Intensive Care Medicine最新文献

{"title":"What's your diagnosis? Pneumonia, splenic and subcutaneous abscesses.","authors":"Hailong Li,Li Zhao,Ying Wang,Long Xiang","doi":"10.1007/s00134-025-07942-w","DOIUrl":"https://doi.org/10.1007/s00134-025-07942-w","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"44 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319874","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":"Publisher Correction: Effect of hydrocortisone on mortality in patients with severe community-acquired pneumonia.","authors":"","doi":"10.1007/s00134-025-07954-6","DOIUrl":"https://doi.org/10.1007/s00134-025-07954-6","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"91 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296015","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":"Traumatic brain injury management in the intensive care unit: standard of care and knowledge gaps.","authors":"Chiara Robba,Victoria McCredie,Randall M Chesnut,Giuseppe Citerio,Tobias Gauss,Gregory W J Hawryluk,Raimund Helbok,Geert Meyfroidt,Virginia Newcombe,Aarti Sarwal,Fabio S Taccone,Mathieu van der Jagt,Sarah Wahlster,Elisa R Zanier,Pierre Bouzat","doi":"10.1007/s00134-025-07967-1","DOIUrl":"https://doi.org/10.1007/s00134-025-07967-1","url":null,"abstract":"Despite advances in the management of traumatic brain injury (TBI) in the intensive care unit (ICU), and the implementation of new diagnostic techniques and monitoring modalities, the rate of poor neurological outcomes remains high. Specialized neurocritical care units have been shown to improve outcomes. Guidelines have been developed, but most recommendations are based on low levels of evidence. This has led to substantial heterogeneity in clinical practice for many aspects of TBI management, including multimodal neuromonitoring indications, treatment of intra- and extra-cranial complications, and use of prognostic tools. New tools have recently emerged, such as biomarkers and the use of artificial intelligence, but further research is needed to establish their application in clinical practice. This narrative review aims to describe standards of practice for the management of TBI in the ICU, highlighting current evidence and knowledge gaps, to provide a pragmatic approach for clinicians caring for this population.","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"65 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296013","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":"Anticoagulation management and outcomes in critically ill patients with acute mesenteric ischemia: an international study.","authors":"Inès Lakbar,Louis Delamarre,Kadri Tamme,Naira Hernandez De La Torre,Joris Pensier,Clément Monet,Joel Starkopf,Mathieu Capdevila,Marc Leone,Audrey De Jong,Annika Reintam Blaser,Samir Jaber,","doi":"10.1007/s00134-025-07980-4","DOIUrl":"https://doi.org/10.1007/s00134-025-07980-4","url":null,"abstract":"BACKGROUNDAcute mesenteric ischemia (AMI) is associated with low survival rates. It is recommended to start early a full dose of anticoagulation therapy in patients with AMI, regardless of etiology, surgical or procedural perspective, or coagulation status. However, there are no international studies addressing the impact of timing and dose of anticoagulation therapy on outcome in AMI patients hospitalized in the intensive care unit (ICU).METHODSThis international study combined data from 33 ICU centers in 19 countries. The primary outcome was 30-day survival. Secondary outcomes assessed duration of mechanical ventilation, ICU length of stay, occurrence of hemorrhagic complications and 90-day survival. We also identified independent risk factors for 30-day survival.RESULTSAmong the 370 analyzed patients, 183 received early full-dose anticoagulation therapy and 187 did not. The 30-day survival was 53.5% (n = 98) in patients receiving early full-dose anticoagulation therapy and 41.7% (n = 78) in patients who did not (p = 0.01), with a number needed to treat (NNT) of n = 8. Early full-dose anticoagulation was associated with a longer duration of mechanical ventilation (p = 0.01). No differences were observed in ICU length of stay or hemorrhagic complications. Improved survival persisted in patients receiving early full-dose anticoagulation at 90 day (p = 0.02). We defined four multivariate Cox hazard models for 30-day survival. Only two intervention therapies were associated with survival: early full-dose anticoagulation and revascularization and/or bowel resection.CONCLUSIONThis study suggests a significant survival benefit of early full-dose anticoagulation in ICU patients with acute mesenteric ischemia and no difference in hemorrhagic complications. Early full-dose anticoagulation and revascularization and/or bowel resection were associated with survival.","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"228 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296016","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: ESICM