Ignacio Martin-Loeches , Antoni Torres , Antoine Roquilly
{"title":"Hospital-acquired pneumonia: Past, present, and perspectives","authors":"Ignacio Martin-Loeches , Antoni Torres , Antoine Roquilly","doi":"10.1016/j.jcrc.2025.155306","DOIUrl":"10.1016/j.jcrc.2025.155306","url":null,"abstract":"<div><div>Hospital-acquired pneumonia (HAP) remains the most frequent and lethal hospital acquired infection, driving ICU mortality, prolonged length of stay, and resource use. Ventilator-associated pneumonia (VAP), the archetypal form of HAP, has long defined both the risks and unintended costs of intensive care. Historically, management was shaped by timelines, culture-based diagnostics, and the central role of the endotracheal tube as both lifesaving and pathogenic. This paradigm promoted rigid definitions and empiric antibiotic strategies but also generated enduring lessons on airway care, aspiration, and biofilm biology.</div><div>Contemporary perspectives have shifted toward ecology and host response. The binary early–late VAP model has been replaced by a continuum of ventilatorassociated lower respiratory tract infections (VA-LRTI), from ventilator-associated tracheobronchitis to VAP. Colonisation, biofilm formation, and microbial–host interactions are now recognised as dynamic drivers of infection. Novel diagnostics—including multiplex PCR and next-generation sequencing—offer rapid pathogen and resistance detection, while biomarkers such as procalcitonin support stewardship and shorter antibiotic courses. Recognition of ventilated HAP (VHAP) has blurred traditional boundaries.</div><div>Looking forward, precision diagnostics, immune monitoring, and artificial intelligence promise to integrate ecology and immunity into personalised management. The future of HAP care lies not in faster antibiotics, but in tailored, ecology-informed, host-guided strategies that improve outcomes and preserve resilience in the critically ill.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155306"},"PeriodicalIF":2.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300962","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: “An economic model for different anticoagulation strategies in continuous renal replacement therapy”","authors":"XiRui Yang , KaiFeng Qin , YingJian Wang","doi":"10.1016/j.jcrc.2025.155292","DOIUrl":"10.1016/j.jcrc.2025.155292","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155292"},"PeriodicalIF":2.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292402","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":"Yifan Shi , Shuwen Zhang","doi":"10.1016/j.jcrc.2025.155301","DOIUrl":"10.1016/j.jcrc.2025.155301","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155301"},"PeriodicalIF":2.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292341","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}
Faisal A. Shaikh, Eric J. Charles, Zoltan H. Nemeth
{"title":"Letter to the editor: “Erythropoietin in ICU patients receiving early red blood cell transfusions: a retrospective study of the impact on transfusion requirements”","authors":"Faisal A. Shaikh, Eric J. Charles, Zoltan H. Nemeth","doi":"10.1016/j.jcrc.2025.155295","DOIUrl":"10.1016/j.jcrc.2025.155295","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155295"},"PeriodicalIF":2.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292330","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}
Addisu G. Ayalew , Mikiyas G. Teferi , Nanati J. Aliye , Kassahun A. Dinku , Getaw W. Hassen , Fetiya Alferid
{"title":"Incidence and predictors of adverse events during intra-hospital transport of critically ill patients in a tertiary ICU in Ethiopia: A prospective observational study","authors":"Addisu G. Ayalew , Mikiyas G. Teferi , Nanati J. Aliye , Kassahun A. Dinku , Getaw W. Hassen , Fetiya Alferid","doi":"10.1016/j.jcrc.2025.155309","DOIUrl":"10.1016/j.jcrc.2025.155309","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155309"},"PeriodicalIF":2.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292373","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}
Quentin Moyon , Jules Stern , Marc Pineton de Chambrun , Guillaume Lebreton , Marylou Para , Juliette Chommeloux , Guillaume Hékimian , Charles Edouard Luyt , Alain Combes , Romain Sonneville , Matthieu Schmidt
{"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 , Jules Stern , Marc Pineton de Chambrun , Guillaume Lebreton , Marylou Para , Juliette Chommeloux , Guillaume Hékimian , Charles Edouard Luyt , Alain Combes , Romain Sonneville , 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 > 30 kg/m<sup>2</sup>) 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 (<25 kg/m<sup>2</sup>, 25-30 kg/m<sup>2</sup>, and > 30 kg/m<sup>2</sup>). 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 < or ≥ 30 kg/m<sup>2</sup> 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 , Yunlai Zhao , 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}
M.P. Gracia Arnillas , F. Alvarez Lerma , X. Nuvials Casals , R. Gimeno Costa , N. Mas Bilbao , J. Lobo Palanco , A. Escribá Bárcena , M. Catalán González , M. Martinez Alonso
{"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 , F. Alvarez Lerma , X. Nuvials Casals , R. Gimeno Costa , N. Mas Bilbao , J. Lobo Palanco , A. Escribá Bárcena , M. Catalán González , 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}
Song Zhou , Yunlai Zhao , Huaiyu Mao , Guoying Wang
{"title":"Letter to the editor: Immediate “sipping” vs. delayed oral fluid intake after extubation: A randomized controlled trial","authors":"Song Zhou , Yunlai Zhao , Huaiyu Mao , 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}