Journal of critical care最新文献

{"title":"Comment on “Is ketamine safe for traumatic brain injury? A systematic review and meta-analysis”","authors":"Wael Ghaly Elmasry , Ahmed Mohammed Abdelbaky , Ahmed Hossameldin Ahmed Awad","doi":"10.1016/j.jcrc.2025.155413","DOIUrl":"10.1016/j.jcrc.2025.155413","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155413"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145880560","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":"A comprehensive analysis of diversity in Türkiye's intensive care medicine: Leadership, workforce and authorship","authors":"Mehmet Yildirim ,&nbsp;Burcin Halacli ,&nbsp;Esat Kivanc Kaya ,&nbsp;Irem Zehra Acar ,&nbsp;Arda Ayten ,&nbsp;Atilla Taşligedik ,&nbsp;Arzu Topeli","doi":"10.1016/j.jcrc.2025.155342","DOIUrl":"10.1016/j.jcrc.2025.155342","url":null,"abstract":"<div><h3>Background</h3><div>Diversity in intensive care medicine (ICM) contributes to equity, team performance, and innovation. However, international data highlight persistent gender disparities in leadership, authorship, and specialty composition. While Türkiye appears to have balanced gender representation in critical care, a national analysis has been lacking.</div></div><div><h3>Methods</h3><div>This descriptive study evaluated gender and specialty diversity among ICM professionals in Türkiye across five domains: (1)national society leadership, (2)congress speaker rosters, (3)fellowship program directors, (4)ICM specialists, and (5)Türkiye-based PubMed-indexed ICM publications between 2015 and 2025. Data were collected from public records, institutional websites, and structured database searches.</div></div><div><h3>Results</h3><div>One of the two national societies demonstrated strong female leadership, with 55.6 % female presidents since 2005. Congress speaker data from 2004 to 2024 (<em>n</em> = 1567) showed increasing female representation (<em>n</em> = 635, 40.5 %), reaching near parity in recent years. Among 53 fellowship programs, 45.3 % of directors were female. ICM specialists (<em>n</em> = 571) had a near-equal gender distribution (50.6 % female). Anesthesiology was the dominant primary specialty (54.6 %) among ICM specialists. In ICM publications from Türkiye indexed in PubMed, women represented 41.6 % of all authors (<em>n</em> = 7073) across 1107 ICM publications, with 59.0 % led by a female first or last author.</div></div><div><h3>Conclusion</h3><div>Türkiye shows encouraging trends in gender equity across clinical and academic ICM. These gains may reflect equitable public policies, gender-balanced specialty pipelines, and visible female role models. While challenges remain—particularly in senior authorship and society leadership—Türkiye's experience may offer valuable lessons for global equity in ICM. Further research should explore other dimensions, including race/ethnicity and socioeconomic background, which are underreported in current systems.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155342"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512937","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":"Seven days versus extended duration antibiotic therapy for multidrug-resistant gram-negative bacterial infections in critically ill patients: A pooled analysis of the OPTIMISE and REGARD-VAP trials","authors":"Muhammed Umer ,&nbsp;Amritpal S. Jagra ,&nbsp;Fizzah Mohammad Hanif ,&nbsp;Marium Khan ,&nbsp;Hari Sharma","doi":"10.1016/j.jcrc.2025.155361","DOIUrl":"10.1016/j.jcrc.2025.155361","url":null,"abstract":"<div><div>Multidrug-resistant Gram-negative bacteria (MDR-GNB) are increasingly encountered in intensive care units (ICUs), where prolonged antibiotic courses are often prescribed despite limited evidence guiding optimal duration. Determining whether shorter regimens are as effective as extended therapy is essential for stewardship and patient outcomes.