Intensive Care Medicine最新文献

{"title":"Contemporary review of critical illness following allogeneic hematopoietic stem cell transplant in adults","authors":"Laveena Munshi, Guillaume Dumas, Bruno Ferreryro, Cristina Gutierrez, Boris Böll, Pedro Castro, Sanjay Chawla, Matteo Di Nardo, Antoine Lafarge, Colleen McEvoy, Djamel Mokart, Antonio Paulo Nassar, Judith Nelson, Frédéric Pène, Peter Schellongowski, Elie Azoulay","doi":"10.1007/s00134-025-07865-6","DOIUrl":"https://doi.org/10.1007/s00134-025-07865-6","url":null,"abstract":"<p>Significant advancements have been made in the care of the allogeneic hematopoietic stem cell (HCT) recipient. However, they remain one of the most vulnerable groups of patients who may be admitted to the ICU. On the one hand, they have been administered treatment with the goal of achieving cure for their underlying disease, yet their unique immunocompromised trajectory and treatment-associated toxicities continue to challenge the intensivist from a diagnostic and management perspective. While infectious disease, allogeneic HCT and critical care research have improved outcomes, there remain significant areas to advance critical care management to further increase the likelihood of bridging to an acceptable quality of life. This review focuses on care of the critically ill patient undergoing allogeneic HCT for hematologic malignancies, critical care conditions that may arise, contemporary practices in their management, and areas to focus future research.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"3 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143837072","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: Liberal vs. restrictive transfusion strategies for acute brain injury: a systematic review and frequentist-Bayesian meta-analysis","authors":"Pierre-Louis Blot, Maxime Renaux, Timothée Ayasse, Lucie Collet, Arthur James, Jean-Michel Constantin, Rayan Braïk","doi":"10.1007/s00134-025-07882-5","DOIUrl":"https://doi.org/10.1007/s00134-025-07882-5","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"1 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143837074","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":"Staircase strategy, tier-three therapies, and effects on outcome in traumatic brain injured patients: the Triple-T TBI study","authors":"Edoardo Picetti, Laura Galarza, Marta Arroyo Diez, Rafael Badenes, Maria Angeles Ballesteros Sanz, Jesús A. Barea-Mendoza, Romina Georgina Bórtoli, Pierre Bouzat, Giuseppe Citerio, Daniel Agustin Godoy, Paolo Gritti, Sandra Magnoni, Marina Munari, Theveen Tellambura, Mathieu van der Jagt, Fabio Silvio Taccone, Chiara Robba","doi":"10.1007/s00134-025-07864-7","DOIUrl":"https://doi.org/10.1007/s00134-025-07864-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To evaluate the clinical practice and timing of use of tier-three therapies (TTT) after traumatic brain injury (TBI), and to explore their association with intensive care unit (ICU) mortality and 3 months neurological outcome.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>International multicenter, retrospective, observational, cohort study performed in 16 ICUs including 408 adult TBI patients requiring at least one of the TTT [i.e. metabolic suppression with barbiturates, secondary decompressive craniectomy (DC), and mild hypothermia] for the control of intracranial hypertension during the ICU stay.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Among 408 adult TBI patients, secondary DC was the most frequent TTT utilized (<i>n</i> = 297, 72.8%), and was associated with reduced ICU mortality [Odds Ratio, OR 0.34 (95% Confidence Interval, CI 0.14–0.78) <i>p</i> = 0.012] and better neurological outcome (<i>p</i> = 0.047), whereas barbiturates were associated with increased ICU mortality [OR: 3.05 (95% CI 1.43–6.49); <i>p</i> = 0.004) and worse neurological outcome (<i>p</i> = 0.032). Two hundred and twenty-four (55%) patients received interventions in adherence to guidelines, which was associated with a non-significant trend towards better outcomes.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The staircase approach before the use of TTT was not often utilized after severe TBI. Secondary DC was performed more often than other treatments and its use was associated with improved mortality and neurological outcome. The benefits of adherence to guidelines before TTT prescription should be further evaluated.