Critical Care最新文献

{"title":"A prediction model for ‘ICU mortality or prolonged ICU stay’ in critically unwell patients with acute pancreatitis: insights from a 2003–2020 cohort analysis using the ANZICS-CORE database","authors":"Karthik Venkatesh, Timothy E. Schlub, S. George Barreto, Christopher R. Andersen, Miles P. Davenport, Anthony Delaney, Billingsley Kaambwa, Shailesh Bihari, David Pilcher, Sarah C. Sasson","doi":"10.1186/s13054-025-05590-6","DOIUrl":"https://doi.org/10.1186/s13054-025-05590-6","url":null,"abstract":"Critically unwell patients with acute pancreatitis (AP) are at increased risk of mortality and prolonged ICU length of stay (LOS). We quantified the frequency, risk factors and complications of prolonged ICU LOS in a large cohort of critically unwell adult patients with AP and developed a model to predict a low-risk trajectory ‘survived ICU with ICU LOS ≤7 days’ versus a high-risk trajectory ‘ICU mortality or ICU LOS > 7 days’. A retrospective cohort analysis of adult patients admitted to Australian and New Zealand ICUs with AP between 2003 and 2020 was conducted using the Australian and New Zealand Intensive Care Society Centre for Outcome Reporting and Evaluation database. Data was censored to December 2020 in order to pre-date the COVID-19 pandemic. The incidence, risk factors and outcomes related to prolonged ICU LOS in AP patients was reported. Multivariate logistic regression was used to build a prediction model for a low-risk versus high-risk outcome. Discrimination was performed with 10-fold cross validation and calibration plot analysis was reported. 13,275 patients met inclusion criteria; 60% were male, with a mean age 59±18, mean APACHE III 56±26. 2860 (21.6%) had an ICU LOS > 7 days, 1022 (7.7%) died in ICU, and 3557 (26.8%) had a high-risk trajectory. Prolonged ICU LOS was associated with increased ICU mortality (OR 1.57 95% CI 1.43–1.73 p < 0.001), hospital mortality (OR 1.69 95% CI 1.56–1.83 p < 0.001), and resource use: mechanical ventilation (OR 5.99 95% CI 5.21–6.90 p < 0.001), inotrope/vasopressor support (OR 3.27 95% CI 2.82–3.79 p < 0.001) and dialysis (OR 4.12 95% CI 3.63–4.68 p < 0.001). Model accuracy was 79.5%, Cohen K = 0.49 and AUROC 0.827. For a high-risk trajectory, sensitivity was 0.54 and specificity 0.916. APACHE III, PaO2:FiO2 ratio and early mechanical ventilation were the most influential covariates. Prolonged ICU LOS was associated with increased rate of hospital discharge to rehabilitation or a nursing home. More than a quarter of ICU patients with AP have a high-risk trajectory. Prolonged ICU admissions are associated with significantly worse mortality and hospital outcomes, and increase resource use. Our prediction model, if confirmed in future studies, may present an opportunity for prognostic enrichment in patients with more severe disease.","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"16 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786585","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":"Infrastructure and current practice of blood culture diagnostics in patients with sepsis: teachings and recommendations from the European Sepsis Care Survey","authors":"Christian S. Scheer, Djillali Annane, Antonio Artigas, Adam Linder, Michael Sander, Oktay Demirkiran, Konrad Reinhart, Evangelos J. Giamarellos-Bourboulis","doi":"10.1186/s13054-025-05582-6","DOIUrl":"https://doi.org/10.1186/s13054-025-05582-6","url":null,"abstract":"The recently published European Sepsis Care Survey (ESCS) by the European Sepsis Alliance (ESA) showed that the standard-of-care strategies regarding infrastructure and logistics on diagnosis and management of sepsis were beyond what is considered satisfactory. This led to a position statement by the Steering Committee of the ESA. A literature search was conducted to compare the compliance with the Surviving Sepsis Campaign Guidelines and/or other medical societies reported by the health care practitioners participating in the ESCS regarding first line fluids and vasopressors, biomarkers, continuous availability for microbiology service and antibiotic stewardship team. In all suggested practices for sepsis care the feedback of the health-care professionals who completed the ESCS showed that the average adherence was more than 80% with two exceptions: availability of microbiology diagnosis limited to 10% and antibiotic stewardship for the selection of the most appropriate antibiotic limited to 65%. ESA suggests that quality measures are applied across Europe towards the implementation of