Critical Care最新文献

{"title":"YesReCan software-based capillary refill time measurement improves reproducibility compared with clinician assessment in critically ill patients","authors":"Tristan Brosse,Chelo Lorteau,Alexandre Vieira,Jean-Luc Fellahi,Frank Bidar,Martin Ruste,Matthias Jacquet-Lagrèze","doi":"10.1186/s13054-026-06295-0","DOIUrl":"https://doi.org/10.1186/s13054-026-06295-0","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"30 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149150314","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":"Pulsation is not perfusion: methodological concerns in EIT-based pulmonary embolism diagnosis.","authors":"YunHai Zhang, Tianfeng He, Shiman Zhang, Kaiyi Peng, Shuang Liu, Menghua Deng","doi":"10.1186/s13054-026-06385-z","DOIUrl":"10.1186/s13054-026-06385-z","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"30 1","pages":""},"PeriodicalIF":11.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147546","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":"Aligning time zero and treatment assignment in target trial emulation of left ventricular unloading.","authors":"Zhanna Zhang","doi":"10.1186/s13054-026-06376-0","DOIUrl":"10.1186/s13054-026-06376-0","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"30 1","pages":""},"PeriodicalIF":11.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135352","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":"Pulmonary herpesvirus reactivation in patients with persistent acute respiratory failure: a single-centre prospective observational cohort study","authors":"Asyl Harbiye,Shiqi Zhang,Lina Kramer,Hélène B. van den Heuvel,Sebastiaan C. M. Joosten,Alessandro Burello,Frank van Someren Gréve,Tom van der Poll,Jan Willem Duitman,Lieuwe D. J. Bos,Leonoor S. Boers,the ArtDECO consortium,S. G. Blok,L. S. Boers,H. J. Bogaard,H. Bontkes,L. D. J. Bos,J. de Brabander,J. W. Duitman,J. J. Garcia Vallejo,L. Heunks,R. F. J. Kullberg,L. J. Meijboom,E. J. Nossent,R. Lutter,T. van der Poll,T. D. Y. Reijnders,A. Saris,A. R. Schuurman,A. P. J. Vlaar,H. de Vries,W. J. Wiersinga,S. Zhang,the BALI consortium,Erna Alberts,Harm-Jan Bogaard,Leonoor S. Boers,Lieuwe D. J. Bos,Peter I. Bonta,Alessandro Burello,Justin de Brabander,Annemiek Dijkhuis,Tamara Dekker,Jan Willem Duitman,J. J. Garcia Vallejo,Asyl Harbiye,Hélène B. van den Heuvel,Ingrid van den Hul,Pleun A. van Hooft,Sebastiaan C. Joosten,Alexandra W. Kolle,Lilian J. Meijboom,Erik H. A. Michels,Esther J. Nossent,Tom van der Poll,Shreshta P. Rakhan,Pieter R. Tuinman,Nicole M. Vermaat,Alexander P. J. Vlaar,Shiqi Zhang,Yihu Zhou","doi":"10.1186/s13054-026-06374-2","DOIUrl":"https://doi.org/10.1186/s13054-026-06374-2","url":null,"abstract":"Abstract Background Pulmonary reactivation of herpes simplex virus (HSV) and cytomegalovirus (CMV) is frequently observed in mechanically ventilated patients. However, whether this reflects underlying host immune dysfunction, directly contributes to alveolar inflammation, and/or predicts clinical outcomes such as delayed extubation or mortality remains unclear. Methods In this single-centre prospective observational cohort study (March 2020 - July 2024), we enrolled HSV- and CMV-seropositive adults undergoing mechanical ventilation for acute respiratory failure with a clinical indication for bronchoalveolar lavage (BAL). Alveolar and systemic host-response profiles were compared between high HSV-load (≥ 10⁴ copies/mL) and negative/low HSV-load (< 10⁴ copies/mL) samples using protein biomarker profiling in BAL fluid and plasma (Luminex) and assessment of BAL immune-cell composition (CyTOF). Clinical outcomes, including successful extubation and mortality, were assessed using competing-risk, multistate, time-dependent Cox, and Bayesian joint models. Result Among 299 HSV-seropositive patients, 102 (34%) developed high pulmonary HSV-load (≥ 10⁴ copies/mL). High HSV-load was associated with higher concentrations of selected alveolar inflammatory mediators, while major BAL immune-cell lineages were largely preserved; increased inducible nitric oxide synthase expression in neutrophils was the most prominent cellular signal. High HSV-load was generally detected late during mechanical ventilation. In the principal time-dependent analysis, high HSV-load was not significantly associated with successful extubation (HR 0.80, 