Critical care science最新文献

{"title":"\"One-way\" clinical extubation: an alternative to tracheostomy or palliative extubation in patients receiving inappropriate mechanical ventilation?","authors":"Sabrina Corrêa da Costa Ribeiro, Ana Laura Jardim Tavares, Fernanda Gomes Lopes, Fernanda Palmas Fernandes Greco, Daniel Neves Forte","doi":"10.62675/2965-2774.20260248","DOIUrl":"10.62675/2965-2774.20260248","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260248"},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596458","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":"Gradual step-up weaning improves liberation in chronically ventilated tracheostomized patients.","authors":"Caroline Colombo, Cassiano Teixeira, Sílvia Regina Rios Vieira","doi":"10.62675/2965-2774.20260255","DOIUrl":"10.62675/2965-2774.20260255","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260255"},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596401","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":"Sex and gender differences in hemostasis in critical illness.","authors":"Julie Helms, Nicole P Juffermans, Toshiaki Iba","doi":"10.62675/2965-2774.20260035","DOIUrl":"10.62675/2965-2774.20260035","url":null,"abstract":"<p><p>Critical illness disrupts hemostasis through tightly linked inflammatory, endothelial, platelet, and coagulation pathways collectively described as immunothrombosis. These mechanisms are not sex-neutral. Biological sex and gender-related factors influence baseline coagulation profiles, vascular function, fibrinolysis, and platelet reactivity, and may therefore modify thrombotic and bleeding phenotypes observed in the intensive care unit. This short review summarizes current evidence on sex-associated differences in hemostatic biology and their clinical implications in critical illness. It outlines priorities for sex-stratified research to support more precise hemostatic management in the intensive care unit.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260035"},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596179","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":"Contemporary validation of a SAPS 3 customized version in patients admitted to Brazilian and Uruguayan intensive care units: a multicenter cohort study.","authors":"Marcio Soares, Lunna Perdigão Borges, Gastón Burghi, Pedro Kurtz, José Raimundo Araújo de Azevedo, Carlos Eduardo Brandão, Aloysio Saulo Breves Beiler Júnior, Niklas Soderberg Campos, Liane Oliveira Cavalcante, Mario Diego Teles Correia, Victor de Souza Cravo, Pedro Henrique Barbosa D'Almeida, Flávio Geraldo Rezende de Freitas, Thais de Almeida Machado, Marcelo de Oliveira Maia, Edson Silva Marques Filho, Gloria Adriana Rocha Martins, Ulisses de Oliveira Melo, Laura Herranz Prinz, Silvia Regina Ramos, Thiago Gomes Romano, Marcos Soares Tavares, Suzana Margareth Lobo, Jorge Ibrain Figueira Salluh, Ederlon Rezende","doi":"10.62675/2965-2774.20260334","DOIUrl":"10.62675/2965-2774.20260334","url":null,"abstract":"<p><strong>Objective: </strong>To compare the performance of the standard equation (SAPS 3-SE) and a customized version (SAPS 3-Custom) of the Simplified Acute Physiology Score 3 in a contemporary cohort of Brazilian and Uruguayan intensive care unit patients.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 262,198 adults admitted to 177 intensive care units between 2022 and 2023. Discrimination was assessed using the area under the Receiver Operating Characteristic curve (AUROC), and calibration by comparing predicted and observed mortality in calibration curves.</p><p><strong>Results: </strong>Of patients 70% were medical, and 21% were scheduled for surgery; mean SAPS 3 was 46.6 ± 16.0. Median intensive care unit and hospital stays were 3 (1 - 5) and 8 (4 - 16) days, respectively. Intensive care unit mortality was 10.6% and hospital mortality was 16.4%. Predicted mortality was 19.0% for SAPS 3-SE and 16.6% for SAPS 3-Custom. Both models had excellent discrimination (AUROC = 0.841). SAPS 3-SE overestimated mortality across all risk deciles, whereas SAPS 3-Custom achieved uniform agreement between predicted and observed values. Standardized mortality rates were 0.86 (95%CI 0.85 - 0.87) for SAPS 3-SE and 0.98 (0.98 - 0.99) for SAPS 3-Custom; standardized resource use rates were 0.90 (0.90 - 0.91) and 0.98 (0.97 - 0.98), respectively. At the intensive care unit level, SAPS 3-Custom produced standardized mortality rates (0.95 [0.77 - 1.17]) and standardized resource use rates (0.97 [0.82 - 1.23]) distributions centered around 1.0, unlike SAPS 3-SE, which yielded lower values. Findings were consistent for medical and surgical subgroups.</p><p><strong>Conclusion: </strong>In this large, contemporary cohort, SAPS 3-Custom demonstrated superior calibration and accuracy over SAPS 3-SE, supporting its use for performance evaluation and benchmarking in intensive care units in Brazil and Uruguay.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260334"},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596469","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":"High-flow nasal cannula in the real world: powerful support, hidden severity.","authors":"Israel Silva Maia, Domenico Luca Grieco, Jean-Pierre Frat","doi":"10.62675/2965-2774.20260012","DOIUrl":"10.62675/2965-2774.20260012","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260012"},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596560","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":"Optimal nutritional support is key to liberation from mechanical ventilation.","authors":"Silvia De Rosa, Sergio Lassola","doi":"10.62675/2965-2774.20260049","DOIUrl":"10.62675/2965-2774.20260049","url":null,"abstract":"<p><p>Liberation from mechanical ventilation is a physiologically demanding phase of critical illness that requires coordinated recovery of respiratory muscle function, metabolic stability, and systemic resilience. Nutritional therapy plays a central role in supporting this transition. However, early aggressive caloric and protein delivery has not improved outcomes and may be detrimental. Current evidence supports a phase-adapted, individualized approach: permissive underfeeding during acute inflammation, moderate protein provision, monitoring of metabolic tolerance, and targeted correction of micronutrient deficiencies. Future research should incorporate time to successful weaning as a clinically meaningful endpoint when evaluating nutritional interventions in the intensive care unit.