bundles for early sepsis recognition, antibiotic stewardship for sepsis patients and availability of a continuous microbiology service on a 24-hour basis including weekends for timely diagnosis. ","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"289 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144778335","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":"When the surgeon becomes the patient: lessons from the brink of death","authors":"Florent Porez","doi":"10.1186/s13054-025-05580-8","DOIUrl":"https://doi.org/10.1186/s13054-025-05580-8","url":null,"abstract":"<p>There are moments when life violently strips away one’s identity as a physician and redefines it, without consent, as that of a critically ill patient. That is exactly what happened to me, at the peak of physical health, in the beginning of my surgical career.</p><p>I was a young, healthy cardiovascular surgeon, passionate about my work and committed to athletic pursuits. One day, I suddenly experienced abrupt and severe chest pain, accompanied by shortness of breath and high fever. I dismissed these symptoms at first, convincing myself it was benign. Later that day, I even collapsed in my own bathroom where I experienced the classic signs of cardiogenic shock: a sudden drop in blood pressure, a creeping veil of black over my vision, marbling of skin, a disturbing clouding of consciousness. Endogenous adrenaline flooded my system; my mouth went dry, my pupils dilated. Despite recognizing these red flags, I stubbornly refused to face the truth and forbade my wife from calling emergency medical services. It wasn’t until she phoned a close friend, a pediatric surgery chief, who gently but firmly insisted we head to the nearest hospital (where I operated) that I finally agreed to get help.</p><p>Within hours of my admission, I was whisked into the ICU, beginning a five-day struggle for survival. Electrocardiography revealed worsening biventricular function. Dobutamine doses were increased to the maximum. Facing fulminant cardiogenic shock, the surgical team seriously discussed the need for mechanical circulatory support with venoarterial extracorporeal membrane oxygenation (VA-ECMO). The prospect of cardiac transplantation was also raised during those crucial hours. The first night, I called my surgical mentor and whispered, “I don’t think I’m going to make it. Yesterday I was trail-running, today I’m close to needing ECMO and a transplant.” His answer was calm and immediate: “We’re preparing for it right now.” The beeping of monitors and alarms from unstable vitals filled my nights. I was haunted by vivid hallucinations—visions so intense they seemed more real than the ICU itself. At times, they felt like a release, a floating detachment from pain and urgency, a kind of inner quiet I had never known. But that stillness was deceptive. I could feel myself being slowly pulled away from reality, drifting toward a zone where choices vanished and identity dissolved. The tunnel of light wasn’t metaphorical—it was real, and it was beautiful in a way that terrified me. It took everything in me to resist surrendering to it. What pulled me back was not a drug or a machine, but people. The ICU staff saved me with acts of care. They refused to let me vanish. I remember a nurse firmly insisting I sit up, helping me to wash, bringing me breakfast I had no strength to eat but was gently encouraged to try. They fought not only for my life, but for my dignity. They treated me like someone who still mattered, when I no longer believed I did.</p><p>Everything change","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"15 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144778203","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 ventilator-free days: review of several estimands","authors":"Laurent Renard Triché, Matthieu Jabaudon, Sylvie Chevret","doi":"10.1186/s13054-025-05593-3","DOIUrl":"https://doi.org/10.1186/s13054-025-05593-3","url":null,"abstract":"Mortality is a critical endpoint in clinical research, but identifying meaningful differences necessitates large sample sizes. Consequently, composite outcomes such as ventilator-free days (VFDs) have been developed, combining survival and ventilation duration into a single measure. Different statistical methods used to analyse VFDs lead to different estimands. Traditionally, VFDs are treated as a count; however, some models consider time to death and time to extubation separately. This review explores the applicability of several time-to-event models and innovative approaches. The