Aurio Fajardo-Campoverdi , Carmen Chica-Meza , Carmelo Dueñas , Elena Ortega
{"title":"Letter to the editor: “Can extracorporeal CO2 removal facilitate ultraprotective ventilation in severe ARDS? A Latin American case series”","authors":"Aurio Fajardo-Campoverdi , Carmen Chica-Meza , Carmelo Dueñas , Elena Ortega","doi":"10.1016/j.jcrc.2025.155154","DOIUrl":"10.1016/j.jcrc.2025.155154","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"89 ","pages":"Article 155154"},"PeriodicalIF":3.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karolinny Borinelli de Aquino de Moura , Mariana Berger do Rosário , Marcos Frata Rihl , Josué Almeida Victorino , Iuri Christmann Wawrzeniak
{"title":"Comparison of PEEP tables based on oxygenation vs. driving pressure-guided PEEP titration in patients with severe acute respiratory syndrome due to COVID-19","authors":"Karolinny Borinelli de Aquino de Moura , Mariana Berger do Rosário , Marcos Frata Rihl , Josué Almeida Victorino , Iuri Christmann Wawrzeniak","doi":"10.1016/j.jcrc.2025.155146","DOIUrl":"10.1016/j.jcrc.2025.155146","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the positive end-expiratory pressure (PEEP) values with decremental PEEP titration based on driving pressure (ΔP) were different in comparison with PEEP-FiO2 tables in patients with Severe Acute Respiratory Syndrome due to COVID-19 (CARDS).</div></div><div><h3>Methods</h3><div>Retrospective cohort study at academic ICU in Brazil with adults with SARS due to COVID-19. The PEEP titration obtained by Best-ΔP was compared with values from PEEP-FiO2 tables.</div></div><div><h3>Results</h3><div>A total of 91 patients were included (141 titrations), with a median PaO2/FiO2 of 133 (97–170). The PEEP titration by ΔP was similar to the ARDSnet table (<em>p</em> = 0.83) and different from the LOVs and ALVEOLI tables (<em>p</em> < 0.001). The subgroup of patients with body mass index (BMI) > 30 kg/m2 was different (<em>n</em> = 73, p < 0.001) in all FiO2-tables and best ΔP .</div></div><div><h3>Conclusions</h3><div>The PEEP by titration based on ΔP was similar to the ARDSnet low PEEP table, both being different from the other tables. In obese patients, the PEEP found by titration was significantly different in all methods evaluated in this study.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"89 ","pages":"Article 155146"},"PeriodicalIF":3.2,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to editor regarding, “Association of vasopressor use during renal replacement therapy and mortality”","authors":"Gurdeep Gambhir","doi":"10.1016/j.jcrc.2025.155157","DOIUrl":"10.1016/j.jcrc.2025.155157","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"89 ","pages":"Article 155157"},"PeriodicalIF":3.2,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Raghavan Murugan , Jorge Echeverri , Javier A. Neyra
{"title":"Authors reply: “Vasopressor use during renal replacement therapy”","authors":"Raghavan Murugan , Jorge Echeverri , Javier A. Neyra","doi":"10.1016/j.jcrc.2025.155156","DOIUrl":"10.1016/j.jcrc.2025.155156","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"89 ","pages":"Article 155156"},"PeriodicalIF":3.2,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Characterization of limitations of life-sustaining therapy decisions and their impact on outcomes in adults with septic shock – Insights from a retrospective cohort","authors":"Jolan Malherbe , Julien Charpentier , Clément Devautour , Sarah Benghanem , Edwige Péju , Nawal Bakir , Cécilia Briand , Élodie Couilleaux , Pascale Courbon , Aude Ruttimann , Jonathan Marey , Anne-Sophie Debue , Alain Cariou , Jean-Daniel Chiche , Jean-Paul Mira , Frédéric Pène","doi":"10.1016/j.jcrc.2025.155153","DOIUrl":"10.1016/j.jcrc.2025.155153","url":null,"abstract":"<div><h3>Purpose</h3><div>In-ICU and in-hospital deaths in critically ill patients are often subsequent to decisions of limitations of life-sustaining therapies (LLST). While septic shock remains associated with high mortality and reduced quality of life in survivors, we addressed the frequency, the decision-making process, the determinants and the attributable mortality of LLST decisions in this setting.</div></div><div><h3>Materials and methods</h3><div>A retrospective (2008–2021) single-center study including consecutive adult patients with septic shock. LLST were distributed into early and delayed when taken within and after the first three days in the ICU, respectively. Determinants of LLST were assessed by multivariate logistic regression and LLST-attributable mortality was assessed after propensity score matching.