Journal of Critical Care Medicine最新文献

{"title":"Percutaneous tracheostomy in Costa Rican intensive care units: multicenter epidemiology, practices, and immediate complications.","authors":"Pablo Alvarez-Aguilar, Leonardo Chacón-Prado, Dennis Rojas-Quirós, Oscar Palma-Rodríguez, Donato Salas-Segura","doi":"10.62838/jccm-2026-0021","DOIUrl":"10.62838/jccm-2026-0021","url":null,"abstract":"<p><strong>Introduction: </strong>This study describes the epidemiological and clinical profile of ICU patients undergoing percutaneous tracheostomy in Costa Rica and identifies predictors of acute complications, addressing ongoing debates on timing, technique, and risk stratification.</p><p><strong>Methods: </strong>We performed a prospective multicenter cohort study in eight CCSS hospitals (2019-2022), including adult ICU patients undergoing percutaneous tracheostomy. Demographic, clinical, and procedural data were collected, and multivariable logistic regression identified predictors of complications.</p><p><strong>Results: </strong>A total of 516 patients were analyzed (mean age 53.2 ± 16.3 years; 68.2% male). The main indications were anticipated prolonged ventilation (32.4%), neurological deficits (26.7%), and ventilation >10 days (21.8%). The Ciaglia and Griggs techniques were used in 51.0% and 48.3% of cases, respectively. Capnography was applied in 74.2%, ultrasound in 17.7%, and bronchoscopy in 3.1%. First-pass success was achieved in 85.1%. Acute complications occurred in 28.3% of patients, predominantly minor bleeding (25.4%), while serious complications (airway loss, false passage, or bleeding requiring surgery) were rare (3.9%). No procedure-related deaths were observed. Independent predictors of complications included anticoagulation (OR 2.82), obesity (OR 2.10), coagulopathy (OR 2.29), prior neck surgery (OR 3.49), cervical immobilization (OR 4.68), and technical difficulty (OR 4.15 for any complication; OR 2.00 for serious complications). Airway management by physicians, compared with respiratory therapists, was also associated with higher risk (OR 1.52).</p><p><strong>Conclusions: </strong>Percutaneous tracheostomy was feasible in multiple ICUs of the CCSS with complication rates comparable to international cohorts. Risk factors for complications included anticoagulation and prior neck surgery. Wider adoption of adjunctive monitoring tools and structured multidisciplinary training may further enhance procedural safety. These findings should be interpreted in the context of an observational design and a broad definition of complications.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"409-417"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life and patient safety: the impact of the work environment on the well-being of medical staff in ICU settings.","authors":"Sebastian Isac, Elisabeta Nita, Victor Cristian Toma, Andrada-Georgiana Badea, Mihaela Camelia Popa, Teodora Isac, Mara Madalina Mihai, Cristina Veronica Andreescu, Cristina Martac, Gabriela Droc","doi":"10.62838/jccm-2026-0025","DOIUrl":"10.62838/jccm-2026-0025","url":null,"abstract":"<p><strong>Background and aim: </strong>Professional Quality of Life (ProQoL) is essential for understanding the well-being of the health-care professionals working in high-stress environments, such as the intensive care units (ICUs). - This study aimed to assess the influence of age, gender, hospital affiliation, and professional role on the ProQoL dimensions (Compassion Satisfaction - CS, Burnout - BO, Secondary Traumatic Stress - STS) and to analyze the relationship between the perceptions of patient safety (measured via the Safety Attitudes Questionnaire - SAQ) and the professional quality of life.</p><p><strong>Method: </strong>This cross-sectional observational study included 247 healthcare professionals (April-November 2024) from 20 different hospitals, working in ICUs (nurses, attending physicians, medical residents -, and other staff). Participants filled out the ProQoL and SAQ questionnaires out of which only 10 SAQ items were used. Statistical analyses were performed using ANOVA, t-tests, and Pearson correlation coefficients.</p><p><strong>Results: </strong>Medical residents and participants in the 20-30 age group reported having the highest burnout scores (28.37 ± 0.37), and the lowest level of compassion satisfaction score (36.65±0.61), while attending physicians had elevated levels of secondary traumatic stress (25.69±0.57). Positive perceptions of the work environment (safety, conflict resolution, workplace satisfaction) were negatively correlated with the burnout (r = -0.5888, p < 0.0001). Finally, the perception of a pleasant job and workplace positively correlates with the CS score (r=0.53 p˂0.0001).