, and 520 patients (53.6%) had septic shock. Admission H3.1 levels were higher in patients with septic shock than sepsis (median, 921.84 vs. 432.71 ng/mL; p < 0.001). In a multivariable analysis for 28-day mortality, a one unit increase in log10 H3.1 levels was associated with a 48% increase in 28-day mortality (adjusted hazard ratio [HR], 1.48, 95% CI, 1.07-2.04; p = 0.02). Plasma H3.1 was also higher in patients with stage 3 AKI requiring RRT with septic shock vs. sepsis (1832 vs. 801.4 ng/mL; p = 0.01). In a multivariable Cox regression controlling for maximum lactate, procalcitonin, and C-reactive protein levels, plasma H3.1 levels were significantly higher in patients who developed AKI requiring RRT when compared with patients who did not develop AKI, with one log10 increase of H3.1 increasing the risk of 28-day RRT by 80% (adjusted HR, 1.8; 95% CI, 1.34-2.40; p < 0.001).</p><p><strong>Conclusions: </strong>Elevated levels of H3.1 nucleosomes at admission are associated with mortality and AKI requiring RRT.</p><p><strong>Trial registration: </strong>The trial was registered in clinicaltrials.gov , identifier: NCT00832039.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":"2567-2578"},"PeriodicalIF":7.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Competing Paradigms in Extracorporeal Membrane Oxygenation Hemostatic Transfusion","authors":"Nicole S. Dersahakian,Hamid R. Vahabzadeh-Monshie,Kenichi A. Tanaka,Amir L. Butt","doi":"10.1097/ccm.0000000000007279","DOIUrl":"https://doi.org/10.1097/ccm.0000000000007279","url":null,"abstract":"","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":"75 1","pages":"2789-2790"},"PeriodicalIF":8.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic Disparities and the Role of Comorbidity in Hospital Mortality: A Dutch Nationwide Critical Care Cohort Study.","authors":"Jip W T M de Kok, Daniëlle J M Koornneef, Fabian Termorshuizen, Ronny M Schnabel, Iwan C C van der Horst, Nicolette F de Keizer, Sylvia Brinkman, Bas C T van Bussel","doi":"10.1097/CCM.0000000000007271","DOIUrl":"10.1097/CCM.0000000000007271","url":null,"abstract":"<p><strong>Objectives: </strong>Lower socioeconomic status (SES) is associated with a higher prevalence of comorbidities and mortality. The association between SES and mortality, as well as the effect-modifying role of specific comorbidities, are not yet fully understood within the critical care context of insurance-based universal healthcare systems. To inform health policy and practice, we examined socioeconomic disparities in Dutch ICU admissions, considering comorbidities in the context of hospital mortality.</p><p><strong>Design: </strong>Nationwide retrospective cohort study.</p><p><strong>Setting: </strong>All 79 Dutch ICUs were included.</p><p><strong>Patients: </strong>We used data from 588,568 ICU admissions (2014-2022) linked with household-level SES data.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>We used mixed-effects logistic regression models to investigate the association between SES quintiles and hospital mortality. We adjusted models for age, sex, year of admission, acute physiologic derangement, and comorbidities. Also, we investigated the effect-modifying role of seven comorbidities: respiratory insufficiency, renal insufficiency, cancer, cardiovascular insufficiency, diabetes mellitus, cirrhosis, and immunological insufficiency. Unadjusted odds ratios (ORs) for hospital mortality were higher among patients with lower SES. After adjustment, SES quintiles remained significantly different from the middle quintile, with attenuated ORs (95% CI): 1.6 (1.5-1.6), 1.1 (1.0-1.1), 1.0 (0.9-1.0), and 0.9 (0.9-1.0), respectively. The association was most pronounced in the lowest SES quintile and persisted in patients with and without specific comorbidities.</p><p><strong>Conclusions: </strong>ICU patients with a lower SES face poorer survival prospects, irrespective of comorbidities. This highlights the persistent health disparities that may influence ICU outcomes. SES should be considered for interpreting outcome measures, designing healthcare policies, and targeting interventions to improve health equity.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":"2754-2765"},"PeriodicalIF":7.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Critical Illness During Different COVID-19 Pandemic Periods Compared With Seasonal Influenza.","authors":"Josefine Beck-Friis, Ailiana Santosa, Huiqi Li, Fredrik Nyberg, Magnus Gisslén, Jonatan Oras, Aylin Yilmaz","doi":"10.1097/CCM.0000000000007308","DOIUrl":"10.1097/CCM.0000000000007308","url":null,"abstract":"<p><strong>Objectives: </strong>Since the onset of the COVID-19-pandemic, emerging virus variants, increasing population immunity, and evolving treatment strategies have substantially altered disease severity. This study aimed to identify predictors of critical illness due to COVID-19 over time and compare them with those of seasonal influenza in Sweden.</p><p><strong>Design, setting, patients, and measurements: </strong>We conducted a retrospective, population-based cohort study using nationwide registry data. All individuals hospitalized for COVID-19 between 2020 and 2022 were categorized into five groups, based on pandemic waves and dominating virus variants. A sixth group included all patients hospitalized for influenza between 2018 and 2022. Patients were followed from hospitalization until ICU admission, in-hospital death, discharge, or end of study. Incidence rates were calculated and Cox regression identified predictors of ICU admission and in-hospital mortality, adjusting for age, sex, socioeconomic factors, comorbidities, and severe acute respiratory syndrome corona virus 2-vaccination. Data on influenza vaccinations were not available from the registers.