Journal of Intensive Care Medicine最新文献

{"title":"Part 1: Current Concepts in Radiologic Imaging and Intervention in Acute Cholecystitis.","authors":"Easton Neitzel, Julia Laskus, Peter R Mueller, Avinash Kambadakone, Shravya Srinivas-Rao, Eric vanSonnenberg","doi":"10.1177/08850666241259421","DOIUrl":"10.1177/08850666241259421","url":null,"abstract":"<p><p>Acute calculous cholecystitis and acute acalculous cholecystitis are encountered commonly among critically ill, often elderly, patients. Multidisciplinary management of these conditions is essential, with intensivists, surgeons, diagnostic radiologists, interventional radiologists, infectious disease physicians, gastroenterologists, and endoscopists able to contribute to patient care. In this article intended predominantly for intensivists, we will review the imaging findings and radiologic treatment of critically ill patients with acute calculous cholecystitis and acute acalculous cholecystitis.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"919-928"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261961","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":"Phenobarbital Addition to Alcohol Withdrawal Treatment Offers Better Outcomes than Dexmedetomidine in Hospitalized Patients.","authors":"Mary Matecki, Ahmed Noureldin, Riad Akkari, Zachary Cohen, Matthew McMullan, Katrina Hawkins, Jeffrey Williams, Azuka Nwude, David Yamane, Babak Sarani, Sean M Lee, Susan Kartiko","doi":"10.1177/08850666251328881","DOIUrl":"10.1177/08850666251328881","url":null,"abstract":"<p><p>BackgroundThis study directly compares outcomes of phenobarbital and dexmedetomidine as adjuncts to symptom-triggered benzodiazepine treatment for alcohol withdrawal syndrome (AWS).MethodsThis is a retrospective cohort analysis at a single tertiary referral institution in a major urban center in the United States. In hospitalized patients above 18 years with AWS between May 1, 2018, and July 31, 2021 we compared the hospital length of stay (LOS), ICU LOS, mechanical ventilation incidence and duration of patients who received dexmedetomidine versus phenobarbital as adjuncts to lorazepam-based treatment. Patients were divided into two cohorts based on treatment they received - dexmedetomidine/lorazepam (DEX) versus phenobarbital/lorazepam (PHENO). The use of phenobarbital or dexmedetomidine was left to the discretion of the treating bedside physician.ResultsOne hundred fifty-six patients met inclusion criteria with 102 patients (65%) in the DEX group and 54 patients (35%) in the PHENO group. The PHENO group had a lower probability of intubation (OR 0.33, 95% CI 0.15-0.70, p = 0.005) and shorter hospital LOS (IRR 0.45, 95% CI 0.31-0.64, p < 0.001), and ICU LOS (IRR 0.58, 95% CI 0.34-1.00, p = 0.050). For both hospital and ICU LOS, the PHENO group had shorter LOS than dexmedetomidine at lower doses of lorazepam (<3 mg), but this protective effect diminished at higher doses of lorazepam, at a rate of 10% (hospital LOS, IRR 1.10, 95% CI 1.05-1.16, p < 0.001) and 6% (ICU LOS, IRR 1.06, 95% CI 0.99-1.13, p = 0.074) per milligram increase in lorazepam.ConclusionsA symptom- triggered lorazepam regimen including early phenobarbital administration for severe alcohol withdrawal syndrome is associated with lower hospital LOS and need for intubation compared to a symptom triggered lorazepam regimen with dexmedetomidine adjunct.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"948-955"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729965","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":"Identification of Risk Factors and Development of Prediction Models for Glasgow Coma Scale Score Deterioration in Stroke Patients: A Study Based on the MIMIC-IV Database.","authors":"Xuehui Fan, Jing Xu, Ruixue Ye, Jingpu Zhao, Yulong Wang","doi":"10.1177/08850666251325788","DOIUrl":"10.1177/08850666251325788","url":null,"abstract":"<p><p>ObjectiveStroke remains a major cause of mortality and disability worldwide. This study aims to identify the risk factors associated with Glasgow Coma Scale (GCS) deterioration in stroke patients using data from the MIMIC-IV database.MethodsWe conducted a retrospective cohort study based on the MIMIC-IV database, involving 1984 adult stroke patients. The main exposure variables included age, Charlson Comorbidity Index (CCI), and Sequential Organ Failure Assessment (SOFA) score. The outcome variable was GCS deterioration during hospitalization. Covariates included demographic information, comorbidities, and laboratory indicators. Multivariate logistic regression models were used to analyze risk factors.ResultsEach 1-point increase in SOFA score was associated with a 50.69% increased risk of GCS score deterioration (OR = 1.5069, 95% CI: 1.2641-1.7964, <i>P</i> < .0001). Each year increase in age was associated with a 24.19% increased risk (OR = 1.2419, 95% CI: 1.0496-1.4695, <i>P</i> = .0116). Each 1 mEq/L increase in minimum anion gap was associated with a 24.56% increased risk (OR = 1.2456, 95% CI: 1.0076-1.5398, <i>P</i> = .0424). Risk factors varied significantly among disease subtypes.ConclusionSOFA score, age, and anion gap are important predictors of GCS score deterioration in patients with neurological diseases. These findings may help identify high-risk patients early and optimize treatment strategies.