Intensive Care Medicine最新文献

{"title":"On the tightrope between life and graft: immunosuppression in critically ill solid organ transplant recipients.","authors":"Elie Azoulay","doi":"10.1007/s00134-025-08061-2","DOIUrl":"10.1007/s00134-025-08061-2","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":"1699-1702"},"PeriodicalIF":21.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873059","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":"Let PEEP do the talking?","authors":"Andrea Bellone, Andrew Bersten","doi":"10.1007/s00134-025-08042-5","DOIUrl":"10.1007/s00134-025-08042-5","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":"1696-1698"},"PeriodicalIF":21.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690109","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":"Antibiotic therapy for severe bacterial infections","authors":"Jean-François Timsit, Lowell Ling, Etienne de Montmollin, Hendrik Bracht, Andrew Conway-Morris, Liesbet De Bus, Marco Falcone, Patrick N. A. Harris, Flavia R. Machado, José-Artur Paiva, David L. Paterson, Garyphallia Poulakou, Jason A. Roberts, Claire Roger, Andrew F. Shorr, Alexis Tabah, Jeffrey Lipman","doi":"10.1007/s00134-025-08063-0","DOIUrl":"https://doi.org/10.1007/s00134-025-08063-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Early antibiotic therapy for patients with severe infections is essential to improve outcomes. Conversely, use of overly broad antibiotic therapy for susceptible pathogens or unnecessary antibiotics in patients without bacterial infections is associated with adverse life-threatening events and superinfections. Antibiotics-induced changes in the human microbiota alter both immune and metabolic systems. Uncontrolled antibiotic use encourages emergence of antibiotic-resistant organisms. Around 50% of ICU patients receiving antibiotic therapy do not have confirmed infections, whilst de-escalation and shortened treatment duration are infrequently performed. Mortality from serious infections remains high, highlighting the need for treatment optimisation.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Narrative review.</p><h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>To summarise the available evidence, emerging options, and unresolved controversies in optimising antibiotic therapy in severe infections.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Local epidemiology, underlying illnesses, accessibility to health care systems, and diagnostic and therapeutic resources are important factors to consider. Rapid diagnostic tests combined with individualised decision-making improve the selection of antibiotic therapy. Rapid de-escalation to narrow-spectrum monotherapy and shortening of the duration of therapy should be the rule. Uncertainty still persists regarding the personalisation of therapy for difficult-to-treat resistant bacteria. Pharmacokinetic (PK) optimisation and prolonged or continuous beta-lactam use is safe and may improve outcomes. Therapeutic drug monitoring (TDM) should be used, especially when altered volume of distribution and/or drug clearance is suspected or where toxicity is likely. The impact of TDM combined with prompt dose adjustment is encouraged. Emerging technologies including rapid broad diagnostic tests and electronic antibiotic optimisation tools will further support collaboration between pharmacists, microbiologists, infectious diseases specialists, and intensivists for optimising antibiotic therapy and stewarding these precious resources.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"204 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923945","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 about the article \"Effect of hydrocortisone on mortality in patients with severe community-acquired pneumonia: the REMAP-CAP corticosteroid domain randomized clinical trial\": author's reply.","authors":"Nicholas Heming, Lindsay Berry, Elizabeth Lorenzi, Scott Berry, Derek C Angus","doi":"10.1007/s00134-025-08046-1","DOIUrl":"10.1007/s00134-025-08046-1","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":"1742-1743"},"PeriodicalIF":21.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690108","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":"A reappraisal of association between ventilator-associated events and mortality among critically ill patients using marginal structural model: multicenter observational study","authors":"Susumu Nakahashi, Kei Suzuki, Takaya Nakashima, Yoshiro Hayashi, Yuko Tanabe, Aiko Tanaka, Shinsuke Hashiuchi, Chizuru Yamashita, Yusuke Ito, Takeshi Wada, Ayahiro Yamashita, Masanori Shima, Tetsuya Hoshino, Kiyoshi Moriyama, Satoshi Kazuma, Hyun Ah Lee, Yoshikazu Yamaguchi, Yukari Nakamura, Yu Kawanobe, Toshiki Sofue, Yuki Nishimura, Tomohiro Shinozaki, Tadahiro Goto, Satoru Hashimoto, Yuji Fujino, Nobuaki Shime","doi":"10.1007/s00134-025-08074-x","DOIUrl":"https://doi.org/10.1007/s00134-025-08074-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Ventilator-associated events (VAEs), developed by the US Centers for Disease Control and Prevention (CDC), are considered a new medical quality indicator associated with poor outcomes. However, previous studies failed to adjust for changes in patient severity, leaving open the possibility that VAEs are just a surrogate for severity. This study aimed to reevaluate the association between VAEs and mortality, adjusting for changes in severity over time.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This multicenter observational study was conducted in 18 ICUs in Japan between May 2020 and December 2022. Patients aged ≥ 12 years who received mechanical ventilation for ≥ 3 consecutive days were eligible. VAE was diagnosed according to the CDC definition. The primary outcome was 30-day in-hospital mortality, whose association with VAE was estimated by the inverse probability weighted proportional hazards model, with temporal changes in patient severity treated as time-dependent confounders.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Among 1,094 subjects, 106 VAEs (9.7%) were identified, giving an incidence rate of 10.0 per 1,000 ventilation days. VAEs were significantly associated with increased 30-day hospital and ICU mortality (HR 2.00; 95% CI 1.23–3.26 and HR 1.92; 95% CI 1.03–3.57), and longer hospital and ICU length of stay (HR 0.72 95% CI 0.54–0.97 and HR 0.47; 95% CI 0.23–0.96). The population attributable risk fraction of VAE-related mortality was 8.8% for in-hospital deaths and 8.2% for ICU deaths.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>VAEs were associated with an increased risk of mortality after adjustment for severity, as a time-dependent confounder.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"52 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923946","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: Continuous infusion of linezolid for critically ill patients: toward a new standard of care.","authors":"Helena Barrasa, Carlos Valdazo, Alejandro Martín","doi":"10.1007/s00134-025-08004-x","DOIUrl":"10.1007/s00134-025-08004-x","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":"1747"},"PeriodicalIF":21.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475103","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":"Post-sepsis recovery: perspectives on measuring what matters. Author's reply","authors":"Peter Halvorsen, Michael Marks-Hultström, Ewa Wallin, Björn Ahlström, Miklós Lipcsey","doi":"10.1007/s00134-025-08096-5","DOIUrl":"https://doi.org/10.1007/s00134-025-08096-5","url":null,"abstract":"No Abstract","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"27 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923947","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":"Near-fatal hiccups","authors":"Valentine Barthel, Juliette Dufour, Clémence Marois, Adam Celier","doi":"10.1007/s00134-025-08086-7","DOIUrl":"https://doi.org/10.1007/s00134-025-08086-7","url":null,"abstract":"No Abstract","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"16 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923944","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 concentration matters: higher concentration for lower greenhouse gas emission","authors":"Nicolas Massart, Pierre Fillatre, Chloé Gisbert Mora, Pierre Bardoult","doi":"10.1007/s00134-025-08094-7","DOIUrl":"https://doi.org/10.1007/s00134-025-08094-7","url":null,"abstract":"No Abstract","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"23 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923955","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":"Transpulmonary flow during ventricular fibrillation","authors":"Federico Pappalardo, Nicoletta D’Ettore, Serena Ambrosi, Andrea Montisci","doi":"10.1007/s00134-025-08087-6","DOIUrl":"https://doi.org/10.1007/s00134-025-08087-6","url":null,"abstract":"No Abstract","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"19 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923956","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}