Critical CarePub Date : 2026-10-05DOI: 10.1186/s13054-026-06355-5
Iain Edmund Kehoe,Jeremy Alanano Pepino,Jin-Oh Hahn,Mary McAuley,Laura Lux,Abigail O’Connell,Noelle Saillant,Haitham S. Alabsi,Jarone Lee,Andrew Tomas Reisner
{"title":"Extrapolation of MAP trends predicts hypotension and vasopressor up-titration in the ICU.","authors":"Iain Edmund Kehoe,Jeremy Alanano Pepino,Jin-Oh Hahn,Mary McAuley,Laura Lux,Abigail O’Connell,Noelle Saillant,Haitham S. Alabsi,Jarone Lee,Andrew Tomas Reisner","doi":"10.1186/s13054-026-06355-5","DOIUrl":"https://doi.org/10.1186/s13054-026-06355-5","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"15 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088224","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}
Critical CarePub Date : 2026-10-05DOI: 10.1186/s13054-026-06366-2
Jinyang Yu
{"title":"A need for bedside surrogates of ventriculoarterial coupling in critical care – can MAPSE be of help?","authors":"Jinyang Yu","doi":"10.1186/s13054-026-06366-2","DOIUrl":"https://doi.org/10.1186/s13054-026-06366-2","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"1 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088219","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}
Critical CarePub Date : 2026-10-05DOI: 10.1186/s13054-026-06370-6
Fei Yang,Haoyang Hu
{"title":"Assessing fluid responsiveness in intra-abdominal hypertension: a pressure difference is not yet a vascular zone","authors":"Fei Yang,Haoyang Hu","doi":"10.1186/s13054-026-06370-6","DOIUrl":"https://doi.org/10.1186/s13054-026-06370-6","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"32 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088221","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":"What is the impact of mechanical circulatory support on outcomes in post-infarction ventricular septal rupture with cardiogenic shock? A systematic review","authors":"Giulia Maj,Astrid Cardinale,Serena Querio,Paola Bianchi,Edoardo Elia,Gioel Gabrio Secco,Marco Lombardi,Alina Gallo,Corrado Cavozza,Antonio Maconi,Serena Penpa,Federico Pappalardo,Andrea Audo","doi":"10.1186/s13054-026-06339-5","DOIUrl":"https://doi.org/10.1186/s13054-026-06339-5","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"26 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088223","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}
Critical CarePub Date : 2026-10-01DOI: 10.1186/s13054-026-06311-3
Andrew J. Boyle,Elizabeth G. Ryan,Lindsay R. Berry,Scott Berry,Lennie Derde,Patrick R. Lawler,Elizabeth Lorenzi,Cecilia M. O’Kane,Manu Shankar-Hari,Frank van de Veerdonk,Anthony C. Gordon,Daniel F. McAuley,on behalf of the REMAP-CAP Immune Modulation Domain Investigators
{"title":"Evaluating plasma ferritin and suPAR as treatable traits for critically ill patients with COVID-19 treated with anakinra: an exploratory analysis of the immune modulation domain of the REMAP-CAP randomised clinical trial","authors":"Andrew J. Boyle,Elizabeth G. Ryan,Lindsay R. Berry,Scott Berry,Lennie Derde,Patrick R. Lawler,Elizabeth Lorenzi,Cecilia M. O’Kane,Manu Shankar-Hari,Frank van de Veerdonk,Anthony C. Gordon,Daniel F. McAuley,on behalf of the REMAP-CAP Immune Modulation Domain Investigators","doi":"10.1186/s13054-026-06311-3","DOIUrl":"https://doi.org/10.1186/s13054-026-06311-3","url":null,"abstract":"Abstract Background Identifying treatable traits in critically ill patients offers potential to enable a precision medicine approach to treatment. The aim of this exploratory analysis of the REMAP-CAP immune modulation domain was to evaluate whether plasma ferritin or soluble urokinase plasminogen activator receptor (suPAR) represent treatable traits for anakinra in critically ill patients with coronavirus disease (COVID-19). Methods An exploratory analysis of patients randomised within the COVID-19 immune modulation domain of the REMAP-CAP trial was conducted. Adults within 24 h of receiving respiratory or cardiovascular organ support in an ICU with suspected or microbiologically confirmed COVID-19 were included. Plasma ferritin was measured at study sites, and plasma suPAR measured in stored plasma samples. The primary outcome was organ support-free days (OSFD) until day 21. Analyses were performed using a Bayesian cumulative logistic regression model, and results are presented as the posterior median odds ratio (OR), along with 95% credible intervals (CrI), for anakinra being superior to control. Results In ferritin analyses, 1243 patients were included. Patients with increasing ferritin levels had numerically fewer OSFDs. The posterior probabilities of anakinra having benefit (OR > 1) were 64%, 71%, and 21% across increasing ferritin terciles, compared to 53% in analyses that did not adjust for ferritin levels. 