Annals of Intensive Care最新文献

{"title":"Refining thresholds and timing in V/Q matching assessment during prone positioning in ARDS.","authors":"Nan Xiong, Yinde Huang","doi":"10.1186/s13613-025-01530-3","DOIUrl":"10.1186/s13613-025-01530-3","url":null,"abstract":"","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"15 1","pages":"108"},"PeriodicalIF":5.5,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regarding the new vascular reactivity index to norepinephrine.","authors":"Enrique Monares-Zepeda, Christopher Barrera-Hoffmann","doi":"10.1186/s13613-025-01519-y","DOIUrl":"10.1186/s13613-025-01519-y","url":null,"abstract":"","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"15 1","pages":"107"},"PeriodicalIF":5.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness, knowledge and practices related to intra-abdominal hypertension and abdominal compartment syndrome among intensive care providers: a systematic scoping review.","authors":"ZhiRu Li, FangYan Lu, JingYun Wu, YanHong Dai, Yan Wang, Li Zheng, HuaFen Wang","doi":"10.1186/s13613-025-01521-4","DOIUrl":"10.1186/s13613-025-01521-4","url":null,"abstract":"<p><strong>Objectives: </strong>To provide a comprehensive overview of current research on intensive care providers' awareness, knowledge, and practices regarding IAP/IAH/ACS, as well as barriers to IAP measurement.</p><p><strong>Methods: </strong>This scoping review was guided by the framework of Arksey and Malley. Eight databases were searched to identify research published after 2007, including MEDLINE Complete, EMBASE, Web of Science, Cochrane Library, CINAHL Complete, ProQuest Health & Medical Complete, CNKI, and WANFANG. Two researchers reviewed and screened potentially relevant studies based on title and abstract. Full-text articles were independently assessed for eligibility based on predefined inclusion criteria.</p><p><strong>Results: </strong>Nineteen articles were included. Overall, pediatric intensive care providers demonstrated a lower awareness and knowledge of IAH/ACS compared to adult intensive care providers, particularly regarding the consensus definitions of IAH/ACS in critically ill children. IAP measurement has not been adequately integrated into clinical practice, with 18.0-73.0% of intensive care providers reporting they have never measured it. The frequency of IAP measurements and the criteria for determining which patients necessitate such measurements exhibited significant variability across different hospitals. The most frequently mentioned barriers to IAP measurement include a lack of knowledge regarding IAP measurement among adult intensivists, an overreliance on physical examination among pediatric intensivists, uncertainty in interpreting IAP data among adult intensive care nurses, and challenges in identifying populations at high risk of IAH among pediatric intensive care nurses. Diuretics were mentioned most often in the management of IAH/ACS, followed by administration of vasopressors and inotropes, decompressive laparotomy, and judicious administration of fluids and blood products. 37.0-66.3% of adult intensivists would choose a decompressive laparotomy in cases of ACS, whereas pediatric intensivists were less inclined to opt for the same approach.</p><p><strong>Conclusions: </strong>Since the publication of the WSACS consensus in 2007, there has been an improvement in awareness and knowledge regarding IAP/IAH/ACS among intensive care providers. Nevertheless, the understanding of the consensus definitions regarding IAH/ACS remains inadequate, particularly among pediatric intensive care providers. It is imperative to advocate for the implementation of WSACS guidelines in hospitals through targeted training programs and to promote the routine practice of IAP measurement in clinical settings.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"15 1","pages":"106"},"PeriodicalIF":5.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angiotensin II, conventional vasopressor therapy, and mortality in shock: a large, multicenter, propensity score-weighted analysis.","authors":"Laurence W Busse, Caitlin Ten Lohuis, Han Xu, Cooper Jannuzzo, Robert H Lyles, J Pedro Teixeira, Ishan Mehta, Yuan Liu","doi":"10.1186/s13613-025-01522-3","DOIUrl":"10.1186/s13613-025-01522-3","url":null,"abstract":"<p><strong>Background: </strong>Angiotensin II (Ang II) is typically used in addition to adrenergic agents and vasopressin (conventional therapy) in patients with shock, but whether its use improves outcomes is unknown.</p><p><strong>Research question: </strong>We evaluated whether Ang II, when added to conventional therapy at different norepinephrine equivalent (NE) doses, was associated with mortality.</p><p><strong>Methods: </strong>We performed a retrospective analysis of 811 patients admitted to four centers in a single healthcare system who received vasopressors for shock, including 275 who received Ang II plus conventional therapy and 536 who received only conventional therapy. Age, gender, sequential organ failure assessment score, serum lactate, background NE dose, corticosteroid use, pre-morbid angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use, and Charlson Comorbidity Index were calculated at initiation of Ang II or at an equivalent point of acuity in the conventional therapy cohort. We used propensity scores with inverse probability of treatment weighting (IPTW) to achieve covariate balance and multivariable logistic regression to compare 30-day mortality, further stratifying patients by 0.10 mcg/kg/min NE increments.