Critical care science最新文献

{"title":"From muscle dysfunction to functionality: challenges and pathways for rehabilitation in critically ill patients.","authors":"Debora Stripari Schujmann, Raquel Annoni, Sabrina Eggmann, Saint Clair Gomes Bernardes Neto","doi":"10.62675/2965-2774.20260002","DOIUrl":"https://doi.org/10.62675/2965-2774.20260002","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260002"},"PeriodicalIF":0.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic status and outcomes in critical illness: an unequal burden.","authors":"Sristi Patodia, Larissa Bianchini, Carla Marchini Dias da Silva, Bharath Kumar Tirupakuzhi Vijayaraghavan","doi":"10.62675/2965-2774.20260130","DOIUrl":"https://doi.org/10.62675/2965-2774.20260130","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260130"},"PeriodicalIF":0.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limited prognostic value of the neutrophil-to-lymphocyte ratio compared with severity scores for mortality prediction in elderly critically ill patients.","authors":"Martín Angulo, Mauricio Ferreira, Andrés Rodríguez, Gastón Burghi","doi":"10.62675/2965-2774.20260006","DOIUrl":"https://doi.org/10.62675/2965-2774.20260006","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260006"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout in the intensive care unit: organizational determinants in focus.","authors":"Regis Goulart Rosa, Carol Hodgson, Cassiano Teixeira","doi":"10.62675/2965-2774.20260175-2","DOIUrl":"https://doi.org/10.62675/2965-2774.20260175-2","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e202601752"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A secondary analysis of the SODa-BIC randomized clinical trial using multiple hierarchical composite outcomes.","authors":"Humphrey G M Walker, Alastair Brown, Kyle C White, Mairead McNamara, D Jamie Cooper, Tomoko Fujii, Alisa M Higgins, Carol L Hodgson, Leanlove Navarra, Alistair Nichol, Sandra Peake, Alvaro Rea-Neto, Paul Secombe, Fiona Osborne, Hugh Burrill, Emily See, Meredith Young, Fernando Godinho Zampieri, Mark Plummer, Connor Christie, Leo Nunnink, Josephine Mackay, Shay McGuinness, Joradee Marmol, Ravindranath Tiruvoipati, Michael Bailey, Paul J Young, Andrew Udy, Ary Serpa Neto","doi":"10.62675/2965-2774.20260279","DOIUrl":"https://doi.org/10.62675/2965-2774.20260279","url":null,"abstract":"<p><strong>Background: </strong>The Sodium Bicarbonate for Metabolic Acidosis in the ICU (SODa-BIC) trial assessed the effect of sodium bicarbonate on Major Adverse Kidney Events at 30 days (MAKE30) in critically ill patients with metabolic acidosis. Although the trial demonstrated no significant difference in the primary outcome, the individual components showed differing magnitudes and directions of effect; we undertook an exploratory analysis of the SODa-BIC trial using different hierarchical outcomes to better understand potential treatment effects of sodium bicarbonate.</p><p><strong>Methods: </strong>Post-hoc analysis of the SODa-BIC trial. All patients included in the SODa-BIC trial were eligible. The primary outcome was a win ratio analysis with a hierarchy consisting of death, requirement for renal replacement therapy, persistent renal dysfunction, and hospital length of stay. Several sensitivity and subgroup analyses were conducted.</p><p><strong>Results: </strong>The primary analysis resulted in 59,250 pairs from 488 patients. Consistent with the SODa-BIC analysis, there was no overall evidence of a treatment effect of sodium bicarbonate, with a win ratio of 0.97 (95%CI 0.79 - 1.19) and a Desirability of Outcome Ranking probability of 0.49 (95%CI 0.45 - 0.54). A majority of pairwise comparisons were resolved by mortality and hospital length of stay. Evidence of significant treatment effect modification was observed across subgroups defined by acute kidney injury and severity of acidemia.</p><p><strong>Conclusion: </strong>In this post-hoc analysis of the SODa-BIC trial, the use of hierarchical composite outcomes did not alter the neutral overall interpretation of the original trial. However, this analysis provides additional insight into the relative contribution of individual components of the primary outcome.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260279"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive mechanical ventilation, functional decline at pediatric intensive care unit discharge, and post-discharge mortality in critically ill pediatric cancer patients: a retrospective cohort study.","authors":"Beatriz Silva Menezes da Cunha-Martins, Rachel Silva Menezes da Cunha, Vanessa Soares Lanziotti, Antonio Paulo Nassar","doi":"10.62675/2965-2774.20260121","DOIUrl":"https://doi.org/10.62675/2965-2774.20260121","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between invasive mechanical ventilation use, functional capacity, and 12-month mortality in critically ill children with cancer after a pediatric intensive care unit stay.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective cohort study of critically ill children with cancer admitted to the pediatric intensive care unit from January 2018 to December 2022. We applied the Functional Status Scale to classify functional capacity before pediatric intensive care unit admission and at discharge, and to determine the onset of new morbidities. We assessed the association between invasive mechanical ventilation use and the development of new morbidity (defined as an increase of at least three points in the Functional Status Scale at discharge, and as an increase of at least two points in any domain of Functional Status Scale at discharge), between invasive mechanical ventilation use and 12-month mortality after pediatric intensive care unit discharge, and of the onset of new morbidities and mortality during the same period.