first model to consider is the competing risks approach using the Fine-Gray model. This approach focuses solely on the initial extubation event and considers death as a competing event. Second, to incorporate all extubation and reintubation events, multistate models can be employed. Specifically, the multiple-event framework, which allows for multiple transitions between intubation and extubation, while the recurrent events framework, focuses on extubation recurrence. However, these models require complete data and a sufficient number of events for analysis. Third, current ventilation-free survival estimates use methods adapted from leukaemia-free survival to evaluate the probability of remaining extubated and alive over time. Finally, the mixture cure model distinguishes between deceased and extubated individuals within the non-deceased population. It models death through logistic regression and extubation timing through survival regression among living patients. In critical care, especially for acute respiratory distress syndrome, three key states are intubation, extubation, and death. We do not advocate a one-size-fits-all model because the choice depends heavily on the specific goals. The key is to decide which estimand the study will target in the statistical plan, before initiating the study, and to ensure the analysis model is the most appropriate for addressing the research question. ","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"58 1","pages":"343"},"PeriodicalIF":15.1,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144778345","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 blood-brain barrier disruption and molecular weight: compartmental kinetics of S100B and NSE for neurological prognostication after cardiac arrest","authors":"So-Young Jeon, Changshin Kang, Yenho You, Jung Soo Park, Jin Hgon Min, Wonjoon Jeong, Hyun Shik Ryu, Jiyoung Choi, Byung Kook Lee","doi":"10.1186/s13054-025-05572-8","DOIUrl":"https://doi.org/10.1186/s13054-025-05572-8","url":null,"abstract":"The prognostic value of serum biomarkers after out-of-hospital cardiac arrest (OHCA) depends on timing, but the physiological basis remains unclear. We investigated whether blood–brain barrier (BBB) integrity and biomarker-specific properties explain the time-dependent differences in prognostic performance. This retrospective study included comatose adult OHCA survivors who underwent paired serum and cerebrospinal fluid (CSF) measurements of neuron-specific enolase (NSE; 47 kDa) and S100 calcium-binding protein B (S100B; 21 kDa) at 0 (H0), 24 (H24), 48 (H48), and 72 (H72) h after return of spontaneous circulation. BBB disruption was assessed using the CSF/serum albumin quotient (QA). Prognostic performance was assessed using AUC analysis for 6-month poor neurological outcome (Cerebral Performance Category 3–5). Among 111 patients (59% poor outcome), 646 serum and 620 CSF samples were analyzed. BBB disruption was more severe in the poor outcome group at all timepoints (all P < 0.001), peaking at H24 (QA 0.0282 [IQR 0.0150–0.120]) and remaining elevated at H72 (0.0228 [IQR 0.0147–0.0598]). In the poor outcome group, serum S100B levels peaked at H0 (0.80 ng/mL [IQR 0.39–2.81]) and declined despite a persistent elevation in CSF levels at or above the upper detection limit (≥ 30 ng/mL). Conversely, NSE levels progressively increased in both compartments, with serum and CSF levels increasing in parallel over time. Serum NSE concentrations showed a time-dependent improvement in prognostic accuracy, peaking at H72 (AUC 0.88), whereas S100B concentrations maintained stable performance across all timepoints (AUCs 0.79–0.85, all P > 0.4). Notably, the prognostic performance of S100B remained relatively consistent regardless of BBB disruption severity, whereas NSE showed progressively improved predictive accuracy with increased BBB disruption. Across all timepoints, CSF biomarkers—particularly S100B and NSE—showed consistently higher AUCs than serum, suggesting superior prognostic utility. Serum NSE levels closely reflect the degree of BBB disruption and CSF levels, while S100B exhibits a transient early-phase profile, with decreased serum detectability over time, even in the presence of sustained CSF elevation or severe BBB disruption. These findings highlight the importance of interpreting biomarker kinetics across compartments and timepoints rather than relying on molecular weight or BBB status alone.","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"726 