Journal of critical care最新文献

{"title":"Impact of body mass index on 90-day survival in patients in cardiogenic shock treated with V-A ECMO: A propensity weighted analysis","authors":"Quentin Moyon ,&nbsp;Jules Stern ,&nbsp;Marc Pineton de Chambrun ,&nbsp;Guillaume Lebreton ,&nbsp;Marylou Para ,&nbsp;Juliette Chommeloux ,&nbsp;Guillaume Hékimian ,&nbsp;Charles Edouard Luyt ,&nbsp;Alain Combes ,&nbsp;Romain Sonneville ,&nbsp;Matthieu Schmidt","doi":"10.1016/j.jcrc.2025.155284","DOIUrl":"10.1016/j.jcrc.2025.155284","url":null,"abstract":"<div><h3>Objective</h3><div>The impact of body mass index (BMI) on outcomes in refractory cardiogenic shock requiring extracorporeal membrane oxygenation (ECMO) is not well understood. We aimed to assess: (i) whether BMI is independently associated with outcomes, and (ii) whether patients with obesity (BMI &gt; 30 kg/m²) have worse outcomes than lean counterparts.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of a prospectively maintained database from two French ECMO centers (2006–2022). The impact of BMI was evaluated using inverse propensity-score weighted (IPSW), propensity-score (PS) matching, and multivariable (MV) models, adjusting for predefined confounders. The primary outcome was 90-day mortality. The relationship between BMI and outcomes was examined using generalized additive models. Outcomes were compared across three BMI categories (&lt;25 kg/m², 25-30 kg/m², and &gt; 30 kg/m²). Patients treated with extracorporeal cardiopulmonary resuscitation (<em>E</em>-CPR) were analyzed separately.</div></div><div><h3>Results</h3><div>Among 921 patients, BMI was not significantly associated with 90-day mortality (HR 0.99, 95 % CI 0.97–1.01, <em>p</em> = 0.2), despite more ECMO-related complications. This was consistent across PS-matched, IPSW, and MV models. No significant non-linear relationship between BMI and 90-day mortality was found. Among the 204 patients with ECMO during cardiopulmonary resuscitation, those with BMI &lt; or ≥ 30 kg/m² had 90-day mortality rates of 76 % and 71 %, respectively (<em>p</em> = 0.5).</div></div><div><h3>Conclusion</h3><div>Patients with obesity treated with ECMO for refractory cardiogenic shock have similar 90-day outcomes to their lean counterparts, despite higher respiratory, renal, and device-related complications.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155284"},"PeriodicalIF":2.9,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265024","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: New prognostic score for mortality in critically ill patients. Development and validation","authors":"Song Zhou ,&nbsp;Yunlai Zhao ,&nbsp;Hongying Wang","doi":"10.1016/j.jcrc.2025.155303","DOIUrl":"10.1016/j.jcrc.2025.155303","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155303"},"PeriodicalIF":2.9,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265027","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":"Response to the Letters to the Editor regarding: “New prognostic score for mortality in critically ill patients. Development and validation”","authors":"M.P. Gracia Arnillas ,&nbsp;F. Alvarez Lerma ,&nbsp;X. Nuvials Casals ,&nbsp;R. Gimeno Costa ,&nbsp;N. Mas Bilbao ,&nbsp;J. Lobo Palanco ,&nbsp;A. Escribá Bárcena ,&nbsp;M. Catalán González ,&nbsp;M. Martinez Alonso","doi":"10.1016/j.jcrc.2025.155304","DOIUrl":"10.1016/j.jcrc.2025.155304","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155304"},"PeriodicalIF":2.9,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265701","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: Immediate “sipping” vs. delayed oral fluid intake after extubation: A randomized controlled trial","authors":"Song Zhou ,&nbsp;Yunlai Zhao ,&nbsp;Huaiyu Mao ,&nbsp;Guoying Wang","doi":"10.1016/j.jcrc.2025.155297","DOIUrl":"10.1016/j.jcrc.2025.155297","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155297"},"PeriodicalIF":2.9,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265702","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: “Immediate ‘sipping’ vs. delayed oral fluid intake after extubation: A randomized controlled trial”","authors":"Liu Luo ,&nbsp;Ziye Zhuang ,&nbsp;Gang Huang ,&nbsp;Chengxuan Lu ,&nbsp;Xiang Shen","doi":"10.1016/j.jcrc.2025.155299","DOIUrl":"10.1016/j.jcrc.2025.155299","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155299"},"PeriodicalIF":2.9,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265026","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' response: “Observational study of cefepime therapeutic drug monitoring in continuous venovenous hemodialysis”","authors":"John Wageh ,&nbsp;Terence Chau ,&nbsp;Soyoung Kim ,&nbsp;Stacy Pasciolla ,&nbsp;Justin Delic ,&nbsp;Geena Kludjian ,&nbsp;Alexandra Hanretty ,&nbsp;Lauren A. Igneri","doi":"10.1016/j.jcrc.2025.155291","DOIUrl":"10.1016/j.jcrc.2025.155291","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155291"},"PeriodicalIF":2.