95% CI 0.56–1.14) or mortality (HR1.39, 95% CI 0.96–2.01). Landmark analyses at day 7 showed similar results, whereas at day 14 high HSV-load was associated with a lower probability of successful extubation (HR 0.58, 95% CI 0.34–0.98). In a complementary joint model evaluating HSV-load continuously over time, each 1-log 10 increase in HSV-load was associated with higher mortality (HR 1.39, 95% CrI 1.08–2.30), but not with successful extubation (HR 1.06, 95% CrI 0.79–1.34). Among 258 CMV-seropositive patients, only 15 (6%) developed high CMV-load, limiting CMV-specific inference. Conclusion Across complementary analytical approaches, high pulmonary HSV-load was not consistently associated with successful extubation or mortality, although effect estimates generally pointed towards less favourable outcomes. High pulmonary HSV-load was, however, consistently associated with a localized alveolar inflammatory response. Taken together, these findings identify high pulmonary HSV-load as a biologically distinct inflammatory phenotype, while its causal significance for clinical outcomes remains unresolved. Whether targeting HSV improves clinical outcomes would require randomized evaluation. Clinical trial number Not applicable.","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"28 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149150317","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":"Beyond the 2-hour dogma: adsorption equilibrium versus saturation in polymyxin B hemoadsorption.","authors":"Chizuru Yamashita, Yu Kato, Takahiro Kawaji, Mariko Nagata, Osamu Nishida, Tomoyuki Nakamura","doi":"10.1186/s13054-026-06383-1","DOIUrl":"10.1186/s13054-026-06383-1","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"30 1","pages":""},"PeriodicalIF":11.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135377","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":"Cardiac-limited ventilator liberation in cardiogenic shock and advanced heart failure: a critical care cardiology framework","authors":"Aryan Shiari,Andrew Boshara","doi":"10.1186/s13054-026-06379-x","DOIUrl":"https://doi.org/10.1186/s13054-026-06379-x","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"1 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088213","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":"Remimazolam versus propofol for sedation in ICU patients with mechanical ventilation: a systematic review and meta-analysis of randomized trials","authors":"Qingfeng Wei,Wen Yu,Quan Zhou,Shibiao Chen","doi":"10.1186/s13054-026-06364-4","DOIUrl":"https://doi.org/10.1186/s13054-026-06364-4","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"53 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088212","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":"Moral luck, shame, and which errors attract sanction: an alternative reading of the Japan–US comparison of second victim syndrome","authors":"Helmar Bornemann-Cimenti,Istvan S. Szilagyi,Sebastian Labenbacher","doi":"10.1186/s13054-026-06377-z","DOIUrl":"https://doi.org/10.1186/s13054-026-06377-z","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"10 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088217","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":"Clinical trials testing early multimodal vasopressor therapy require a dose ceiling, not a dose floor","authors":"Patrick M. Wieruszewski,Ashish K. Khanna","doi":"10.1186/s13054-026-06378-y","DOIUrl":"https://doi.org/10.1186/s13054-026-06378-y","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"4 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088218","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":"Direct, real-time visualization-assisted nasoenteral tube placement in critically ill patients: a multicenter experience","authors":"Guoli Yang,Jinhan Huang,Huaqin Wang,Shaozhen Chen,Hui Yi,Yuequn Chen,Weijie Qiu,Fang Peng,Xiangrong Nie,Yihao Liu,Qian Zhou,Dingfeng Lai,Jinxia Li,Mingzhu Jiang,Cuiling Li,Wendan Li,Cheng Liu,Liqin Zhang,Bo Yu,Juan Zheng,Hui Yang,Xiaozhu Li,Kar Keung Cheng,Jun Jin,Xin Tian,Yifeng Luo","doi":"10.1186/s13054-026-06372-4","DOIUrl":"https://doi.org/10.1186/s13054-026-06372-4","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"40 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088214","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}