</div></div><div><h3>Results</h3><div>The cohort comprised 907 patients with septic shock. On admission, median SOFA score was 10 [IQR 7–13] points. LLST were decided for 257 (28.3 %) patients after a median of 5 [IQR 2–10] days in the ICU. The first LLST decisions were taken within and after the first three days following ICU admission in 106 and 151 patients, respectively. Independent determinants associated with early LLST decisions were age, disease severity on admission and increasing year of admission. Delayed LLST decisions were significantly associated with comorbidities, duration of organ-support, in-ICU complications and platelet transfusion. The overall in-ICU mortality rate was 37.6 % and reached 75.9 % among patients with LLST.</div></div><div><h3>Conclusion</h3><div>Among septic shock patients, LLST are frequent, increasingly decided soon after ICU admission, vary during the ICU stay and carry a negative impact on ICU survival.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"89 ","pages":"Article 155153"},"PeriodicalIF":3.2,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Differences between men and women in the ICU: Time for intentional data collection","authors":"Sharon Einav , Marc Leone , Craig M. Coopersmith","doi":"10.1016/j.jcrc.2025.155150","DOIUrl":"10.1016/j.jcrc.2025.155150","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"89 ","pages":"Article 155150"},"PeriodicalIF":3.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reply of the authors: “Emergency critical care - life-saving critical care before ICU admission: A consensus statement of a Group of European Experts”","authors":"Martin W. Dünser , Wilhelm Behringer","doi":"10.1016/j.jcrc.2025.155148","DOIUrl":"10.1016/j.jcrc.2025.155148","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"89 ","pages":"Article 155148"},"PeriodicalIF":3.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lisa Smit , Mathieu van der Jagt , Sandra M.A. Dijkstra-Kersten , Irene J. van Diem-Zaal , Arjen J.C. Slooter
{"title":"Agitation control with clonidine and haloperidol in critically ill patients: A retrospective analysis","authors":"Lisa Smit , Mathieu van der Jagt , Sandra M.A. Dijkstra-Kersten , Irene J. van Diem-Zaal , Arjen J.C. Slooter","doi":"10.1016/j.jcrc.2025.155135","DOIUrl":"10.1016/j.jcrc.2025.155135","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the effects of clonidine and haloperidol on ICU agitation control.</div></div><div><h3>Methods</h3><div>This cohort study included mixed ICU patients with at least one agitation episode (Richmond Agitation Sedation Scale [RASS] score > 1) treated with clonidine and/or haloperidol. Primary outcome was agitation control (−2 ≤ target RASS score ≤ 1) within six hours of medication administration, using propensity score matching and Markov multinomial logistic regression. We further explored associations with concomitant medication.</div></div><div><h3>Results</h3><div>We analyzed 510 agitation episodes in 247 patients, with 273 (54 %) receiving clonidine only, 88 (17 %) haloperidol only, and 149 (29 %) both. Neither haloperidol only (OR 1.00, 95 %CI 0.57 to 1.76) nor administration of both medications (OR 0.83, 95 %CI 0.52 to 1.32) showed improved agitation control compared to clonidine only. Haloperidol only (adjusted difference − 44.8 mg, 95 %CI -89.1 to −0.5 mg) and both clonidine and haloperidol (adjusted difference − 48.4 mg, 95 %CI -85.6 to −11.1 mg) was associated with reduced propofol usage compared to clonidine only. Treatment with both clonidine and haloperidol was associated with lower opioid usage (adjusted difference − 52.3 mg, 95 %CI -93 to −11.7 mg). There was no difference in benzodiazepine administration.</div></div><div><h3>Conclusion</h3><div>This study found no difference in agitation control among ICU patients treated with clonidine, haloperidol or both.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"89 ","pages":"Article 155135"},"PeriodicalIF":3.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the editor: “Emergency critical care - life-saving critical care before ICU admission: A consensus statement of a Group of European Experts”","authors":"Ken De Smet , Olivier Hoogmartens , Marc Sabbe","doi":"10.1016/j.jcrc.2025.155147","DOIUrl":"10.1016/j.jcrc.2025.155147","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"89 ","pages":"Article 155147"},"PeriodicalIF":3.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Authors reply: “What every intensivist should know about type D hyperlactatemia”","authors":"Raquel Simões Ballarin, Taline Lazzarin, Marcos Ferreira Minicucci","doi":"10.1016/j.jcrc.2025.155139","DOIUrl":"10.1016/j.jcrc.2025.155139","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"89 ","pages":"Article 155139"},"PeriodicalIF":3.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}