Intensive Care Medicine最新文献

{"title":"A challenging diagnosis","authors":"Andy Li, Alice Fu, Maxime Hamon, Hanna Paktoris","doi":"10.1007/s00134-025-07783-7","DOIUrl":"https://doi.org/10.1007/s00134-025-07783-7","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"2676 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142989869","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":"Bronchoscopic examination of an invasive aspergillosis in acute myeloid leukemia","authors":"Charles-Hervé Vacheron, Anthony Moreau, Fabio Silvio Taccone","doi":"10.1007/s00134-025-07788-2","DOIUrl":"https://doi.org/10.1007/s00134-025-07788-2","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"24 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142989870","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":"Association of hospital and intensive care unit occupancy and non-admission to the intensive care unit decisions: a retrospective cohort study","authors":"Adonis Sotoodeh, Pontus Hedberg, Johan Mårtensson, Pontus Nauclér","doi":"10.1007/s00134-025-07790-8","DOIUrl":"https://doi.org/10.1007/s00134-025-07790-8","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"23 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142989867","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":"How we could use critical care echocardiography in the assessment of and management of cardiovascular phenotypes in septic shock: the good, the bad, and the ugly profiles","authors":"Antonio Messina, Antoine Vieillard‑Baron","doi":"10.1007/s00134-025-07782-8","DOIUrl":"https://doi.org/10.1007/s00134-025-07782-8","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"205 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142990929","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":"Using AI to detect and treat delirium","authors":"Marcus Young, Katarzyna Kotfis, Rinaldo Bellomo","doi":"10.1007/s00134-024-07774-0","DOIUrl":"https://doi.org/10.1007/s00134-024-07774-0","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"127 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142989866","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":"Natural language processing in critical care: opportunities, challenges, and future directions","authors":"Bairbre A. McNicholas, Michael G. Madden, John G. Laffey","doi":"10.1007/s00134-024-07776-y","DOIUrl":"https://doi.org/10.1007/s00134-024-07776-y","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"8 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142989912","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":"Optimizing ICU weaning: globalizing personalized weaning strategies-author's reply.","authors":"Mathieu Capdevila,Audrey De Jong,Samir Jaber","doi":"10.1007/s00134-024-07769-x","DOIUrl":"https://doi.org/10.1007/s00134-024-07769-x","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"9 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988677","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 intensivists need to know about cytomegalovirus infection in immunocompromised ICU patients","authors":"Sara Fernández, Pedro Castro, Elie Azoulay","doi":"10.1007/s00134-024-07737-5","DOIUrl":"https://doi.org/10.1007/s00134-024-07737-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Advances in therapeutic care are leading to an increase in the number of patients living with overt immunosuppression. These patients are at risk of cytomegalovirus (CMV) infection and disease that can lead to or develop during ICU admission. This manuscript aims to describe the clinical presentation, risk factors, and management of CMV infection and disease in this patient population.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We conducted a literature search in PubMed up to April 2024, focusing on CMV infection and disease in patients with overt immunosuppression (hematopoietic stem cell and solid organ transplantation, solid or hematologic malignancies, HIV infection, immunosuppressive drugs, including corticosteroids, and primary immunodeficiencies) admitted to the intensive care unit (ICU). As there is limited ICU-specific data on CMV in immunosuppressed patients, many of the findings were extrapolated from the general literature.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>CMV infection and disease in immunocompromised critically ill patients is associated with increased mortality and presents significant management challenges. Clinical manifestations are diverse, shaped by the underlying immune deficiency and primary disease. Pneumonia and encephalitis are among the most severe CMV end-organ diseases. CMV infection may also increase the risk of secondary infections and induce life-threatening conditions, such as thrombotic microangiopathy. Importantly, CMV reactivation is not synonymous with CMV disease, and qPCR testing of body fluids cannot reliably differentiate between viral shedding and tissue-invasive infection, which requires histopathological confirmation. Ganciclovir is commonly the first-line anti-viral, though maribavir shows potential for patients unresponsive to other antivirals. Identifying patients who require prophylactic or preemptive antiviral therapy is essential.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>CMV infection and disease in critically ill immunocompromised patients pose a unique challenge for intensivists. The broad spectrum of clinical presentations and the difficulty in distinguishing CMV-related symptoms from other causes require a high level of clinical suspicion. Accurate interpretation of nucleic acid load levels and careful evaluation of CMV’s pathogenic role when it is found are critical. Further studies focusing specifically on CMV infection and disease in critically ill immunocompromised patients are needed to optimize management strategies.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"5 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934522","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":"Sepsis subtypes and differential treatment response to vitamin C: biological sub-study of the LOVIT trial","authors":"J. Rynne, M. Mosavie, Marie-Hélène Masse, Julie Ménard, Marie-Claude Battista, David M. Maslove, Lorenzo del Sorbo, Charles St-Arnaud, Frederick DAragon, Alison Fox-Robichaud, Emmanuel Charbonney, Neill K. J. Adhikari, François Lamontagne, M. Shankar-Hari","doi":"10.1007/s00134-024-07733-9","DOIUrl":"https://doi.org/10.1007/s00134-024-07733-9","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>We hypothesised that the biological heterogeneity of sepsis may highlight sepsis subtypes with differences in response to intravenous vitamin C treatment in the Lessening Organ Dysfunction with VITamin C (LOVIT) trial. Our aims were to identify sepsis subtypes and to test whether sepsis subtypes have differences in treatment effect to vitamin C and describe putative biological effects of vitamin C treatment.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We measured biomarkers of inflammation, at baseline and at 7 days post-randomisation, in 457/863 (53.0%) of participants with plasma samples in the LOVIT trial. We used agglomerative hierarchical clustering on log₁₀-transformed baseline data of 26 biomarkers to identify sepsis subtypes. We analysed differences in vitamin C treatment effect with regression models incorporating robust standard errors to report odds ratio and 95% confidence intervals (OR(95% CI)). All analyses were completed blinded to treatment allocation.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Our cohort included 233/429 (54.3%) allocated to vitamin C and 224/434 (51.6%) allocated to placebo. A three-subtype model best explained the variance in our data. Subtype-2 had the highest, and subtype-3 had the lowest levels of inflammatory response. In paired longitudinal samples, vitamin C did not have discernible anti-inflammatory effects, with anti-inflammatory effects related to time since randomisation and concomitant hydrocortisone treatment. The treatment effect estimates (OR (95% CI)) for subtype-1, subtype-2 and subtype-3 were 1.04 (0.63–1.73), 1.33 (0.53–3.36) and 1.95 (0.85–4.49), respectively (test of heterogeneity <i>p</i> = 0.002).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>We report three sepsis subtypes based on inflammatory response profile. No subtype benefitted from vitamin C treatment in the LOVIT trial, with heterogeneity of treatment effect in the magnitude of harm.</p><h3 data-test=\"abstract-sub-heading\">Trial registration</h3><p>Funded by the Lotte and John Hecht Memorial Foundation; LOVIT ClinicalTrials.gov number, NCT03680274.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"207 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934442","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":"Role of nuclear imaging techniques in the management of infections in critically ill patients.","authors":"Camilla Genovese, Besma Mahida, François Rouzet, Jean-François Timsit, Michael Thy","doi":"10.1007/s00134-024-07773-1","DOIUrl":"https://doi.org/10.1007/s00134-024-07773-1","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948304","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}