consensus-based recommendations for the management of very old patients in intensive care.","authors":"Michael Beil, Laura Alberto, Richard S Bourne, Nathan E Brummel, Bas de Groot, Dylan W de Lange, Paul Elbers, Marielle Emmelot-Vonk, Hans Flaatten, Yonathan Freund, Alessandro Galazzi, Ana Garcia-Martinez, Bertrand Guidet, Iva Holmerova, Jeremy M Jacobs, Gavin M Joynt, Susannah Leaver, Marc Leone, Bairbre McNicholas, David McWilliams, Victoria Metaxa, Christian H Nickel, Daniele Poole, Chiara Robba, Kevin Roedl, Marc Romain, Anne-Françoise Rousseau, Sigal Sviri, Wojciech Szczeklik, Helene Vallet, James van Oppen, Christian Jung","doi":"10.1007/s00134-025-07881-6","DOIUrl":"https://doi.org/10.1007/s00134-025-07881-6","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302003","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":"Oncology as a gateway for integrating palliative care training in intensive care: toward a contextual and scalable model. Author's reply.","authors":"Mohammed Aabdi, Youssef Motiaa, Choukri Bahouh, Khalil El Yachioui, Hicham Sbai","doi":"10.1007/s00134-025-07994-y","DOIUrl":"https://doi.org/10.1007/s00134-025-07994-y","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293700","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":"Author Correction: Hemoadsorption in septic shock-CON.","authors":"Massimo Girardis, Martina Tosi, Sascha David","doi":"10.1007/s00134-025-07984-0","DOIUrl":"https://doi.org/10.1007/s00134-025-07984-0","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283829","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":"Correspondence on \"A common longitudinal intensive care unit data format (CLIF) for critical illness research\".","authors":"Benjamin Popoff, Alexandre Bourgeois, Boris Delange, Michael Poette, Adrien Parrot","doi":"10.1007/s00134-025-07999-7","DOIUrl":"https://doi.org/10.1007/s00134-025-07999-7","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283830","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":"Altered lower brainstem neurophysiological response is associated with mortality in deeply sedated critically ill patients.","authors":"Eléonore Bouchereau, Estelle Pruvost-Robieux, Shidasp Siami, Cendrine Chaffaut, Adrien Bouglé, Martine Gavaret, Nicholas Heming, Sivanthiny Sivanandamoorthy, Julie Zyss, Vincent Degos, Stanislas Kandelman, Cassia Righy Shinotsuka, Sarah Benghanem, Lionel Naccache, Benjamin Rohaut, Bertrand Hermann, Eric Azabou, Sylvie Chevret, Tarek Sharshar","doi":"10.1007/s00134-025-07945-7","DOIUrl":"https://doi.org/10.1007/s00134-025-07945-7","url":null,"abstract":"<p><strong>Background and objectives: </strong>Absent cough reflex is associated with mortality in intensive care unit (ICU) patients requiring deep sedation, suggesting that lower brainstem dysfunction contributes to adverse outcomes. We conducted a multicenter observational cohort study to confirm this hypothesis by assessing the peak latency (PL) of the lower brainstem-generated P14 evoked potential (EP), which is slightly increased by sedatives. We aimed to demonstrate that a P14-PL > 16 ms is independently associated with day-28 mortality.</p><p><strong>Patients and methods: </strong>Mechanically ventilated adult patients, comatose or deeply sedated, brain injured or not, were included. At day 3, EPs were performed in patients remaining unconscious. The Simplified Acute Physiological Score (SAPSII), initial Glasgow Coma Scale (GCS), sedation depth, and brainstem reflexes were collected. The primary outcome was day-28 mortality. The secondary outcomes were delayed awakening and delirium after sedation discontinuation.</p><p><strong>Results: </strong>Between 2015 and 2019, 322 patients were included. EPs were performed in 264 (82%) patients, including 140 (53%) brain-injured and 251 (95%) deeply sedated patients. The median age, SAPSII and initial GCS were 62 [50; 71], 49 [40; 62] and 11 years [6; 15], respectively. A P14-PL > 16 ms was found in 76 (29%) patients and was associated with day-28 mortality (adjusted hazard ratio, 3.0; 95% confidence interval, [1.7-5.2]). Absent cough and pupillary light reflexes were associated with death. Only absent oculocephalogyric reflex was associated with delayed awakening (adjusted odds ratio, 2.1, 95%CI, [1.1-3.7]).</p><p><strong>Interpretation: </strong>Impaired neurological and neurophysiological lower brainstem responses are associated with mortality in deeply sedated patients. Funded by the French Ministry of Health; PRORETRO; no. P120915; ClinicalTrials.gov registry: NCT02395861; date: 24 March 2015.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283828","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":"OPTPRESS or OPTPRESSIN?","authors":"Rui Shi, Jianfeng Wu, Jean-Louis Teboul","doi":"10.1007/s00134-025-08000-1","DOIUrl":"https://doi.org/10.1007/s00134-025-08000-1","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283831","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}