</p><p><strong>Conclusions: </strong>Professional well-being varies significantly in terms of age, and position. These findings suggest that workplace strategies focusing on safety, teamwork, and workload balance may play a role in supporting the ICU staff well-being.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"444-452"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of prehospital amiodarone on survival in adult out-of-hospital cardiac arrest: a retrospective observational study.","authors":"Yuki Kishihara, Shunsuke Amagasa, Yosuke Homma, Takashi Tagami, Hideto Yasuda, Masahiro Kashiura, Yutaro Shinzato, Takashi Moriya","doi":"10.62838/jccm-2026-0024","DOIUrl":"10.62838/jccm-2026-0024","url":null,"abstract":"<p><strong>Aim of the study: </strong>This study sought to determine whether prehospital administration of amiodarone improves outcomes among adult patients with out-of-hospital cardiac arrest (OHCA) presenting with ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT). The analysis accounted for time-dependent confounding and resuscitation time bias using real-world registry data.</p><p><strong>Material and methods: </strong>We conducted a multicenter, retrospective cohort study using a nationwide Japanese OHCA database, including adult nontraumatic shockable rhythms. The exposure was prehospital amiodarone administration at a given time, and the comparator was no amiodarone at the same time point. The comparison reflects amiodarone administration at that time versus no amiodarone, not 'amiodarone versus never-amiodarone'. The primary and secondary endpoints were favorable neurological status and survival at 30 days. Patients were matched 1:3 using time-dependent propensity score matching, followed by generalized estimating equations to address intrahospital clustering. Sensitivity analyses included covariates with standardized mean differences greater than 0.25 after matching. Associations were expressed as risk ratios (RRs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Among 9,909 eligible patients, 56 (0.6%) remained after matching, including 19 (0.2%) who received amiodarone at the index time point. Median (IQR) age was 65 (52-76) years, and 81.8% were male. The median interval from first medical contact to drug administration was 27 (22-32) minutes. In models adjusted for timing variables and hospital clustering, amiodarone was not significantly related to favorable neurological recovery (RR, 0.45 [95% CI, 0.14-1.47]) or survival (RR, 0.74 [95% CI, 0.31-1.73]). Sensitivity analyses yielded consistent findings, though survival model convergence was limited.</p><p><strong>Conclusions: </strong>Prehospital administration of amiodarone in adult OHCA patients with shockable rhythms was not associated with improved neurological or survival outcomes. However, these findings should be interpreted with caution, and further studies are warranted to confirm and extend these observations.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"426-437"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain-kidney crosstalk in subarachnoid hemorrhage patients.","authors":"Elisabete Monteiro, Sofia Rocha E Silva, Silvina Barbosa, Isaac Barroso, Cláudia Camila Dias, Marek Czosnyka, José Artur Paiva, Celeste Dias","doi":"10.62838/jccm-2026-0037","DOIUrl":"10.62838/jccm-2026-0037","url":null,"abstract":"<p><strong>Background: </strong>A \"crosstalk\" between brain and kidney after Subarachnoid Hemorrhage (SAH) is suggested. A link can be the vascular autoregulation. It can be evaluated with cerebrovascular Pressure Reactivity index (PRx). It is not clear if augmented renal clearance (ARC) can be used as a marker of kidney dysregulation or if ARC is associated with brain autoregulation. Our aim was to evaluate correlation between ARC and PRx in SAH.</p><p><strong>Methods: </strong>Pilot study of SAH patients admitted to a Neurocritical Care Unit (NCCU), at tertiary Portuguese hospital, submitted to multimodal brain monitoring. Fifteen patients were included over a period of two years. Daily observations from 15 patients were analysed, during the first 14 days after admission. Creatinine clearance was measured (MCC) using plasma creatinine and urinary creatinine in a 6-hour urine collection. Multimodal brain monitoring data included intracranial pressure, cerebral perfusion pressure, optimal perfusion pressure (optCPP; CPP level which makes autoregulation working optimally) and PRx.