Journal of Intensive Care Medicine最新文献

{"title":"Adrenal Insufficiency After Glucocorticoid Use in the Pediatric Intensive Care Unit.","authors":"Ashley N Radig, Vanessa A Curtis, Erik Westlund, Christina L Cifra","doi":"10.1177/08850666251352447","DOIUrl":"https://doi.org/10.1177/08850666251352447","url":null,"abstract":"<p><p>IntroductionGlucocorticoids are commonly used in pediatric critical illness and may lead to subsequent adrenal insufficiency, causing morbidity among pediatric intensive care unit (PICU) survivors. We aimed to determine the prevalence of and risk factors for adrenal insufficiency among children who received glucocorticoids during PICU admission.MethodsWe conducted a retrospective cohort study using structured medical record review to determine the prevalence of adrenal insufficiency and clinical characteristics of PICU patients 0-18 years old who received enteral and/or parenteral glucocorticoids. Patients were consecutively admitted to an academic tertiary referral PICU over 2 years.ResultsAmong 530 patients who received glucocorticoids, 12 (2.3%) were diagnosed with adrenal insufficiency at a median of 55 (IQR 8-156) days after initial glucocorticoid exposure. Unadjusted analyses showed that patients with adrenal insufficiency were younger (median 0.5 vs 2 years, <i>p</i> = .020), had a longer PICU stay (79 vs 4 days, <i>p</i> < .001) and hospital stay (96 vs 6 days, <i>p</i> < .001), and had a lower survival rate at 1 year after PICU discharge (75% vs 94%, <i>p</i> = .033). There were no significant differences in sex, race/ethnicity, illness severity, or diagnostic categories. Patients with adrenal insufficiency were more likely to have received glucocorticoids for hyperinflammation (21% vs 8%) and less likely for reactive airway disease (10% vs 26%) (<i>p</i> = .036), had a higher median total hydrocortisone equivalent dose (2508 vs 480 mg, <i>p</i> = .007), and were more likely to have had a steroid taper (48% vs 24%, <i>p</i> = .003). Multivariable logistic regression showed no significant associations between clinical characteristics and the diagnosis of adrenal insufficiency.ConclusionsAmong PICU patients who received glucocorticoids, 2.3% were subsequently diagnosed with adrenal insufficiency. We identified potential risk factors for adrenal insufficiency after glucocorticoid use in the PICU, which warrant future study to better delineate and mitigate adrenal insufficiency's contribution to morbidity and mortality among critically ill children.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251352447"},"PeriodicalIF":3.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497356","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":"Navigating Appropriateness of Care in the ICU: A Case-Based Application of the Fourfold Assessment.","authors":"Katerina Rusinova, Louis Voigt, Andrej Michalsen","doi":"10.1177/08850666251352456","DOIUrl":"https://doi.org/10.1177/08850666251352456","url":null,"abstract":"<p><p>PurposeAppropriateness of care is a fundamental yet often underexamined aspect of critical care medicine. Drawing on Kant's notion of appropriateness as providing \"no more and no less than the matter requires,\" we explore how clinicians can align medical indication with patient or surrogate consent. Misalignments in this regard may result in overtreatment or undertreatment, contributing to moral distress, burnout, and dissatisfaction among families and clinicians.MethodsWe present a case report of an elderly patient whose clinical course in the intensive care unit (ICU) traverses all four quadrants of a proposed framework-the Fourfold Table of Appropriateness. This conceptual tool classifies medical interventions according to two dimensions: medical indication (yes/no) and patient or surrogate consent (yes/no). Each quadrant is associated with ethical and clinical implications and is color-coded like a traffic light to support real-time decision-making: green (appropriate), yellow (caution), red (stop).ResultsThe case illustrates how alignment between indication and consent fosters goal-concordant care. It also demonstrates how therapeutic obstinance, paternalism, or emotionally driven demands may lead to inappropriate care. Each episode reveals different challenges-physician biases, surrogate distress, unclear prognoses-and highlights the role of communication, shared decision-making, and clinical humility.ConclusionThe Fourfold Table provides a didactic framework to guide structured reflection among ICU clinicians. By naming and examining patterns of inappropriateness, it fosters ethical awareness and better communication practices. This case-based approach highlights the necessity of early recognition of misalignments, the importance of addressing emotional and cognitive biases, and the value of interventions such as time-limited trials and family-centered care. Ultimately, this framework contributes to more compassionate, appropriate, and goal-aligned critical care.