Intensive Care Medicine最新文献

{"title":"Personalized approach to high-risk and intermediate-high-Risk pulmonary embolism in older adults.","authors":"Manuel Ruiz-Bailén","doi":"10.1007/s00134-026-08414-5","DOIUrl":"https://doi.org/10.1007/s00134-026-08414-5","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"116 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751230","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":"Vasopressor weaning in septic shock: the missing piece in the 2026 guidelines; author's reply.","authors":"Hallie C Prescott,Hayley B Gershengorn,Massimo Antonelli","doi":"10.1007/s00134-026-08450-1","DOIUrl":"https://doi.org/10.1007/s00134-026-08450-1","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"21 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751231","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":"Critical illness-associated cerebral microbleeds in a patient with severe organophosphate poisoning.","authors":"Shuhua Xie,Xianghong Liu,Zhaohui Lai","doi":"10.1007/s00134-026-08428-z","DOIUrl":"https://doi.org/10.1007/s00134-026-08428-z","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"26 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751232","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":"Dr Rick van Saene 1946–2026","authors":"Hans Rommes, Andy Petros, Durk Zandstra, Nia Taylor, Luciano Silvestri, Francisco Abecasis","doi":"10.1007/s00134-026-08436-z","DOIUrl":"https://doi.org/10.1007/s00134-026-08436-z","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"151 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751564","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":"Tuberculous spondylitis causing airway compromise","authors":"Inês Correia Brasil, Pedro de Abreu, Eugénia Germano, Nuno Deveza","doi":"10.1007/s00134-026-08408-3","DOIUrl":"https://doi.org/10.1007/s00134-026-08408-3","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"26 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751671","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 outcomes are defined in randomized controlled trials of acute kidney injury: a scoping review.","authors":"Nathalia Mavignier,Gobinder Pandher,Maxime Goldstein,Natalja L Stanski,Dana Y Fuhrman,Ayse Akcan Arikan,Emily See,Peggy Tahir,Javier A Neyra,Sean M Bagshaw,Matthieu Legrand,Bruno Garcia","doi":"10.1007/s00134-026-08419-0","DOIUrl":"https://doi.org/10.1007/s00134-026-08419-0","url":null,"abstract":"INTRODUCTIONResearch on acute kidney injury (AKI) is hindered by heterogeneous definitions, measurements, and follow-up periods, which limit comparability across randomized controlled trials (RCTs) and the translation of findings into evidence-based practice. This review aimed to describe outcomes reported in RCTs of AKI prevention and treatment.METHODSThis scoping review followed PRISMA-ScR guidance. PubMed, Embase, Web of Science, and Cochrane CENTRAL were searched for RCTs published between January 2014 and April 2024. Eligible studies included adults or children with AKI or at risk for AKI. Outcomes were categorized using the COMET taxonomy according to core area, core domain, specific domain, measurement method, and timing.RESULTSAmong 3921 abstracts screened, 251 RCTs were included. Prevention trials represented 197/251 (78.5%). Most outcomes belonged to the Physiological/Clinical Core Area (194/197, 98.5%), in the Renal outcomes Core Domain (186/197, 94%). Renal function (162/197, 82%) and renal damage (15/197, 7.5%) were the most frequent domains. Measurements relied mainly on serum creatinine, alone (130/162, 80%) or combined with urine output (25/162, 15%), assessed between 48-72 h (65%) and 7 days (22%). Outcomes in therapeutic RCTs (54/251, 21.5%) belonged to the Physiological/Clinical (37/54, 69%) and Mortality/Survival (14/54, 26%) Core Areas. Renal outcomes (33/54, 61%) included renal function (9/54, 17%), renal recovery (10/54, 19%), and use of RRT (3/54, 6%). Measurements included serum creatinine (16/54, 30%), mortality (14/54, 26%) and estimated glomerular filtration rate (eGFR) (3/54, 6%), assessed between 7 and 90 days.CONCLUSIONOutcome reporting is heterogeneous, highlighting the need for a standardized core outcome set.","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"30 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751235","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":"Reconsidering transfusion thresholds in traumatic brain injury with multiple trauma: implications from the HEMOTION sub-study.","authors":"Congrui Wang,Longteng Nan,Wenkai Zhang","doi":"10.1007/s00134-026-08439-w","DOIUrl":"https://doi.org/10.1007/s00134-026-08439-w","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"24 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147726097","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":"Gaps or paradoxes in clinical responses in obese patients.","authors":"Gonzalo Hernández,Guillermo Muñiz Albaiceta,Arnaud W Thille","doi":"10.1007/s00134-026-08435-0","DOIUrl":"https://doi.org/10.1007/s00134-026-08435-0","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"1 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147726100","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":"Implementation of a kidney protection strategy to prevent acute kidney injury after major surgery in high-risk patients identified by biomarkers: a systematic review and individual