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"69 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827568","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":"Continuous infusion of linezolid for critically ill patients: toward a new standard of care","authors":"Helena Barrasa, Carlos Valdazo, Alejandro Martín","doi":"10.1007/s00134-025-07889-y","DOIUrl":"https://doi.org/10.1007/s00134-025-07889-y","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"218 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822772","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":"Bridging the gap: implementing ESICM end-of-life care guidelines in resource-limited settings.","authors":"Mohammed Aabdi,Khalil El Yachioui,Hicham Sbai","doi":"10.1007/s00134-025-07891-4","DOIUrl":"https://doi.org/10.1007/s00134-025-07891-4","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"246 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819005","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":"Shortening antibiotic therapy duration for hospital-acquired bloodstream infections in critically ill patients: a causal inference model from the international EUROBACT-2 database","authors":"Lena Gajdos, Niccolo Buetti, Alexis Tabah, Stephane Ruckly, Murat Akova, Frederik Sjöval, Kostoula Arvanti, Jan de Waele, Hendrik Bracht, Francois Barbier, Jean-François Timsit","doi":"10.1007/s00134-025-07857-6","DOIUrl":"https://doi.org/10.1007/s00134-025-07857-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Hospital-acquired bloodstream infections (HA-BSIs) are severe and require antibiotic therapy. In non-complicated BSIs, shortened therapy reduces side effects without compromising efficacy. The impact of shortened antibiotic therapy in HA-BSI critically ill patients without indication of prolonged therapy requires further evaluation.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Using the international prospective EUROBACT-2 cohort, we compared shortened (7–10 days) versus long (14–21 days) treatment durations in ICU patients eligible for shortened therapy. Patients without antibiotic therapy within 3 days after HA-BSI occurrence or requiring prolonged therapy (due to infection source, microorganism, or clinical deterioration) were excluded. Treatment failure, defined as death, persistent infection, or subsequent infectious complications by Day 28, was assessed using an inverse-probability of treatment weighted (IPTW) logistic regression.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Among 2600 patients, 550 were eligible for shortened treatment, 213 received short, and 337 received long treatment. The most common infection source was intravascular catheters (33%), most common microorganisms were <i>Enterobacterales</i> (39%). Patients with long treatment were more frequently infected with <i>Staphylococcus aureus</i> (11% vs. 5.6%, <i>p</i> = 0.025) or difficult-to-treat microorganisms (23% vs. 7%, <i>p</i> &lt; 0.001), and received more commonly combination therapy (46% vs. 30%, <i>p</i> &lt; 0.001). Short treatment was associated with reduced 28-day treatment failure (OR 0.64, 95% CI 0.44–0.93, <i>p</i> = 0.019), mainly due to reduction in subsequent infectious complications (OR 0.58, 95% CI 0.37–0.91, <i>p</i> = 0.018). Mortality (OR 0.92 [95% CI 0.59, 1.43], <i>p</i> = 0.7) and persistent infection rates (OR 0.47 [95% CI 0.17, 1.14], <i>p</i> = 0.12) were similar.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>In selected ICU patients with HA-BSI, shortened antibiotic treatment might be considered. <i>Eurobact2 was a prospective international cohort study, registered in ClinicalTrials.org (NCT03937245).</i></p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"34 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143790163","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":"Diastolic dysfunction in septic patients: an alice-in-wonderland perspective on mortality impact.","authors":"Luigi Vetrugno, Daniele Guerino Biasucci","doi":"10.1007/s00134-025-07887-0","DOIUrl":"https://doi.org/10.1007/s00134-025-07887-0","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795247","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 \"Management of adult sepsis in resource-limited settings: global expert consensus statements using a Delphi method\".","authors":"Ayooluwa O Douglas, Kenneth T Shelton","doi":"10.1007/s00134-025-07858-5","DOIUrl":"https://doi.org/10.1007/s00134-025-07858-5","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772168","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":"Through the looking glass: lessons from the inside","authors":"Joao Gabriel Rosa Ramos","doi":"10.1007/s00134-025-07880-7","DOIUrl":"https://doi.org/10.1007/s00134-025-07880-7","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"21 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767084","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":"Supporting the bereaved child in the adult ICU: let's take the first step! Author's reply.","authors":"Annelies Rowland, Carole Boulanger, Louise Dalton","doi":"10.1007/s00134-025-07886-1","DOIUrl":"https://doi.org/10.1007/s00134-025-07886-1","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772085","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}