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251352456"},"PeriodicalIF":3.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497357","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":"Mortality Predictors in Stroke Patients Requiring Mechanical Ventilation: A Multicenter Prospective Observational Study.","authors":"Vadim Ershov, Andrey Belkin, Vladimir Gorbachev, Alexey Gritsan, Igor Zabolotskikh, Konstantin Lebedinsky, Ilya Leiderman, Sergey Petrikov, Denis Protsenko, Alexander Solodov, Alexey Shchegolev, Victor Silkin, Alexey Dobrynin, Artem Kuzovlev, Michail Pisarev, Alexander Kulikov","doi":"10.1177/08850666251342731","DOIUrl":"https://doi.org/10.1177/08850666251342731","url":null,"abstract":"<p><p>BackgroundPatients with acute severe stroke requiring mechanical ventilation represent a significant clinical challenge. Identification of mortality predictors is necessary to improve outcomes. MethodsFourteen hospitals located around Russia participated in this prospective multicenter observational clinical study. Patients admitted to ICU between November 1, 2017, and November 1, 2019 with confirmed cerebral stroke, aged 18 to 90 years, and requiring mechanical ventilation were included. The impact of various clinical factors on mortality during the 28-day period after stroke was assessed.ResultsA total of 1289 patients were included in the registry, and 1144 met the study criteria. The 28-day mortality rate for stroke patients on mechanical ventilation was 64.3%. The most common indications for mechanical ventilation were impaired consciousness (75.7%) and hypoxemia (60.9%). In the cohort of strokes with NIHSS severity greater than 20 points, hypoxemia at the start of ventilation (OR 1.85 [1.21; 2.81], P = 0.004) and the use of hyperventilation mode (OR 1.46 [1.02; 2.06], P = 0.0336) were associated with increased mortality. Pressure-controlled mode as the primary ventilation method (OR 0.36 [0.21; 0.60], P < 0.001) and ICP monitoring (OR 0.23 [0.12; 0.44], P < 0.001) were associated with decreased mortality. Infectious complications were associated with longer mechanical ventilation and ICU stay (P < 0.001). The relationship between probable mortality and the severity of neurological deficit on the NIHSS scale at the start of mechanical ventilation is non-linear. A critical threshold was reached at 16 points NIHSS, where a trend of increasing probable mortality emerged.ConclusionThe identified predictors of mortality in stroke patients requiring mechanical ventilation are essential for decision-making in this cohort. They include hypoxemia, hyperventilation (used to control intracranial hypertension), volume-controlled (VC) versus pressure-controlled (PC) initial ventilation, and the use of clinical methods for monitoring ICP alone versus invasive monitoring.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251342731"},"PeriodicalIF":3.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317087","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":"Prediction of Acute Kidney Injury in Critically ill Patients with Community-Acquired Pneumonia Using Machine Learning.","authors":"Wenwen Ji, Guangdong Wang, Tingting Liu, Mengcong Li, Na Wang, Tinghua Hu, Zhihong Shi","doi":"10.1177/08850666251349792","DOIUrl":"https://doi.org/10.1177/08850666251349792","url":null,"abstract":"<p><p>BackgroundThe incidence of acute kidney injury (AKI) is increased in patients with community-acquired pneumonia (CAP), contributing to poor outcomes in ICUs. Early identification of patients at high risk for AKI is essential for timely intervention. This study aimed to develop a machine learning model for predicting AKI in CAP patients.MethodsPatients with CAP were identified from the MIMIC-IV database using ICD codes. AKI was defined according to the KDIGO criteria. Baseline characteristics, vital signs, laboratory data, comorbidities, and clinical scores were extracted. LASSO regression was applied for feature selection, and eight machine learning models, including logistic regression, k-nearest neighbors, decision tree, random forest, support vector machine, neural network, XGBoost, and LightGBM, were developed. Model performance was evaluated using AUC, sensitivity, specificity, accuracy, recall, F1 score, calibration curves, and decision curve analysis (DCA). SHapley Additive exPlanations (SHAP) were used to interpret the final model. A web-based risk calculator was created for clinical application.ResultsA