145 patients were included in the suPAR analyses. Patients with high baseline plasma suPAR (≥ 6 ng/ml; n = 85) had numerically fewer OSFDs than patients with low plasma suPAR (-1.0 (-1.0, 9.0) vs. 13.0 (-1.0, 17.0)). The posterior probabilities of anakinra having benefit (OR > 1) were 94.8% (OR 2.28 [0.85–6.06]) in patients with low baseline suPAR, and 38.6% (OR 0.88 [0.39–2.00]) in patients with high baseline suPAR. Conclusion Plasma ferritin does not identify patients with COVID-19 who benefit from treatment with anakinra, whilst anakinra may be beneficial in patients with low, rather than high, baseline plasma suPAR. These hypothesis-generating findings contrast with the results of clinical trials in non-critically ill patients with COVID-19. Trial registration NCT02735707. Date of trial registration: 06/04/2016","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"1 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088222","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":"Manual versus mechanical-bed passive leg raising test for predicting fluid responsiveness in patients with shock: a prospective single-center study","authors":"Xin-Er Cai,Ming-Kun Yan,Xiao-Tian Cai,Ji-Yue Shao,Yan-Jie Zhang,Wan-Ting Lin,Yi-Chun Sun,Zhu Luo,Wei-Jie Yu,Zhen Wang,Jing-Yuan Xu","doi":"10.1186/s13054-026-06365-3","DOIUrl":"https://doi.org/10.1186/s13054-026-06365-3","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"20 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088227","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":"A specialist-led interprofessional weaning program to prevent weaning failure in high-risk patients: the PRiVENT study","authors":"Franziska C. Trudzinski,Benjamin Neetz,Biljana Joveš,Axel Kempa,Armin Schneider,Elena Biehler,Thomas Fleischhauer,Janina Schubert-Haack,Teresa Byczkowski,Manuel Feißt,Peter Rosenberger,Jörg Krebs,Simone Britsch,Joachim Szecsenyi,Felix J. F. Herth,the PRiVENT-Study Group,Felix J. F. Herth,Gabriele Iberl,Julia Dorothea Michels-Zetsche,Jana Christina Dahlhoff,Michael Müller,Benjamin Neetz,Franziska Christina Trudzinski,Philipp Höger,Elena Biehler,Thomas Fleischhauer,Gerhard Fuchs,Nicola Litke,Markus Qreini,Joachim Szecsenyi,Michel Wensing,Timm Frerk,Thomas Grobe,Janina Schubert-Haack,Anja Klingenberg,Teresa Byczkowski,Manuel Feißt,Axel Kempa,Biljana Joves,Andreas Rheinhold,Ahmed Ehab,Claus Neurohr,Alessandro Ghiani,Nina Lutz,Swenja Walcher,Konstantinos Tsitouras,Joanna Paderewska,Selina Briese,Armin Schneider,Christoph Rauch,Patrick Gehrig,Joachim Sugg,Susanne Hirschmann,Simone Britsch,Christa Straub,Claude Jabbour,Michael Hahn,Jörg Krebs,Peter-Tobias Graf,Petra Denzer,Uta Merle,Monica Boxberger,Mascha Fiedler-Kalenka,Guido Hundt,Jens Regula,Thushira Weerawarna,Miriane Bomeken,Lisa Amega,Shumallah Basit,Sebastian Stier,Matthias Körner,Jens Müller,Sergej Markin,Ute Oltmanns,Oliver Gorgs,Mark Hackbarth,Sebastian Münz,Dominik Scharpf,Thomas J. Dengler,Mathias Borst,Brigitte Mayer,Wolfgang Reikow,Markus Kredel,Patrick Keppeler,Konstantin Frey,Holger Wolff,Florian Seidlitz,Stefanie Bientzle,Boris Nohé,Sebastian Allgäuer,Alexej Schöpp,Jörg Winckelmann,Christoph Schlegel,Imke Hübner,Andrzej Kuzniar,Helene Häberle,Alice Bernard,Reimer Riessen,Benjamin Schempf,Ingo Rebenschütz,Andreas Straub,Marc Kollum,Markus Winter,Paul Hartveg,Andreas Junginger,Thomas Abt,Mathias Vogel,Ralf Völker,Thomas Wiesmann","doi":"10.1186/s13054-026-06357-3","DOIUrl":"https://doi.org/10.1186/s13054-026-06357-3","url":null,"abstract":"Abstract Purpose Effective strategies to prevent weaning failure and prolonged invasive mechanical ventilation (IMV) in patients at high risk of weaning failure are limited. We evaluated a structured, specialist-led interprofessional weaning program. Methods In this prospective, multicenter, non-randomized interventional study, mechanically ventilated patients were screened 96 h to 11 days after intubation. Patients meeting predefined high-risk criteria received a specialist-led interprofessional weaning program, while a parallel control group was derived from health insurance claims data. The primary outcome was successful weaning at ICU discharge. Results The primary analysis included 349 intervention patients and 1,768 controls. Successful weaning occurred in 58.3% of intervention patients and 51.7% of controls. In the adjusted primary analysis, the odds ratio for successful weaning was 1.46 (95% CI, 0.99–2.17; P = 0.057), and the difference did not reach statistical significance. In prespecified propensity score-matched analysis, successful weaning occurred in 58.3% of intervention patients and 46.4% of matched controls (OR, 2.90; 95% CI, 1.61–5.24; P < 0.001). An exploratory analysis restricted to ICU survivors also showed higher odds of successful weaning in the intervention group (OR, 2.10; 95% CI, 1.09–4.04; P = 0.026). Overall, 16.3% of intervention patients were transferred to a specialized weaning center. These patients had longer ventilation durations, contributing to a longer overall duration of IMV in the intervention group. Conclusions The PRiVENT intervention was feasible and successful weaning was numerically more frequent in the intervention group, although the prespecified adjusted primary analysis did not reach statistical significance. These findings suggest a potential benefit of structured, multidisciplinary weaning support. Trial registration ClinicalTrials.gov, NCT05260853, registered on March 2, 2022.","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"8 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088268","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}
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