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265025","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: “Immediate “sipping” vs. delayed oral fluid intake after extubation: A randomized controlled trial”","authors":"Muhammad Hamza Akram ,&nbsp;Ahsen Javaid Chattha ,&nbsp;Asher Tariq ,&nbsp;Iqra Chattha ,&nbsp;Satesh Kumar","doi":"10.1016/j.jcrc.2025.155298","DOIUrl":"10.1016/j.jcrc.2025.155298","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155298"},"PeriodicalIF":2.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258389","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: “An increase in skin blood flow after red blood cell transfusion is associated with an improvement in organ function in critically ill patients”","authors":"Elaine Cavalcante dos Santos,&nbsp;Fabio Silvio Taccone","doi":"10.1016/j.jcrc.2025.155281","DOIUrl":"10.1016/j.jcrc.2025.155281","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155281"},"PeriodicalIF":2.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258458","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":"Associations of positive end-expiratory pressure (PEEP) with extubation failure and clinical outcomes in invasively ventilated patients with acute brain injury: A secondary analysis of the ENIO study","authors":"Denise Battaglini ,&nbsp;Raphael Cinotti ,&nbsp;Karim Asehnoune ,&nbsp;Andrea Loggini ,&nbsp;Luca Montagnani ,&nbsp;Lorenzo Ball ,&nbsp;Francesca Gualdi ,&nbsp;Patricia R.M. Rocco ,&nbsp;Marcus J. Schultz ,&nbsp;Nicolò Antonino Patroniti ,&nbsp;Chiara Robba ,&nbsp;For the ENIO collaborators","doi":"10.1016/j.jcrc.2025.155274","DOIUrl":"10.1016/j.jcrc.2025.155274","url":null,"abstract":"<div><h3>Background</h3><div>Invasive mechanical ventilation (IMV) is crucial for managing acute brain injury (ABI) patients, yet the effects of positive end-expiratory pressure (PEEP) on outcomes are not well understood. This study aimed to evaluate the relationship between PEEP levels and risk of extubation failure as well as intensive care unit (ICU) mortality in ABI patients.</div></div><div><h3>Methods</h3><div>This post-hoc analysis of the ENIO study included 1512 ABI patients from the ENIO cohort, excluding those without available data on PEEP at day 1 and who never received an extubation trial. PEEP levels were recorded at days 1, 3, 7, and on the day of extubation. Logistic regression assessed the association between PEEP and extubation failure, while Cox proportional hazards regression analyzed ICU mortality.</div></div><div><h3>Results</h3><div>Among 1154 included patients, extubation failure occurred in 21.2 % and ICU mortality was 3.7 %. Higher median PEEP at days 1, 3, and 7 was independently associated with increased odds ratio (OR) of extubation failure (OR = 1.13; 95 %CI = 1.01–1.26; <em>p</em> = 0.0294). At the time of extubation, higher PEEP was also significantly associated with extubation failure (OR = 1.13; 95 %CI = 1.02–1.25; p = 0.0218) and ICU mortality (Hazard Ratio, HR = 1.38; 95 %CI = 1.12–1.69; p = 0.0026). However, at sensitivity analyses adjusted for acute respiratory distress syndrome (ARDS), PEEP was no longer significantly associated with outcomes, while ARDS itself was an independent predictor of extubation failure.</div></div><div><h3>Conclusions</h3><div>Extubating ABI patients at higher PEEP levels was associated with an increased risk of extubation failure and ICU mortality. However, this association likely reflects underlying respiratory pathology or disease severity. Our findings suggest that PEEP level may serve as a surrogate marker for extubation readiness, rather than a modifiable risk factor, and highlight the need for individualized assessment prior to extubation.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155274"},"PeriodicalIF":2.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251327","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: Portable handheld ultrasound for VExUS assessment in critical care: Reliability and time efficiency in resident-led examinations","authors":"Songsong Luo,&nbsp;Xiaoyuan Shen","doi":"10.1016/j.jcrc.2025.155300","DOIUrl":"10.1016/j.jcrc.2025.155300","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155300"},"PeriodicalIF":2.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251363","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}