</p><p><strong>Results: </strong>We included 423 patients, of whom 176 (41%) used invasive mechanical ventilation. The frequency of new morbidities was higher in the mechanically ventilated patients (39.2% versus 4.8%; p < 0.001). Invasive mechanical ventilation use was associated with the development of new morbidity (adjusted OR = 13; 95%CI = 6.6 - 27.3; p < 0.001). New morbidity was associated with increased mortality at 12 months after pediatric intensive care unit discharge (adjusted OR = 2.1; 95%CI = 1.2 - 3.7; p = 0.013), but mechanical ventilation was not.</p><p><strong>Conclusion: </strong>Critically ill children with cancer who required invasive mechanical ventilation during pediatric intensive care unit stay had 13-fold higher odds of developing new morbidities. The onset of new morbidity was associated with doubled odds of death within 12 months after pediatric intensive care unit discharge. However, invasive mechanical ventilation use was not directly associated with 12-month mortality.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260121"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life-sustaining therapy limitation in critical illness: unequal weights of demographics, disease severity, and comorbidities.","authors":"Gustavo Luís Hubert Ribeiro, João Gabriel Rosa Ramos, Edison Moraes Rodrigues Filho, Cassiano Teixeira","doi":"10.62675/2965-2774.20260348","DOIUrl":"https://doi.org/10.62675/2965-2774.20260348","url":null,"abstract":"<p><strong>Objective: </strong>To identify independent clinical predictors of life-sustaining treatment limitation in critically ill adults and to quantify their relative contribution across predefined conceptual domains.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including all adults admitted to a tertiary medical-surgical intensive care unit in Brazil between May 2016 and May 2020. Patients with documented life-sustaining treatment limitations (withholding or withdrawal) were compared with those who received full treatment. Multivariable logistic regression was used to identify independent predictors of life-sustaining treatment limitation, and predictors were grouped into conceptual domains to assess their relative contributions.</p><p><strong>Results: </strong>Among 6,725 intensive care unit admissions, 336 patients (5.0%) had documented life-sustaining treatment limitation. Compared with patients without limitation, those with life-sustaining treatment decisions were older (median 77 versus 67 years; p < 0.001), more frequently frail (Clinical Frailty Scale ≥ 5: 7.6% versus 3.1%; p = 0.002), and had more metastatic cancer (15.6% versus 5.8%; p < 0.001). Independent predictors of life-sustaining treatment limitation included age ≥ 80 years (OR 2.08; 95%CI 1.32 - 3.28), frailty (OR 2.37; 95%CI 1.53 - 3.71), metastatic cancer (OR 2.38; 95%CI 1.53 - 3.71), medical admission (OR 1.86; 95%CI 1.02 - 3.40), higher SAPS 3 scores (OR 1.02 per point; 95%CI 1.01 - 1.03), and prolonged mechanical ventilation (OR 5.78 for ≥10 days). The presence of any organ support was inversely associated with life-sustaining treatment limitation (OR 0.69; 95%CI 0.49 - 0.97). When predictors were aggregated into conceptual domains and evaluated using Wald χ² proportions, acute illness severity and life-suppor-related variables accounted for approximately 45% of the model signal, followed by demographic factors (≈38%) and chronic comorbidities (≈17%).</p><p><strong>Conclusion: </strong>Life-sustaining treatment limitation decisions in critically ill adults are influenced by frailty, comorbidities, and acute severity. Grouping predictors into conceptual domains enhances interpretability and may support more structured and transparent decision-making frameworks in intensive care unit settings.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260348"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond survival: the imperative, innovation, and implementation of long-term intensive care unit follow-up.","authors":"José Mário Meira Teles, João Gabriel Rosa Ramos, David Pilcher","doi":"10.62675/2965-2774.20260479","DOIUrl":"https://doi.org/10.62675/2965-2774.20260479","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260479"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive care unit admission among adults with tuberculosis: a systematic review of clinical characteristics.","authors":"Marjorie Fairuzy Stolarz, Melissa Ferrari Gomes, Gabriel Pavinati, Matheus Cordeiro Marchiotti, Francisco Beraldi de Magalhães, Gabriela Tavares Magnabosco","doi":"10.62675/2965-2774.20260018","DOIUrl":"https://doi.org/10.62675/2965-2774.20260018","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260018"},"PeriodicalIF":0.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged capillary refill time is associated with intolerance to enteral nutrition in critically ill patients.","authors":"Lucas Vieira de Souza, Magno Tauceda Borges, Gilberto Friedman, Rafael Barberena Moraes","doi":"10.62675/2965-2774.20260017","DOIUrl":"https://doi.org/10.62675/2965-2774.20260017","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260017"},"PeriodicalIF":0.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}