</div><div>We performed an aggregate data meta-analysis pooling two randomized controlled trials (RCTs): OPTIMISE (7 vs. 14 days) and REGARD-VAP (individualized 6–7 vs. 8–9 days) in MDR-GNB infections. The primary outcomes were composite outcome of mortality and reinfection/recurrence, mortality, and reinfection/recurrence. Random- effects models generated pooled odds ratios (OR) with 95 % confidence intervals (CI). Across 602 ICU patients, <em>Klebsiella pneumoniae</em> was the most frequent resistant pathogen, with <em>Pseudomonas aeruginosa</em> more prominent in OPTIMISE and <em>Acinetobacter baumannii</em> in REGARD-VAP. Short-course therapy did not significantly differ from extended therapy for mortality (OR 0.74, 95 % CI 0.45–1.23, I² = 18 %) or clinical failure (OR 0.82, 95 % CI 0.50–1.36, I² = 0 %). Relapse occurred more often with short-course therapy (OR 2.04, 95 % CI 0.85–4.92, I² = 22 %) but was not statistically significant.</div><div>Shorter regimens appear comparable to extended courses in critically ill patients, though potential relapse risk warrants further study. Future individual patient data meta-analyses may clarify pathogen- and host-specific factors guiding optimal duration.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155361"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615782","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":"A multicenter survey of critical care clinicians' attitudes and practices on guidance during percutaneous dilatational tracheostomy","authors":"Ningning Yang ,&nbsp;Fengyong Yang ,&nbsp;Meiqi Wang ,&nbsp;Xinghan Tian ,&nbsp;Chunli Liu","doi":"10.1016/j.jcrc.2025.155399","DOIUrl":"10.1016/j.jcrc.2025.155399","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155399"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733370","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":"What every intensivist should know about how to survive alarm fatigue with the F.ALARM method","authors":"Judy Edworthy ,&nbsp;Elif Özcan","doi":"10.1016/j.jcrc.2025.155406","DOIUrl":"10.1016/j.jcrc.2025.155406","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155406"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145863056","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":"Acute renal replacement therapy in cardiogenic shock: Prognostic impact of timing, modality, and indications – Insights from the FRENSHOCK study","authors":"Nans Florens ,&nbsp;Miloud Cherbi ,&nbsp;Etienne Puymirat ,&nbsp;Laurent Bonello ,&nbsp;François Roubille ,&nbsp;Guillaume Schurtz ,&nbsp;Nicolas Combaret ,&nbsp;Benoit Lattuca ,&nbsp;Fanny Vardon ,&nbsp;Guillaume Leurent ,&nbsp;Edouard Gerbaud ,&nbsp;Eric Bonnefoy ,&nbsp;Hamid Merdji ,&nbsp;Clément Delmas","doi":"10.1016/j.jcrc.2025.155404","DOIUrl":"10.1016/j.jcrc.2025.155404","url":null,"abstract":"<div><h3>Background</h3><div>Cardiogenic shock (CS) carries high mortality and is often complicated by acute kidney injury requiring renal replacement therapy (RRT). The prognostic impact of RRT timing and indications remains unclear. We retrospectively evaluated outcomes associated with RRT in CS.</div></div><div><h3>Methods</h3><div>FRENSHOCK is a multicenter registry including 772 CS patients from 49 centers. Association between acute RRT and 30-day mortality was assessed in a 1:1 propensity-matched cohort. RRT outcomes were compared by timing (early ≤48 h vs. late), modality (continuous/intermittent), and indications (acidosis/hyperkalemia, fluid overload/oliguria). Predictors for RRT were identified through multivariable logistic regression.</div></div><div><h3>Results</h3><div>Among 772 patients, 114 (15 %) required acute RRT, with greater severity: lower mean arterial pressure and higher ECMO use. Thirty-day mortality was higher in the RRT group (matched cohort, HR 3.19 [2.07–4.92], <em>p</em> &lt; 0.01). Neither timing (early ≤48 h vs. late &gt;48 h) nor modality (continuous vs. intermittent) significantly impacted mortality. However, indication for RRT was associated with poor outcomes: patients dialyzed for metabolic disturbances (acidosis/hyperkalemia) had higher 30-day mortality than those treated for fluid overload/oliguria (HR 1.99 [1.08–2.68], <em>p</em> = 0.02). Independent predictors for RRT included elevated bilirubin, severe anemia, advanced chronic kidney disease, infectious trigger, epinephrine use, mechanical ventilation, and mechanical circulatory support.</div></div><div><h3>Conclusions</h3><div>Acute RRT in CS is associated with increased mortality. Clinical indications for dialysis identify distinct prognostic subgroups, emphasizing the need to explore cardiorenal sub-phenotypes. These results support the need for prospective studies combining hemodynamic and biomarker data to characterize AKI subtypes in CS.