total of 3213 CAP patients were included, with 2723 (84.8%) developing AKI. XGBoost demonstrated the best performance with an AUC of 0.937 (95% CI: 0.922-0.952), sensitivity of 0.875, specificity of 0.855, accuracy of 0.865 (95% CI: 0.841-0.887), recall of 0.875, and F1 score of 0.866. DCA showed the highest net benefit for XGBoost across various risk thresholds. After recursive feature elimination, a simplified model with seven key variables, including urine output, weight, ventilation, first-day minimum PTT, first-day maximum sodium, first-day minimum heart rate, and first-day maximum temperature, maintained high predictive performance (AUC = 0.925, 95% CI: 0.908-0.941).ConclusionsThe XGBoost model accurately predicted AKI risk in CAP patients, demonstrating robust performance and clinical utility. The web-based calculator offers an accessible tool for individualized risk assessment, supporting early detection and management of AKI in ICUs.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251349792"},"PeriodicalIF":3.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302299","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":"Application of New Pediatric Sepsis Definition to a Multicenter Observational Cohort of Previously Enrolled Severe Sepsis Patients Defined by SIRS Plus Organ Dysfunction.","authors":"Kate F Kernan, Mohammed Shaik, Christopher M Horvat, Dana Y Fuhrman, Zachary Aldewereld, Robert A Berg, David Wessel, Murray M Pollack, Kathleen Meert, Mark W Hall, Christopher J L Newth, Tom Shanley, Rick E Harrison, Joseph A Carcillo, Rajesh K Aneja","doi":"10.1177/08850666251349790","DOIUrl":"10.1177/08850666251349790","url":null,"abstract":"<p><p>IntroductionIn 2024, a Society of Critical Care Medicine task force updated the pediatric sepsis definition from the presence of suspected or confirmed infection, and a systemic inflammatory response (SIRS) with organ dysfunction, to a novel definition. Our objective is to identify how many patients previously identified as having severe sepsis would continue to meet the new definition.Materials and methodsWe performed a secondary analysis of the Phenotyping Sepsis-Induced Multiple Organ Failure cohort of 401 children with suspected or confirmed infection, two of four SIRS criteria and organ dysfunction enrolled between 2015-2017. We calculated a modified Phoenix Sepsis Criteria Score (mPSC) for participants and compared those with mPSC of greater than or equal to 2 or less than 2 according to the 2024 definition.ResultsOf 401 children, 132 (33%) did not meet mPSC definitions. While children meeting mPSC had more organ dysfunction, the total mortality did not differ. One in 4 children requiring extracorporeal membrane oxygenation and 1 in 4 mortalities did not meet the mPSC definition. In logistic regression models, in the complete cohort, hematologic (OR 4.4, 95% CI: 1.8-10.2, <i>P</i>-value = .001), central nervous system (OR 2.3, 95% CI: 1.0-5.1, <i>P</i>-value = .046) and renal failure (OR: 3.2, 95% CI:1.2-7.9, <i>P</i>-value = .017) predicted mortality; in the mPSC subgroup pulmonary (OR: 3.6, 95% CI:1.3-13.3, <i>P</i>-value = .030) and hematologic failure (OR 5.6, 95% CI: 2.2-14.5, <i>P</i>-value = .0003) were significant predictors. In the mPSC excluded subgroup, only renal failure predicted mortality (OR 9.6, 95% CI 1.1-73.0, <i>P</i>-value = .028).ConclusionsFurther study of the impact of the 2024 data-driven organ dysfunction definition on pediatric sepsis research, patient safety, and clinical benchmarking efforts is warranted.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251349790"},"PeriodicalIF":3.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12216587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302298","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":"Impact of Music Intervention or Usual Care on Sedative Exposure During a Spontaneous Awakening Trial among Intensive Care Unit Patients Receiving Mechanical Ventilation: A Prospective Randomized Feasibility Study.","authors":"Justin R Culshaw, Christopher A Droege, Elsira M Pina, Neil E Ernst, Dalton J Kuebel, Eric W Mueller","doi":"10.1177/08850666251343799","DOIUrl":"https://doi.org/10.1177/08850666251343799","url":null,"abstract":"<p><strong>Purpose of research: </strong>The objective of this study was to determine if protocolized music intervention paired with spontaneous awakening trial (SAT) is a feasible intervention for mechanically ventilated and sedated intensive care unit (ICU) patients to reduce overall sedation exposure.