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"937-947"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326019","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":"Venoarterial Extracorporeal Membrane Oxygenation Therapy in Patients with Sickle Cell Disease: Case Series and Review for Intensive Care Physicians.","authors":"Alison Grazioli, Joseph Rabin, Raymond P Rector, Zhongjun J Wu, Allen P Burke, Nima Sharifai, Aakash Shah, Bradley S Taylor, Mark T Gladwin","doi":"10.1177/08850666241260605","DOIUrl":"10.1177/08850666241260605","url":null,"abstract":"<p><p>Sickle cell disease (SCD) is associated with substantial morbidity and early mortality in afflicted adults. Cardiopulmonary complications that occur at increased frequency in SCD such as pulmonary embolism, pulmonary arterial hypertension, and acute chest syndrome can acutely worsen right ventricular function and lead to cardiogenic shock. Mechanical circulatory support including venoarterial extracorporeal membrane oxygenation (VA ECMO) is being increasingly utilized to treat hemodynamic collapse in various patient populations. However, a paucity of literature exists to guide the use of mechanical circulatory support in adults with SCD where disease-related sequela and unique hematologic aspects of this disorder may complicate extracorporeal therapy and must be understood. Here, we review the literature and describe three cases of adult patients with SCD who developed cardiogenic shock from acute decompensated right heart failure and were treated clinically with VA ECMO. Using an in vitro ECMO system, we investigate a potential increased risk of systemic fat emboli in patients with SCD who may be experiencing vaso-occlusive events with bone marrow involvement given the high-volume shunting of blood from venous to arterial systems with VA ECMO. The purpose of this study is to describe available extracorporeal life support experiences, review potential complications, and discuss the special considerations needed to further our understanding of the utility of VA ECMO in those with SCD.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"929-936"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975887","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":"The Relationship Between the Type of Microorganisms Isolated in Cultures and Outcomes in Children on Extracorporeal Membrane Oxygenation Support Following Corrective Surgery for Congenital Heart Disease.","authors":"Mónica Arias-Andrade, Carlos Miguel Santacruz, Martha Cecilia Reyes Casas, Juan Sebastián Barajas, Marco Fidel Sierra-Zuñiga, Catalina Duque, Martha I Àlvarez-Olmos, Nestor Sandoval, Jaime Fernández-Sarmiento","doi":"10.1177/08850666251327995","DOIUrl":"10.1177/08850666251327995","url":null,"abstract":"<p><p>ObjetivesExtracorporeal membrane oxygenation (ECMO) after surgery for congenital heart disease (CHD) provides hemodynamic support to patients when their myocardial function is temporarily affected. Postoperative infections in children with CHD on ECMO are a significant challenge, as they complicate recovery and affect outcomes during this critical period of hemodynamic support. The objective of this study was to analyze the mortality related to the micro-organism isolated in children with ECMO after surgery for CHD.MethodsRetrospective cohort study from January 2014 to December 2021 at a university hospital in Colombia. The primary outcome was the infection-related inpatient mortality of children undergoing surgery for CHD who received ECMO support, according to the type of microorganisms isolated in cultures.ResultsA total of 3307 surgeries for CHD were performed during the study period. Of these, 108 (3.3%) required veno-arterial ECMO after surgery. We found positive cultures in 35% of these patients. The incidence of infection was 14.5 cases per 1000 days of ECMO. The overall mortality of infected patients was 54.1%. Isolation of Gram-negative bacteria in cultures was associated with higher odds of dying compared with other isolations, regardless of age and type of CHD (aOR 6.92 95% CI 1.91-25.02; p < .01). We found no differences in hospital length of stay or PICU stay based on the type of bacteria isolated. The most commonly isolated Gram-negative bacteria was <i>Klebsiella pneumoniae</i>, which was associated with longer mechanical ventilation [26 (IQR 18.2-31.0) versus 11 (IQR 8.0-15.0) days; p < .01].ConclusionsThe presence of a Gram-negative bacterium as the cause of infection in any sample was associated with increased odds of mortality in children receiving ECMO support in the postoperative period following corrective surgery for congenital heart disease. Infections occurred in 1 out of 3 children on ECMO following surgery for CHD.