</p><p><strong>Results: </strong>Fifteen patients were included. Median age was 58 and initial Glasgow Coma Score 13, Hunt and Hess classification was ≥3 in 66%, and Fisher was 4 in 100%. ARC is highly prevalent since the admission. There was a positive correlation between the number of days in ICU and CPP (R2=0.37), optimal CPP (R2=0.23), and PRx (R2=0.25), indicating loss of autoregulation over time. There was no significant association between ARC and preserved autoregulation (R2=0.05) suggesting that ARC is itself a manifestation of kidney dysregulation. ARC doesn't correlate with noradrenaline or fluid balance. In multivariate analysis only age has an impact on MCC, with MCC expected to decrease by 1.328 for one year of life.</p><p><strong>Conclusions: </strong>ARC is highly prevalent in SAH patients during the first two weeks after NCCU admission. Presence of ARC, evaluated with MCC, was not significantly associated with the presence of cerebral autoregulation.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"342-350"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between steroid therapy and increased mortality in patients at risk for ARDS.","authors":"Sultan Almuntashiri, Andrew Bennett, Duo Zhang, Andrea Sikora, Aaron Chase","doi":"10.62838/jccm-2026-0026","DOIUrl":"10.62838/jccm-2026-0026","url":null,"abstract":"<p><strong>Background: </strong>Corticosteroids are commonly used in critically ill patients with established risk factors for acute respiratory distress syndrome (ARDS), often for indications like sepsis or pneumonia, yet the choice of steroid and its impact on outcomes remain debated.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 160 ICU patients with documented clinical risk factors for ARDS at the time of ICU admission to evaluate the effect of corticosteroid therapy on hospital mortality. Clinical characteristics, treatment variables, and outcomes were compared between patients who received corticosteroids and those who did not. A subgroup exploratory analysis further compared outcomes between dexamethasone and hydrocortisone users. Logistic regression models were used to identify mortality predictors.</p><p><strong>Results: </strong>Of 160 patients, 91 (56.9%) received corticosteroids. Steroid-treated patients had higher Simplified Acute Physiology Score II (SAPS II) scores (54.4 vs. 48.0, p = 0.011), but no significant differences in age, partial pressure of arterial oxygen to fraction of inspired oxygen ratio (PaO₂/FiO₂), or mechanical ventilation use. Overall mortality was not significantly different between steroid and non-steroid users (42.9% vs. 33.3%, p = 0.221). Among steroid-treated patients, dexamethasone (n = 26) and hydrocortisone (n = 50) were the most frequently used agents. Mortality was significantly higher with hydrocortisone (58%) compared to dexamethasone (26.9%) (p = 0.010). In multivariate analysis, hydrocortisone use was associated with higher hospital mortality (adjusted OR = 4.41; 95% CI: 1.11-17.48; p = 0.035).</p><p><strong>Conclusion: </strong>Overall corticosteroid use was not associated with improved survival in patients with documented clinical risk factors for ARDS; however, in an exploratory analysis, hydrocortisone use was associated with higher hospital mortality than dexamethasone. Given the retrospective observational design and real-world factors influencing corticosteroid selection, including illness severity, these findings should be interpreted with caution and support the need for prospective studies to clarify these associations.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"418-425"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148606944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of presepsin dynamics in septic patients with and without liver cirrhosis.","authors":"Monica Mlesnite, Petra Fischer, Oana Nicoara-Farcau, Oana Antal, Elena Stefanescu, Horia Stefanescu, Emanuel Palade, Daniela Ionescu, Bogdan Procopet","doi":"10.62838/jccm-2026-0028","DOIUrl":"10.62838/jccm-2026-0028","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is associated with high short-term mortality, particularly in patients with decompensated liver cirrhosis. Conventional inflammatory biomarkers have limited prognostic accuracy in this population. Presepsin has emerged as a promising biomarker; however, its dynamic behavior in early sepsis remains insufficiently characterized.</p><p><strong>Objectives: </strong>To evaluate the prognostic value of presepsin dynamics in sepsis, with and without underlying liver cirrhosis, and to compare it with established inflammatory markers.