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155404"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780800","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":"Lighting the path to personalized sedation in the ICU","authors":"Rafael Badenes ,&nbsp;Thomas Godet ,&nbsp;Yuki Kotani","doi":"10.1016/j.jcrc.2025.155408","DOIUrl":"10.1016/j.jcrc.2025.155408","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155408"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145786899","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: “Recovery of motor functions and cognitive functions in patients with intensive care unit–acquired weakness”","authors":"Raihan Mohammed Mohiuddin,&nbsp;Mohammed Misbah Ul Haq","doi":"10.1016/j.jcrc.2025.155350","DOIUrl":"10.1016/j.jcrc.2025.155350","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155350"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570177","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":"Association between anemia and trauma-related severe acute kidney injury in trauma patients at risk of major bleeding: A post-hoc analysis of the RESTRIC trial","authors":"Yuko Okishio ,&nbsp;Kyohei Miyamoto ,&nbsp;Tsuyoshi Nakashima ,&nbsp;Mineji Hayakawa ,&nbsp;Daisuke Kudo ,&nbsp;Shigeki Kushimoto ,&nbsp;Takashi Tagami ,&nbsp;Kosei Kunitatsu ,&nbsp;Shuji Kawashima ,&nbsp;Kentaro Ueda ,&nbsp;Shigeaki Inoue","doi":"10.1016/j.jcrc.2025.155364","DOIUrl":"10.1016/j.jcrc.2025.155364","url":null,"abstract":"<div><h3>Purpose</h3><div>Trauma-related acute kidney injury (AKI) is associated with increased mortality. Anemia on admission has been reported as a risk factor for AKI in non-trauma patients. Several studies have reported an association between anemia and trauma-related AKI. However, very few studies specifically focused on the association between anemia at emergency department (ED) admission and trauma-related severe AKI. We aimed to investigate this association in this post-hoc analysis.</div></div><div><h3>Materials and methods</h3><div>We retrospectively analyzed the dataset of the Restrictive Red Blood Cell Transfusion Strategy for Critically Injured Patients (RESTRIC) trial, a cluster-randomized, crossover, non-inferiority multicenter study that included 422 trauma patients at risk of major bleeding to compare restrictive and liberal transfusion strategies. Patients undergoing chronic hemodialysis were excluded. We assessed the association between anemia at ED admission (hemoglobin &lt;10 g/dL) and trauma-related severe AKI defined as Kidney Disease: Improving Global Outcomes Stage 3, occurring within 7 days of admission. A multivariate logistic regression model was employed to adjust for propensity scores predicting the likelihood of anemia at ED admission, calculated from predefined risk factors relevant to trauma-related severe AKI and randomized allocations (e.g., transfusion strategies).</div></div><div><h3>Results</h3><div>Trauma-related severe AKI occurred in 15 (3.6 %) of the final study population of 417 patients. Of all patients, 63 (15 %) presented with anemia at ED admission. The multivariate logistic regression model revealed a significant association between anemia at ED admission and trauma-related severe AKI (adjusted odds ratio 3.9, 95 % confidence interval 1.2–12.9, <em>p</em> = 0.029).</div></div><div><h3>Conclusions</h3><div>Anemia at ED admission might be associated with trauma-related AKI in trauma patients at risk of major bleeding.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155364"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604497","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":"Pre-operative risk stratification from admission data: Clustering and KNN-modelling for identifying high-risk patients before surgery","authors":"Armin Podtschaske ,&nbsp;Bernhard Ulm ,&nbsp;Simone Kagerbauer","doi":"10.1016/j.jcrc.2025.155376","DOIUrl":"10.1016/j.jcrc.2025.155376","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155376"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022460","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}