</p><p><strong>Main results: </strong>We included 92,428 COVID-19 hospitalizations and 21,355 influenza hospitalizations. Hospitalization rates were lowest during the delta-dominant period, while ICU admission rates were lowest during the Omicron-dominant period. The Omicron period most closely resembled influenza inpatient demographics, hospital stay duration, ICU admissions, and in-hospital mortality. Age distributions varied across pandemic periods, with the Omicron period showing an age profile similar to influenza (≈ 50% ≥ 75 yr). Adjusted hazard ratios for ICU-admission were strongest in unvaccinated patients, males, and individuals of 45-74 years for COVID-19, and in individuals of 45-64 years or with chronic lung diseases for influenza. Common predictors of in-hospital mortality included age older than 45 years (with a sharp increase after 74), male sex, and chronic comorbidities, and for COVID-19 also unvaccinated status.</p><p><strong>Conclusions: </strong>Although COVID-19 consistently resulted in higher hospitalization rates than influenza, demographic and clinical patterns converged during the later pandemic stages. Advanced age was the strongest predictor of severe illness in both infections, with lack of vaccination additionally associated with severe COVID-19.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":"2670-2685"},"PeriodicalIF":7.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Criteria for Refractory Septic Shock: Relying on Treatment to Define a Disease","authors":"David M. Maslove,Tim Baker,Fitsum Kifle","doi":"10.1097/ccm.0000000000007244","DOIUrl":"https://doi.org/10.1097/ccm.0000000000007244","url":null,"abstract":"","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":"167 1","pages":"2779-2780"},"PeriodicalIF":8.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic Access to Care and Mortality in Cardiogenic Shock: A Nationwide Cohort Analysis.","authors":"Ki Hong Choi, Danbee Kang, Junwoo Seo, Ji Hyun Cha, Taek Kyu Park, Joo Myung Lee, Young Bin Song, Joo-Yong Hahn, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Juhee Cho, Jeong Hoon Yang","doi":"10.1097/CCM.0000000000007287","DOIUrl":"10.1097/CCM.0000000000007287","url":null,"abstract":"<p><strong>Importance: </strong>Timely access to advanced care is critical for patients with cardiogenic shock (CS), yet the impact of regional disparities in hospital arrival time on mortality remains unclear.</p><p><strong>Objectives: </strong>To investigate whether regional disparities in hospital arrival time are associated with in-hospital and long-term mortality among patients with CS.</p><p><strong>Design: </strong>Population-based, nationwide cohort study.</p><p><strong>Setting: </strong>Tertiary hospitals in South Korea, using data from the Korean National Health Insurance Service database and regional hospital accessibility indicators from the Korea Transport Institute.</p><p><strong>Participants: </strong>A total of 80,263 adults (≥ 18 yr) admitted to an ICU with a diagnosis of CS between 2017 and 2022. The study population was stratified by estimated hospital arrival time using region-level average daytime travel times (< 10, 10-30, 30-60, and > 60 min) for the present study.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was all-cause mortality, including in-hospital and post-discharge mortality. Multivariable logistic and Cox regression models were used to assess associations.</p><p><strong>Results: </strong>Median estimated hospital arrival time was 9.15 minutes. In-hospital mortality increased progressively with longer arrival times: 29.6% (< 10 min), 33.5% (10-30 min), 34.9% (30-60 min), and 38.8% (> 60 min). Compared with less than 10 minutes, the adjusted odds ratios for in-hospital mortality were 1.27 (95% CI, 1.23-1.32), 1.24 (95% CI, 1.14-1.35), and 1.51 (95% CI, 1.29-1.75), respectively. At 1-year follow-up, the adjusted hazard ratios for all-cause mortality were 1.16 (95% CI, 1.14-1.19 for 10-30 min), 1.16 (95% CI, 1.09-1.21 for 30-60 min), and 1.31 (95% CI, 1.19-1.43 for > 60 min), relative to less than 10 minutes. These associations were consistent in both de novo and acute-on-chronic CS.</p><p><strong>Conclusions: </strong>Longer hospital arrival times are significantly associated with increased in-hospital and long-term mortality in patients with CS. These findings underscore the need for system-level interventions, such as regionally coordinated shock networks and early prehospital triage, to ensure timely access to definitive care.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":"2625-2635"},"PeriodicalIF":7.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing a New Method of Care: The Scientific and Business Development of the eICU","authors":"Brian Rosenfeld","doi":"10.1097/ccm.0000000000007149","DOIUrl":"https://doi.org/10.1097/ccm.0000000000007149","url":null,"abstract":"","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":"8 1","pages":"2517-2520"},"PeriodicalIF":8.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}