</p><p><strong>Methods: </strong>We conducted an observational cohort study including two patient groups: patients with sepsis and de-compensated liver cirrhosis (Group A) and patients with sepsis without cirrhosis (Group B). Presepsin levels were measured at admission and after 48 hours, and delta presepsin was calculated. Prognostic performance was assessed using receiver operating characteristic (ROC) analysis and Cox proportional hazards regression. The primary endpoint was 28-day mortality.</p><p><strong>Results: </strong>In Group A, presepsin measured at 48 hours demonstrated superior prognostic performance compared with baseline levels (AUROC 0.91 vs. 0.78). Changes in presepsin further enhanced risk stratification, with a negative delta associated with improved survival, whereas an increase of ≥500 pg/mL was independently associated with higher mortality. (HR 5, 95% CI:1.64-15.26). In Group B presepsin showed moderate prognostic performance at baseline and 48 hours, whereas delta presepsin demonstrated limited overall accuracy, except in patients with positive delta values. Established biomarkers, including C-reactive protein and procalcitonin, showed inferior prognostic performance compared with presepsin in both cohorts.</p><p><strong>Conclusions: </strong>Dynamic assessment of presepsin provides clinically relevant prognostic information in sepsis, particularly in patients with decompensated liver cirrhosis. Early changes in presepsin levels may enhance risk stratification beyond conventional inflammatory biomarkers.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"386-400"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing length of stay between adult patients admitted to the intensive care unit with alcohol withdrawal syndrome treated with phenobarbital versus lorazepam.","authors":"Mary C Hoye, Sorin Danciu, Marc A Jacobs, Brad J Glavan","doi":"10.62838/jccm-2026-0020","DOIUrl":"10.62838/jccm-2026-0020","url":null,"abstract":"<p><strong>Objective: </strong>Review the use of phenobarbital and lorazepam to treat alcohol withdrawal syndrome (AWS) in the ICU, compare length of stay, examine medication use trends, implement provider training, and evaluate outcomes post-training.</p><p><strong>Methods: </strong>Design - Retrospective observational study, Quality improvement. Setting - Tertiary care hospital with 36 ICU beds. Patients - Adults admitted to the ICU and placed on clinical institute withdrawal assessment (CIWA) protocol. Patients with epilepsy were excluded.</p><p><strong>Results: </strong>During the 34-month baseline period, 713 patients were admitted to the ICU with alcohol use disorder (AUD) on CIWA, without epilepsy. 189 patients were treated with phenobarbital, 460 patients received only lorazepam, 64 patients received neither medication. All but 2 of the patients who received phenobarbital also received lorazepam. Compared to phenobarbital, lorazepam-only patients had shorter ICU LOS (p<0.001, 95% CI -2.36, -1.32) but higher mortality 13.91% vs. 4.76% (p=0.0008). We then developed and provided a training (which we refer to as an \"intervention\") to all ICU providers encouraging consistent use of phenobarbital in the ICU when appropriate. During the 3-month post-intervention period 44 patients were admitted to the ICU with AUD on CIWA protocol. Of the 44 patients: 26 received phenobarbital, 12 received only lorazepam, 6 received neither medication. Significantly more patients were treated with only phenobarbital (57.69%)) compared to baseline (1.06%). Compared to patients treated with phenobarbital, patients treated with only lorazepam had a significantly higher mortality rate (33.33% vs. 7.69%, p=0.04).</p><p><strong>Conclusions: </strong>We found significant variability in the use of phenobarbital and lorazepam for treatment of AWS in the ICU. After a quality improvement training for ICU physicians, there was less frequent concurrent use of benzodiazepines and barbiturates, no difference in ICU or hospital LOS, and significantly lower mortality rate for those treated with phenobarbital.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"368-375"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of gabapentin versus trospium chloride for prevention of catheter-related bladder discomfort inside the surgical intensive care unit: a prospective, randomised, controlled clinical study.","authors":"Ahmed Moustafa Mohamed, Wessam Zaher Selima","doi":"10.62838/jccm-2026-0018","DOIUrl":"10.62838/jccm-2026-0018","url":null,"abstract":"<p><strong>Introduction: </strong>Catheter-related bladder discomfort (CRBD) after perioperative catheterisation of the urinary bladder (COUB) is not uncommon.</p><p><strong>Aim of the study: </strong>We evaluated the efficacy of both oral gabapentin and trospium in preventing CRBD during the early postoperative period in patients admitted to the surgical intensive care unit (S-ICU).