1","pages":"342"},"PeriodicalIF":15.1,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144778311","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":"Visualizations of autoregulatory insults in moderate-to-severe paediatric traumatic brain injury: a secondary analysis from the multicentre STARSHIP trial","authors":"Teodor Svedung Wettervik, Claudia Ann Smith, Anders Hånell, Stefan Yu Bögli, Peter Hutchinson, Shruti Agrawal, Peter Smielewski","doi":"10.1186/s13054-025-05568-4","DOIUrl":"https://doi.org/10.1186/s13054-025-05568-4","url":null,"abstract":"Paediatric traumatic brain injury (TBI) is a heterogeneous condition with age-dependent differences in systemic and cerebral physiology, making cerebral perfusion pressure (CPP) challenging to target. Monitoring cerebral autoregulation using the pressure reactivity index (PRx) and deriving an autoregulatory optimal CPP (CPPopt) may personalize treatment, but evidence in children remains limited. In this multicentre paediatric TBI study, we aimed to explore and visualize PRx and CPPopt in relation to outcome. In this secondary analysis of the prospective, multicentre study (STARSHIP), 98 paediatric TBI patients (1–16 years) from 10 paediatric intensive care units, in the UK, between 2018 and 2023, with high-frequency physiological data and 12-month GOS-E Peds outcomes, not treated with decompressive craniectomy, were included. Intracranial pressure (ICP), PRx, CPP, and ΔCPPopt were correlated with outcome using insult intensity/duration heatmaps across the full monitoring period. Two-variable heatmaps incorporating PRx were also used to assess how autoregulation modified the relationship between ICP, CPP, and ΔCPPopt with outcome. There was a transition from favourable to unfavourable outcome when PRx exceeded + 0.00 for longer episodes. Furthermore, there was a transition towards worse outcome when CPP went below 40 mmHg and above 100 mmHg for sustained durations. For ΔCPPopt, the transition towards poor prognosis occurred for values below − 20 mmHg, but positive ΔCPPopt was tolerated. In the two-variable heatmaps, PRx above + 0.50 together with ICP above 20 mmHg, CPP below 60 mmHg, or negative ΔCPPopt were particularly associated with unfavourable outcome. This novel study visualized the safe and dangerous intervals for PRx and CPPopt as well as the interaction effect between the autoregulatory status and ICP, CPP, and ΔCPPopt in relation to outcome in paediatric TBI. Future prospective trials are needed to evaluate the safety, feasibility, and efficacy of PRx/CPPopt guided management.","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"37 1","pages":"344"},"PeriodicalIF":15.1,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144778337","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":"Correction: Electrical impedance tomography-guided the optimal awake prone position in a moderate ARDS patient","authors":"Yongzhen Sun, Jiale Tao, Jinjun Jiang, Shujing Chen","doi":"10.1186/s13054-025-05584-4","DOIUrl":"https://doi.org/10.1186/s13054-025-05584-4","url":null,"abstract":"<p><b>Correction: Crit Care (2025) 29:95</b> <b>https://doi.org/10.1186/s13054-025-05332-8</b></p><p>Following publication of the original article [1], the authors identified an error in Fig. 1F. Thinker’s position should be 320, however it appeared as 20. Both the incorrect and correct Fig. 1 is given hereafter.</p><p>The incorrect Fig. 1:</p><figure><picture><source srcset=\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs13054-025-05584-4/MediaObjects/13054_2025_5584_Figa_HTML.png?as=webp\" type=\"image/webp\"/><img alt=\"figure a\" aria-describedby=\"Figa\" height=\"760\" loading=\"lazy\" src=\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs13054-025-05584-4/MediaObjects/13054_2025_5584_Figa_HTML.png\" width=\"685\"/></picture></figure><p><b>Fig. 1</b> Changes in lung ventilation status and S/F, RR, and ROX of the patient in different positions under EIT monitoring. <b>A</b> shows the EIT images from the first day to the third day. The images in each panel from top to bottom are: global impedance waveforms, tidal impedance variation distribution (RVD: region ventilation delay, in yellow), difference image (CW: compliance win, in turquoise; CL: compliance loss, in orange), and data trend chart. (I), (II), (III), and (IV) in Figure A represent the supine position, semi-recumbent position, “Thinker’s position”, and prone position respectively, and each position was maintained for 10 min. <b>B</b> shows the changes in the global inhomogeneity index (GI) of the lungs in different positions monitored by EIT on the first and second days.