</p><p><strong>Major findings: </strong>Patients were admitted to the medical ICU (MICU) or surgical ICU (SICU), mechanically ventilated for at least 24 h with anticipated duration of at least 72 h, and with hearing optimized to baseline disposition. Patients were excluded if they had a specified prior to admission diagnosis, traumatic or medical encephalopathy, or need for deep sedation. Eligible patients were randomized to music intervention or usual care during SAT. Patients in the music intervention group underwent a second randomization to Commercial Music Intervention (CMI) or Preference Music Intervention (PMI).The primary outcome was sedation exposure via sedation intensity score (SIS), an aggregate of the frequency and intensity of sedatives from disparate drug classes such as opioids, anxiolytics, antipsychotics, and others, which was summed for exposure comparison. The usual care group had significantly higher median SIS compared to the music intervention group (4 [IQR 4.9-6.4] vs 3 [IQR 3.1-4.2], <i>P</i> = .0006). Patients who received PMI had significantly higher mean SIS compared to the CMI group (5 ± 2.4 vs 2.3 ± 1.7, <i>P</i> = .0002). Compared to usual care, the music intervention group had a higher percentage of delirium-free ICU days (37% vs 22%, <i>P</i> = .009) and a higher percentage of CPOT scores at goal (69% vs 52%, <i>P</i> = .002), but no difference in percentage of goal sedation scores (64% vs 67%, <i>P</i> = .7).</p><p><strong>Conclusions: </strong>Protocolized music intervention paired with daily spontaneous awakening trial is a feasible routine intervention for mechanically ventilated patients. Future studies are needed to confirm if this intervention may reduce overall sedation requirements.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251343799"},"PeriodicalIF":3.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258261","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":"Analyses of Lung Parenchyma Infiltrates Using Ultrasonography in Neurocritically ill Patients.","authors":"Evan Skinner, Alok Patel, Fawaz Ahmad, Rajeev Garg, Ivan Da Silva","doi":"10.1177/08850666251343005","DOIUrl":"https://doi.org/10.1177/08850666251343005","url":null,"abstract":"<p><p>PurposeTo evaluate the presence of pulmonary infiltrates on admission among patients with intracranial hemorrhages, further refining on etiology and the agreement between ultrasonography and chest radiography.Materials and MethodsProspective analysis of patients with aneurysmal subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH), during a 3-month period in a single center, utilizing a standardized protocol of lung ultrasonography. Clinical and ancillary testing data were also collected.Results44 patients were studied, 30 (68.18%) with ICH, and 14 (31.81%) with SAH. Among patients with ICH, 73.3% had B-lines detected in the assessment, and in the SAH group, 57.14% had presence of lung B-lines. Etiologically, 43% of patients with ICH and 7.1% with SAH had findings suggestive of neurogenic pulmonary edema. 13% of ICH patients and 28.5% in the SAH group had assessments consistent with cardiogenic pulmonary edema. Findings between chest radiography and lung ultrasonography showed poor agreement.ConclusionSonographic lung infiltrates in patients with severe brain injuries are common, reaching up to two-thirds of ICH admissions and the majority of SAH cases. The etiology varied, with presumed neurogenic pulmonary edema leading the incidence in the ICH cohort, and with cardiogenic pulmonary edema being the most common culprit within SAH patients.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251343005"},"PeriodicalIF":3.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258260","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 Diagnosis and Management of Hepatorenal Syndrome: A Comprehensive Update for the Intensivist.","authors":"J Pedro Teixeira, Constantine J Karvellas, Juan Carlos Q Velez","doi":"10.1177/08850666251345408","DOIUrl":"https://doi.org/10.1177/08850666251345408","url":null,"abstract":"<p><p>Intensivists are being increasingly tasked with caring for critically ill patients with cirrhosis (ie, acute-on-chronic liver failure), many of whom develop acute kidney injury (AKI). Among the most morbid and complex causes of AKI in patients with cirrhosis is hepatorenal syndrome (HRS-AKI). Though HRS-AKI accounts for a fraction of AKI cases in the setting of cirrhosis, recent data suggest that effective pharmacologic treatment of HRS-AKI requires rapid diagnosis to allow for prompt intervention. Consequently, a firm understanding of the diagnosis and treatment of HRS-AKI is vital for all intensivists. In this review, we summarize recent developments in the diagnosis and treatment of HRS-AKI. Chief among these is the recent realization that HRS-AKI is not a diagnosis of exclusion, but instead may coexist with