</p><p><strong>Material and methods: </strong>120 patients aged 20-65 years, ASA I, II or III who were admitted to S-ICU after undergoing elective spinal surgery (ESS) with COUB were included. They were randomly assigned to be administered either an oral 400 mg gabapentin capsule (Group G) or an oral 60 mg slow-release trospium chloride capsule (Group T) or nothing (Group C). The primary goal was the occurrence of CRBD and its severity at 1, 2, 6, 12, and 24 hours after the study drug administration (SDA).</p><p><strong>Results: </strong>Group G and group T had a statistically significant lower incidence of CRBD than group C at 1, 2, 6, 12, and 24 hours after SDA, respectively. Both had considerably lower severity than group C in the first two hours only (P= 0.001 and 0.001, respectively). Group T had non-significantly lower incidence and severity of CRBD than group G. Group G had significantly lower mean total fentanyl requirements for up to 24 hours after SDA than group T and group C (P < 0.001).</p><p><strong>Conclusion: </strong>Both oral gabapentin capsules and slow release trospium chloride capsules administered postoperatively, significantly decreased both the incidence of CRBD and its severity in the early postoperative period amongst S-ICU patients, without significant differences between the two drugs.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"376-385"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency anticancer therapy in intensive care medicine: A mainland China survey.","authors":"Hao Zhang, DongHao Wang, ChangSong Wang, Xue-Zhong Xing","doi":"10.62838/jccm-2026-0019","DOIUrl":"10.62838/jccm-2026-0019","url":null,"abstract":"<p><strong>Objective: </strong>To identify intensivists' attitudes toward emergency anticancer therapy (EAT) in patients with cancer in intensive care units (ICUs).</p><p><strong>Material and methods: </strong>A 11-question survey was performed among intensivists in the Cancer Critical Care Medicine Committee of the Chinese Anti-Cancer Association and Critical Care Medicine Committee of Beijing Association of Oncology between November 11 and December 11, 2024. Response were compared between mixed and oncologic ICU physicians.</p><p><strong>Results: </strong>In total, 120 intensivists completed the survey. For 9 of 11 questions, the agreement rate exceeded 85%. There were 61.5% mixed ICU physicican and 35.5% oncologic ICU physicians in favor of compostion of the composition of a multidisciplinary team (MDT) composing of an intensivist, an oncologis and a pharmacist, respectively. However this difference was not significant (P=0.281).</p><p><strong>Conclusions: </strong>Intensivists in China generally hold positive attitudes toward emergency anticancer therapy in ICUs for critically ill patients with cancer-related organ dysfunction. However, opinions differ regarding the MDT composition between mixed and oncologic ICU physicicans.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"438-443"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Necrotizing enterocolitis with gastric perforation in a 24-day old preterm neonate.","authors":"Tamas Toth, Reka Borka-Balas, Manuela Cucerea, Radu-Alexandru Prisca","doi":"10.62838/jccm-2026-0023","DOIUrl":"10.62838/jccm-2026-0023","url":null,"abstract":"<p><strong>Introduction: </strong>Neonatal gastric perforation (NGP) is a rare, life-threatening surgical emergency that predominantly affects premature and extremely low birth weight (ELBW) infants and remains associated with high mortality.</p><p><strong>Case presentation: </strong>A 600 g female infant born at 25/26 weeks of gestational age developed necrotizing enterocolitis (NEC) during the third postnatal week and deteriorated with abdominal distension and pneumoperitoneum. Emergency laparotomy on day 24 revealed a single posterior gastric wall perforation with circumferential necrotic margins; the nasogastric tube tip was located at the defect. After minimal debridement and primary two-layer closure, the infant survived a prolonged intensive care course complicated by recurrent sepsis, cholestasis, bronchopulmonary dysplasia, and later adhesive obstruction requiring adhesiolysis.</p><p><strong>Conclusions: </strong>Gastric perforation may represent an uncommon manifestation of severe NEC in ELBW infants. Delayed onset, necrotic margins, and systemic inflammatory deterioration may favor ischemic NEC-related injury over iatrogenic trauma. Early radiographic evaluation and prompt surgical exploration are crucial for survival.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"453-458"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}