<b> C</b> shows the changes in the ventilation center (CoV) of the lungs in different positions monitored by EIT on the first and second days.<b> D </b>shows the changes in GI and CoV of the lungs in different positions monitored by EIT on the third day. E shows the changes in the patient’s respiratory rate and ROX index during the 2-h maintenance of the“Thinker’s position (TP)”. F shows the changes in S/F, RR, and ROX of the patient in different positions from the first day to the third day</p><p>The correct Fig. 1:</p><figure><figcaption><b data-test=\"figure-caption-text\">Fig. 1</b></figcaption><picture><source srcset=\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs13054-025-05584-4/MediaObjects/13054_2025_5584_Fig1_HTML.png?as=webp\" type=\"image/webp\"/><img alt=\"figure 1\" aria-describedby=\"Fig1\" height=\"852\" loading=\"lazy\" src=\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs13054-025-05584-4/MediaObjects/13054_2025_5584_Fig1_HTML.png\" width=\"685\"/></picture><p>Changes in lung ventilation status and S/F, RR, and ROX of the patient in different positions under EIT monitoring. <b>A</b> shows the EIT images from the first day to the third day. The images in each panel from top to bottom are: global impedance waveforms, tidal impedance variation distribution (RVD: region ventilation delay, in yellow), difference image (CW: compliance win,","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"15 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763327","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":"Targeting high circulating dipeptidyl peptidase 3 in circulatory failure","authors":"Adrien Picod, Feriel Azibani, Veli-Pekka Harjola, Mahir Karakas, Antoine Kimmoun, Bruno Levy, Peter Pickkers, Holger Thiele, Uwe Zeymer, Karine Santos, Alexandre Mebazaa","doi":"10.1186/s13054-025-05545-x","DOIUrl":"https://doi.org/10.1186/s13054-025-05545-x","url":null,"abstract":"Circulating dipeptidyl peptidase 3 is a new biomarker linked to circulatory failure prognosis and pathophysiology and is a potential actionable therapeutic target. In this short review intended for the clinician, a question-and-answer format provides key insights on the nature of this biomarker and the therapeutical potential of its targeted inhibition in critically ill patients.","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"26 1","pages":"340"},"PeriodicalIF":15.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756373","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":"Correction: Peri‑intubation complications in critically ill obese patients: a secondary analysis of the international INTUBE cohort","authors":"Vincenzo Russotto, John G. Laffey, Elena Tassistro, Sheila N. Myatra, Emanuele Rezoagli, Giuseppe Foti, Laura Antolini, Maria Grazia Valsecchi, Philippe R. Bauer, Konstanty Szułdrzyński, Luigi Camporota, Robert Greif, Andy Higgs, Matteo Parotto, Roberto Fumagalli, Massimiliano Sorbello, Chiara Robba, Giacomo Grasselli, Giacomo Bellani, Pietro Caironi, Jean Baptiste Lascarrou","doi":"10.1186/s13054-025-05475-8","DOIUrl":"https://doi.org/10.1186/s13054-025-05475-8","url":null,"abstract":"&lt;p&gt;&lt;b&gt;Correction: Critical Care (2025) 29:192&lt;/b&gt; &lt;b&gt;https://doi.org/10.1186/s13054-025-05419-2&lt;/b&gt;&lt;/p&gt;&lt;p&gt;Following the publication of the original article [1], the author reported that due to an error the institutional author group was not indicated on the title page and therefore the institutional authors were not visible as being part of the INTUBE Study Investigators. The institutional author names given in the additional file 1 of the original article [1] have been added to the INTUBE Study Investigators institutional author group.&lt;/p&gt;&lt;p&gt;The title page and the institutional author group has been updated in this correction article and the original article [1] has been corrected.&lt;/p&gt;&lt;ol data-track-component=\"outbound reference\" data-track-context=\"references section\"&gt;&lt;li data-counter=\"1.\"&gt;&lt;p&gt;Russotto V, Laffey JG, Tassistro E, et al. Peri-intubation complications in critically ill obese patients: a secondary analysis of the international INTUBE cohort. Crit Care. 2025;29:192. https://doi.org/10.1186/s13054-025-05419-2.