other forms of AKI, such as acute tubular injury, or may develop in the context of pre-existing chronic kidney disease. Moreover, with multiple recent trials suggesting that administration of fixed doses of intravenous albumin to unselected patients with cirrhosis and AKI may cause harm via volume overload and pulmonary edema, no longer is a 48-h trial of intravenous albumin recommended for all patients with AKI and cirrhosis. Instead, the newest guidelines recommend thoughtful assessment of volume status in all patients with AKI and cirrhosis and determination of an HRS-AKI diagnosis within 24 h to allow for prompt initiation of effective therapy. Short of liver transplantation, treatment of HRS-AKI is with vasoconstrictive agents. Though commonly used, midodrine/octreotide should largely be abandoned due to lack of efficacy. While recent trials have confirmed the effectiveness of terlipressin, its use is associated with a risk of potentially fatal respiratory failure and therefore requires careful patient selection and monitoring. As such, treatment of HRS-AKI with norepinephrine in the intensive care unit will remain the primary treatment option for many patients.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251345408"},"PeriodicalIF":3.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234357","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":"Lung Ultrasound Score and Bronchiolitis: What can be Predicted in a Single Center Experience.","authors":"Matteo D'Alessandro, Tommaso Bellini, Marta Bustaffa, Benedetta Chianucci, Francesca Ridella, Daniele Franzone, Emanuela Piccotti","doi":"10.1177/08850666251344465","DOIUrl":"https://doi.org/10.1177/08850666251344465","url":null,"abstract":"<p><strong>Background: </strong>Bronchiolitis is a viral respiratory illness affecting children younger than one year of age, and its accurate prognosis in the emergency department (ED) is often difficult. Lung ultrasound (LUS) has been shown to be useful in risk stratification with respect to the likelihood of being admitted to the hospital or high-intensity care units, receiving supplemental oxygen, or non-invasive ventilation (NIV). Our aim is to evaluate the predictive value of point-of-care lung ultrasound performed in a pediatric ED, especially regarding hospitalization, need for oxygen therapy and NIV.</p><p><strong>Methods: </strong>Observational prospective monocentric study including 109 patients with bronchiolitis younger than 12 months presenting to the ED. Both clinical and LUS scores were assigned at the time of medical examination, then main data regarding admission, need for oxygen supply and NIV were collected.</p><p><strong>Results: </strong>Comparing patient who required hospital care (admission, oxygen supply or NIV) or not, we found a higher median LUS score for patients requiring hospital care (4 <i>vs</i> 1 <i>p</i> < .001 for hospital admission, 4 <i>vs</i> 2 <i>p</i> < .001 for oxygen supply, 5 <i>vs</i> 3 <i>p</i> < .001 for NIV); furthermore, setting the threshold of LUS score at 3.5 as a predictive marker, the ROC AUC for hospital admission, need for oxygen supply or NIV was 0.78, 0.75 and 0.8, respectively. A logistic regression analysis evaluated the risk associated with LUS score: an increase in score affects the risk of hospital admission, need for oxygen supplementation and NIV (OR 1.4, 95%CI 1.04-1.78, <i>p</i> < .05; OR 1.4, 95%CI 1.10-1.78, <i>p</i> < .05; OR 1.6, 95%CI 1.17-2.06, <i>p</i> < .05, respectively).</p><p><strong>Conclusions: </strong>LUS has demonstrated to be a useful tool to help clinician in the process of risk stratification for bronchiolitis, although further (multicentric) studies would be advisable to strengthen this result.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251344465"},"PeriodicalIF":3.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234322","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":"Ten Influential Point-of-Care Ultrasound Papers: 2023 in Review.","authors":"Scott J Millington, Mangala Narasimhan, Paul H Mayo, Antoine Vieillard-Baron","doi":"10.1177/08850666241233556","DOIUrl":"10.1177/08850666241233556","url":null,"abstract":"<p><p>In an effort to help keep busy clinicians up to date with the latest ultrasound research, our group of experts has selected 10 influential papers from the past 12 months and provided a short summary of each. We hope to provide emergency physicians, intensivists, and other acute care providers with a succinct update concerning some key areas of ultrasound interest.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"583-587"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905837","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}