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"956-963"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692589","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 of Admission Times on Mortality in Adult Patients with Severe Community-Acquired Pneumonia.","authors":"You-Lian Zhou, Shijie Duan, Xingmei Zhong, Liang Yang, Jun Qiu","doi":"10.1177/08850666251332116","DOIUrl":"10.1177/08850666251332116","url":null,"abstract":"<p><p>ObjectivesThe objective of this study was to examine the association between admission time and in-hospital mortality in patients with severe community-acquired pneumonia.Research DesignThe study population consisted of individuals who were enrolled between January 2019 and December 2023. These individuals were divided into two groups based on the time of admission: daytime admission from 8:00 am to 6:00 pm and nighttime admission from 6:00 pm to 8:00 am The primary endpoint of the study was in-hospital mortality. Binary logistic regression was employed to assess the association between admission time and in-hospital mortality.ResultsA total of 307 patients with severe community-acquired pneumonia were ultimately enrolled in the study. Of the total number of patients, 57% (175 patients) were admitted at night. A comparative analysis of the clinical outcomes in the two groups revealed that the mortality rate for patients admitted at night was 28%, which was not significantly different from that of patients admitted during the day, which was 35.6% (<i>P</i> = .155). The findings from binary logistic regression analyses revealed no statistically significant correlation between nighttime admissions and in-hospital mortality.ConclusionsThis study's findings indicate that nighttime admission for patients diagnosed with severe community-acquired pneumonia is not associated with an elevated risk of mortality. Conversely, there may be a reduced mortality rate for patients admitted during nighttime hours. However, further prospective multicenter studies are required in the future to confirm this.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"985-992"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005142","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":"Experiences of Moral Distress in Canadian Intensive Care Unit Professionals During and After the COVID-19 Pandemic: A Qualitative Exploratory Multiple Case Study in Ontario and Alberta, Canada.","authors":"Monica L Molinaro, Aimun Qadeer Shah, Asiana Elma, Alison Scholes, Nicole Pinto, Myles Leslie, Allison Brown, Deborah Cook, Daniel Niven, Kirsten Fiest, Elizabeth Peter, Lawrence Grierson, Meredith Vanstone","doi":"10.1177/08850666251329828","DOIUrl":"10.1177/08850666251329828","url":null,"abstract":"<p><p><b>Background:</b> Since the beginning of the COVID-19 pandemic, moral distress among healthcare workers in the Intensive Care Unit (ICU) has garnered both media and academic attention. Moral distress has been theorized as occurring when individuals are constrained from doing what they perceive as morally right. This study sought to empirically examine the lived experiences of moral distress among clinical and administrative healthcare professionals in a sample of Canadian ICUs during the COVID-19 pandemic. <b>Methods:</b> Qualitative case study methodology was used as the overarching approach, collecting and comparing data from two distinct cases: one ICU in Ontario and one in Alberta. Data collection involved two primary sources: semi-structured interviews with staff and document review of institutional and government directives to provide contextual data. Data analysis commenced concurrently with data collection, and generated within- and across-case themes, as well as allowed descriptive accounts of moral distress. <b>Results:</b> Thirty-six healthcare workers across two sites were interviewed. Participants described three primary categories of constraints leading to moral distress. These were: 1) The rapidity and opaqueness of policy development, specifically pertaining to 2) the implementation of family visitation and treatment triage decisions, and 3) resource shortages, which reduced patient interactions, shifted professional responsibilities. Each of these constraints yielded circumstances and forced decisions that were perceived as morally wrong because they compromised care quality and outcomes. <b>Conclusions:</b> While sharing similarities with the growing literature on moral distress in the context of the COVID-19 pandemic, this study reveals new insights on how provincial and institutional policy has direct bearing on experiences of moral distress. Policies and circumstances forced ICU staff to choose between actions they considered the most right and the least wrong. Understanding these specific policy-driven constraints highlights the need for healthcare systems and processes that mitigate moral distress and sustain our health workforce.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"973-984"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Outcomes of Hemoadsorption with CytoSorb^® in Patients with Septic Shock: Insights from a Single-Center Study.","authors":"Giorgio Berlot, Paolo Carocci, Valentina Votrico, Barbara Iacoviello, Nicolò Taverna, Ugo Gerini, Vittorio di Maso, Ariella Tomasini","doi":"10.1177/08850666251331905","DOIUrl":"10.1177/08850666251331905","url":null,"abstract":"<p><p>BackgroundHemoadsorption is currently employed to treat septic shock and other clinical conditions involving massive inflammatory mediator release. CytoSorb^®, a device utilizing synthetic resin microbeads, provides a large adsorption surface for blood purification. This study aimed to review the clinical course of patients with septic shock treated with CytoSorb^® in our hospital's intensive care unit (ICU).Patients and MethodsThis study retrospectively analyzed the clinical course of patients with septic shock treated with CytoSorb^®, focusing on treatment timing and the volume of blood processed.ResultsBetween July 1, 2016, and