&lt;/p&gt;&lt;p&gt;Article Google Scholar &lt;/p&gt;&lt;/li&gt;&lt;/ol&gt;&lt;p&gt;Download references&lt;svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"&gt;&lt;use xlink:href=\"#icon-eds-i-download-medium\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"&gt;&lt;/use&gt;&lt;/svg&gt;&lt;/p&gt;&lt;h3&gt;Authors and Affiliations&lt;/h3&gt;&lt;ol&gt;&lt;li&gt;&lt;p&gt;Department of Oncology, University of Turin, Turin, Italy&lt;/p&gt;&lt;p&gt;Vincenzo Russotto &amp; Pietro Caironi&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Department of Anesthesia and Intensive Care, University Hospital San Luigi Gonzaga, Orbassano, Turin, Italy&lt;/p&gt;&lt;p&gt;Vincenzo Russotto &amp; Pietro Caironi&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Anesthesia and Intensive Care Medicine, School of Medicine, University of Galway, Galway, Ireland&lt;/p&gt;&lt;p&gt;John G. Laffey&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Department of Anesthesia and Intensive Care Medicine, University Hospital Galway, Galway, Ireland&lt;/p&gt;&lt;p&gt;John G. Laffey&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Biostatistics and Clinical Epidemiology, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy&lt;/p&gt;&lt;p&gt;Elena Tassistro &amp; Maria Grazia Valsecchi&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4 Center), School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy&lt;/p&gt;&lt;p&gt;Elena Tassistro, Laura Antolini &amp; Maria Grazia Valsecchi&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India&lt;/p&gt;&lt;p&gt;Sheila N. Myatra&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Department of Emergency and Intensive Care, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy&lt;/p&gt;&lt;p&gt;Emanuele Rezoagli &amp; Giuseppe Foti&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy&lt;/p&gt;&lt;p&gt;Emanuele Rezoagli, Giuseppe Foti &amp; Roberto Fumagalli&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, USA&lt;/p&gt;&lt;p&gt;Philippe R. Bauer&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Department of Anesthesiology and Intensive Care, National Medical Institute of the Ministry of Interior and Administration, Warsaw, ","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"15 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747066","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":"Assessing inspiratory drive and effort in critically ill patients at the bedside","authors":"Roberto Tonelli, Alessandro Protti, Elena Spinelli, Domenico Luca Grieco, Takeshi Yoshida, Annemijn H. Jonkman, Evangelia Akoumianaki, Irene Telias, Mattia Docci, Antenor Rodrigues, Joaquin Perez, Lise Piquilloud, Jeremy Beitler, Ling Liu, Oriol Roca, Lara Pisani, Ewan Goligher, Guillaume Carteaux, Giacomo Bellani, Enrico Clini, Jian-Xin Zhou, Giacomo Grasselli, Samir Jaber, Alexandre Demoule, Daniel Talmor, Leo Heunks, Laurent Brochard, Tommaso Mauri","doi":"10.1186/s13054-025-05526-0","DOIUrl":"https://doi.org/10.1186/s13054-025-05526-0","url":null,"abstract":"Monitoring inspiratory drive and effort may aid proper selection and setting of respiratory support in patients with acute respiratory failure (ARF), whether they are intubated or not. Although diaphragmatic electrical activity (EAdi) and esophageal manometry can be considered the reference methods for assessing respiratory drive and inspiratory effort, respectively, various alternative techniques exist, each with distinct advantages and limitations. This narrative review provides a comprehensive overview of bedside methods to assess respiratory drive and effort, with a primary focus on patients with ARF. First, EAdi and esophageal manometry are described and discussed as reference techniques. Then, alternative methods are categorized along the neuromechanical pathway from inspiratory drive to muscular effort into three groups: (1) techniques assessing the respiratory drive: airway occlusion pressure (P0.1), mean inspiratory flow (Vt/Ti) and respiratory muscle surface electromyography (sEMG); (2) techniques assessing the respiratory muscle effort: whole-breath occlusion pressure (ΔPocc), pressure-muscle index (PMI), nasal pressure swing (ΔPnose), diaphragm ultrasonography (USdi), central venous pressure swing (ΔCVP), breathing effort (BREF) models, and flow index; (3) techniques and clinical parameters assessing the consequences of effort: tidal volume (Vt), electrical impedance tomography (EIT), dyspnea. For each, we summarize the physiological rationale, measurement methodology, interpretation of results, and key limitations.","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"137 1","pages":""},"PeriodicalIF":15.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747288","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}