participant data meta-analysis of randomized controlled trials.","authors":"Thilo von Groote,Eike Bormann,Matteo Marcello,David J Tunnicliffe,Ivan Göcze,Mahan Sadjadi,Lui G Forni,Hernando Gómez,John A Kellum,Alexander Zarbock","doi":"10.1007/s00134-026-08399-1","DOIUrl":"https://doi.org/10.1007/s00134-026-08399-1","url":null,"abstract":"PURPOSEAcute kidney injury (AKI) is a common complication after major surgery and is associated with increased morbidity and mortality. Kidney protection strategies may help prevent moderate or severe AKI in high-risk patients. This study aims to assess the effect of the Kidney Disease: Improving Global Outcomes (KDIGO) kidney protection strategy for the prevention of AKI in patients after major surgery.METHODSWe conducted a systematic review and individual participant data (IPD) meta-analysis of randomized controlled trials (RCTs) comparing the kidney protection strategy recommended by international guidelines consisting of hemodynamic and fluid status optimization, avoidance of nephrotoxins or radiocontrast agents, regular monitoring of kidney function, and glycemic control to standard care in high-risk patients after major surgery with an enrichment strategy based on renal biomarkers. The primary outcome was moderate or severe AKI (KDIGO stage ≥ 2) within 72 h after surgery. MEDLINE via PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from January 1, 2000, to September 1, 2025. References of eligible trials and related reviews were hand-searched. Two reviewers independently assessed trial quality using the Cochrane Risk of Bias tool version 2.0. Certainty of the evidence was assessed using GRADE. IPD were pooled. Odds ratios (ORs) and mean difference with 95% confidence intervals (CIs) were computed with one-stage IPD meta-analysis. Heterogeneity was assessed by I2 and Cochran's Q.RESULTSWe identified four RCTs, two single-center trials and two multinational-multicenter trials. We pooled IPD from all four trials. The final cohort included 1,851 participants with 921 participants in the intervention group and 930 participants in the control group. Moderate or severe AKI occurred significantly less frequently in the intervention group (162/918 participants (17.7%)) compared to the control group (252/929 participants (27.1%)) (OR 0.55, 95% CI 0.44-0.70; p < 0.0001). There was no evidence of heterogeneity across studies (p = 0.7309, I2 = 0.0%, τ2 = 0). Secondary endpoints varied across trials and did not demonstrate major differences between groups. When measured, the intervention tended to result in fewer persistent AKI events and larger decreases in renal tubular stress biomarkers.CONCLUSIONThe implementation of a kidney protection strategy reduces the rates of moderate or severe AKI in biomarker-enriched high-risk patients after major surgery compared to standard of care, while the incremental clinical value of biomarker-guided selection itself remains uncertain.REGISTRATIONThe study was registered at the international, prospective register of systematic reviews PROSPERO. Identifier: PROSPERO 2025 CRD420251138328.","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"22 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147726098","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":"Temperature control in acute brain injury.","authors":"Andrea Lavinio,Katharina M Busl,Jonathan P Coles,Katia Donadello,Raimund Helbok,Mypinder S Sekhon,Markus B Skrifvars,Fabio Silvio Taccone,Sarah Wahlster,Chiara Robba","doi":"10.1007/s00134-026-08367-9","DOIUrl":"https://doi.org/10.1007/s00134-026-08367-9","url":null,"abstract":"PURPOSETemperature is a key determinant of cerebral vulnerability after acute brain injury and a physiological variable that can be continuously monitored and actively controlled in the intensive care unit. Its therapeutic role has evolved from hypothermia-centred strategies toward early recognition of fever and controlled normothermia. This review examines the physiological rationale, clinical evidence, and contemporary practice of temperature management in neurocritical care.METHODSWe synthesised evidence from major randomised trials, observational studies, and international consensus recommendations across traumatic brain injury, acute vascular brain injury, and post-cardiac arrest encephalopathy, together with current monitoring and implementation approaches.RESULTSFever is consistently associated with worse neurological outcomes. In traumatic brain injury, hypothermia reduces intracranial pressure but does not improve functional outcome when used prophylactically and is reserved for refractory intracranial hypertension. In acute vascular brain injury, neutral trials and feasibility constraints have shifted practice toward early detection and treatment of fever rather than hypothermia. In post-cardiac arrest care, contemporary guidelines recommend protocolised temperature control with selection and maintenance of a constant target between 32°C and 37.5°C and active prevention of fever, rather than mandatory hypothermia.CONCLUSIONSTemperature control is a fundamental component of care aimed at protecting the injured brain through continuous monitoring, early detection of fever, and prevention of temperature-related harm.","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"22 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147726099","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}