December 31, 2023, 175 patients (106 men, 69 women; median age: 67 years, interquartile [IQR]: 58-85) received CytoSorb^® therapy. Survivors exhibited a significantly lower simplified acute physiology score at admission than nonsurvivors. CytoSorb^® was initiated within 24 h of shock onset in 102 patients (58%, early starters) and between 25 and 48 h in 73 patients (42%, late starters). Hemodynamic improvements elevated mean arterial pressure and reduced lactate, procalcitonin, C-reactive protein, sequential organ failure assessment scores, and noradrenaline doses in survivors. These effects were more pronounced in early starters receiving intensive treatment, who also demonstrated significantly lower lactate levels and higher mean arterial pressure at the end of therapy. Overall, 86 patients (49%) died in the ICU. Survivors underwent longer treatment durations and processed greater blood volumes than nonsurvivors.ConclusionsIn patients with septic shock treated with CytoSorb^® within 48 h of onset, treatment intensity-rather than timing-was associated with lower ICU mortality rates.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"993-1000"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764129","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":"Strain in the Pediatric Intensive Care Unit and its Association with Patient Outcomes.","authors":"Matthew S Baker, Kristen R Miller, Jaime S LaVelle, Julia A Heneghan, Michele M Loi, Cameron F Gunville, Aline B Maddux","doi":"10.1177/08850666251329902","DOIUrl":"10.1177/08850666251329902","url":null,"abstract":"<p><p><b>Objective:</b> To characterize measures of pediatric intensive care unit (PICU) strain and test for associations between strain and patient outcomes. We hypothesized that periods of increased strain would be associated with increased odds of experiencing a post-ICU floor escalation event. <b>Design:</b> Retrospective cohort study. <b>Setting:</b> Quaternary care children's hospital PICU. <b>Study Population:</b> PICU admissions (2014-2023). <b>Interventions:</b> None. <b>Measurements and Main Results:</b> We measured PICU strain metrics daily including percent occupancy, percent turnover, and acuity. Percent occupancy and turnover were higher during annual peak viral season versus non-peak season (percent occupancy: median 84.4 [interquartile range (IQR) 72.9, 91.7] versus 68.8 [IQR 56.3, 82.1], <i>P</i> < .001; percent turnover: median 25.0 [IQR 20.0, 31.3] versus 21.9 [IQR 15.6, 28.1], <i>P</i> < .001). Acuity metrics did not differ during these periods. In patients admitted for respiratory or neurologic illness, we used multivariable logistic regression to test for associations between strain metrics on the day of transfer and odds of a floor escalation event defined as an unplanned PICU readmission or rapid response or code blue activation within 48 h of transfer. Of 12 832 patient transfers, 429 (3.3%) experienced a floor escalation event. After controlling for patient and clinical characteristics, percent occupancy and turnover were independently associated with an increase in floor escalation events. This risk was not linear for occupancy: above 87.5% (95% confidence interval (CI): 80.4, 94.6%), per 5% increase in occupancy patients experienced more floor escalation events (odds ratio [OR] 1.29 [95% CI: 1.07, 1.57]). For every 5% increase in turnover, patients experienced more floor escalation events (OR 1.06 [95% CI: 1.01, 1.12]). <b>Conclusions:</b> Occupancy and turnover characterized recognized periods of PICU strain. High occupancy and turnover were associated with more floor escalation events. Multicenter studies are needed to evaluate the generalizability of these findings across other PICUs.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"964-972"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976077","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":"Antibiotic Stewardship in the Neonatal Intensive Care Unit.","authors":"Dustin D Flannery, Sarah A Coggins, Alexandra K Medoro","doi":"10.1177/08850666241258386","DOIUrl":"10.1177/08850666241258386","url":null,"abstract":"<p><p>Antibiotic stewardship is a multidisciplinary, evidence-based approach to optimize antibiotic use and mitigate development of antibiotic resistance. Neonates have high rates of antibiotic exposure, particularly those born preterm and admitted to the NICU, and mounting evidence describes the adverse consequences of such exposures in the absence of infection. Here, we review the general principles of antibiotic stewardship and how they can be applied in NICUs. The unique characteristics of NICUs and patients cared for in this setting, which warrant unique implementation strategies and special considerations are discussed. We summarize current antibiotic use metrics for assessment of responses to stewardship interventions and changes over time, and review evidence-based infection prevention practices in the NICU. Current recommendations for empiric antibiotic use in the NICU and the utility of infection biomarkers are summarized. Lastly, given the growing global threat of increasing antibiotic resistance, specific threats in the NICU are highlighted.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"862-875"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247335","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}