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260049"},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596543","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":"Reply to: Ultrasonographic assessment of the muscle mass of the rectus femoris in mechanically ventilated patients at intensive care unit discharge is associated with deterioration of functional status at hospital discharge: a prospective cohort study.","authors":"Thiele Cabral Coelho Quadros, Thaline Lima Horn, Marina Santos de Moraes, Luisa da Cunha Selmo, Alexandre Ribas, Clarissa Netto Blattner, Márcio Manozzo Boniatti","doi":"10.62675/2965-2774.20260387","DOIUrl":"10.62675/2965-2774.20260387","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260387"},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596030","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":"Benchmarking and efficiency assessment in intensive care units: a systematic review protocol.","authors":"Luís Filipe Azevedo de Oliveira, Fernando Luiz Cyrino Oliveira, Leonardo Dos Santos Lourenço Bastos, Giulliana Martines Moralez, Jorge Ibrain Figueira Salluh, Igor Tona Peres","doi":"10.62675/2965-2774.20260280","DOIUrl":"10.62675/2965-2774.20260280","url":null,"abstract":"<p><strong>Objective: </strong>To identify research gaps and propose strategies for enhancing the quality and efficiency of critical care services globally.</p><p><strong>Methods: </strong>We will explore and analyze metrics, models, and methodologies for efficiency assessment and benchmarking in intensive care units, including both static and longitudinal approaches. For so, we will comprehensively search three electronic databases (Scopus, Web of Science, and Embase) using predefined keywords combined with Boolean operators. The search will target peer-reviewed studies without time frame restrictions. Duplicates will be removed, and two reviewers will independently assess the eligibility of articles based on predefined inclusion and exclusion criteria. Relevant data will be extracted and organized thematically using a standardized form aligned with PRISMA guidelines. The extracted data will include a study of characteristics, methodologies, and outcomes, enabling structured mapping and synthesis of existing evidence. This review does not require ethical approval.</p><p><strong>Results: </strong>The findings will be disseminated through open-access journal publications and national and international conferences presentations. The results will also be shared with key stakeholders, including healthcare professionals, policymakers, and researchers, to foster discussions on improving intensive care unit performance.</p><p><strong>Conclusion: </strong>This review will synthesize available evidence on ICU efficiency assessment, contributing to standardization efforts and guiding future research priorities aimed at strengthening critical care management and benchmarking practices worldwide.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260280"},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12977217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596412","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":"Personalizing brain perfusion in traumatic brain injury.","authors":"Adrián Marcos-Morales, Geert Meyfroidt","doi":"10.62675/2965-2774.20260073","DOIUrl":"10.62675/2965-2774.20260073","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260073"},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596550","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":"Longitudinal variation in muscle strength and mobility in patients in an intensive care unit: a retrospective cohort study.","authors":"Liana Accioly Melo Habib, Larissa Laranjeira Pinheiro Dos Santos, Isabel Lisboa Santiago Nascimento, Thaysa Vitorio de Lima, Yone Kauane da Silva Lima, Manuella Franco Cerqueira da Silva, Dimitri Gusmao-Flores, Bruno Prata Martinez","doi":"10.62675/2965-2774.20260229","DOIUrl":"10.62675/2965-2774.20260229","url":null,"abstract":"<p><strong>Objective: </strong>To longitudinally evaluate muscle strength and mobility in an intensive care unit and identify factors associated with muscle weakness at intensive care unit discharge.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted with patients who had their muscle strength measured at some point during their intensive care unit stay. Muscle strength was assessed using the Medical Research Council score, and measurements were taken at two points: as soon as medically possible (first assessment) and discharge. Mobility was assessed using the Functional Status Score for the intensive care unit scale, which includes bed transfer and locomotion activities. These activities were evaluated at three points: previous status, as soon as medically possible (first assessment), and discharge.</p><p><strong>Results: </strong>The change in muscle strength in the sample of 1,310 patients between the assessment at discharge [56 (48 - 60)] and the first assessment [54 (48 - 60)] was significant (p value < 0.001). When comparing mobility levels, a significant difference (p < 0.001) was observed between the time prior to hospitalization [35 (34 - 35)], the first assessment [28 (20 - 33)], and discharge [29 (21 - 35)]. Factors associated with muscle weakness were length of stay in the intensive care unit [OR 1.16 (1.06 - 1.28); p = 0.002]; use of sedation [OR 3.8 (1.27 - 11.16); p = 0.016] and muscle strength score at the first assessment [OR 0.84 (0.79 - 0.90); p = 0.001].</p><p><strong>Conclusion: </strong>Muscle strength and mobility increased from the first assessment to discharge. Prospective studies are needed to explore the trends observed in this study.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"38 ","pages":"e20260229"},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12977221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596496","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}