</p><p><strong>Results: </strong>Overall 30-day mortality was 56.4%. Groups statistically differed by all baseline variables. In multivariable logistic regression, Ang II treatment was associated with lower 30-day mortality compared to conventional therapy alone (odds ratio [OR] 0.65, 95% confidence interval [CI] 0.45-0.95, p = 0.025). After IPTW, Ang II use was independently associated with lower mortality (OR 0.74, 95% CI 0.55-0.99, p = 0.040). When stratifying by increments of background NE dose, Ang II initiation was associated with lower 30-day mortality compared to conventional therapy alone in patients on background NE doses > 0.4, > 0.5, and ≤ 0.6 mcg/kg/min. Ang II use in patients on background NE dose > 0.6 was not significantly associated with mortality.</p><p><strong>Conclusions: </strong>Ang II administration was associated with a lower risk of death in unadjusted and adjusted analyses. This effect was preserved only with patients receiving NE at doses ranging from 0.4 to 0.6 mcg/kg/min. Though additional prospective studies are required, these findings suggest that Ang II may be beneficial across a specific range of background vasopressor doses.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"15 1","pages":"104"},"PeriodicalIF":5.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the Venous Excess Ultrasound (VExUS) score and acute kidney injury in critically ill patients with sepsis: a multicenter prospective observational study.","authors":"Jia Song, Gongze Chen, Detian Lai, Li Zhong, Haozhe Fan, Weihang Hu, Minjia Wang, Caibao Hu, Wenwei Chen, Ziqiang Ming, Shijin Gong, Qiancheng Luo","doi":"10.1186/s13613-025-01529-w","DOIUrl":"10.1186/s13613-025-01529-w","url":null,"abstract":"<p><strong>Background: </strong>Venous congestion is associated with adverse clinical outcomes in critically ill patients, yet its assessment remains challenging. Recently, the Venous Excess Ultrasound (VExUS) score has shown great potential as a non-invasive tool for assessing venous congestion in cardiac patients. However, the relationship between VExUS and clinical outcomes in patients with sepsis remains understudied. This study aims to evaluate the incidence of venous congestion based on VExUS assessment within the first 5 days of intensive care unit (ICU) admission in critically ill patients with sepsis, and to investigate the association between VExUS and clinical outcomes.</p><p><strong>Methods: </strong>We conducted a prospective, observational study in four ICUs, enrolling adult patients with sepsis who stayed in the ICU for at least 24 h. VExUS assessments were performed on days 1 (within 24 h), 3 (48-72 h), and 5 (96-120 h) following ICU admission. Patients were classified according to VExUS score ≥ 2 or < 2. The primary outcome was the prevalence of acute kidney injury (AKI) during ICU stay, while secondary outcomes included 30-day mortality, ICU mortality, and requirement for renal replacement therapy (RRT).</p><p><strong>Results: </strong>Among the 108 patients included, 18% (19 patients) showed VExUS score ≥ 2 on day 1 of ICU admission, and the prevalence progressively decreased to 15% (15 patients) by day 3 and 6% (6 patients) by day 5. The VExUS score ≥ 2 was not associated with AKI (OR 1.82, 95% CI 0.62-5.31, p = 0.274), 30-day mortality (OR 0.82, 95% CI 0.28-2.4, p = 0.711), ICU mortality (OR 1.12, 95% CI 0.41-3.04, p = 0.82), or requirement for RRT (OR 2.29, 95% CI 0.68-7.64, p = 0.179). There was no significant correlation between VExUS and central venous pressure (coefficient: - 0.019, 95% CI -0.01 to 0.05, p = 0.204).</p><p><strong>Conclusion: </strong>In critically ill patients with sepsis, approximately 20% exhibit early (within 24 h of ICU admission) venous congestion, with the prevalence progressively decreasing over the subsequent 5 days. Venous congestion assessed by VExUS was not associated with the occurrence of AKI or with mortality.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry, ChiCTR2200066987. Registered 22 December 2022, https://www.chictr.org.cn/.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"15 1","pages":"105"},"PeriodicalIF":5.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers to guide sepsis management.","authors":"Vasiliki Bourika, Evangelia-Areti Rekoumi, Evangelos J Giamarellos-Bourboulis","doi":"10.1186/s13613-025-01524-1","DOIUrl":"10.1186/s13613-025-01524-1","url":null,"abstract":"<p><strong>Background: </strong>Sepsis remains a major cause of morbidity and mortality. Precision therapeutics are now regarded as a novel prospective to improve outcome. This approach relies on biomarkers to identify a pathway of pathogenesis which prevails and directs the best available therapeutic option to modulate this pathway. This review provides the most recent findings on biomarkers for bacterial or viral sepsis. These biomarkers provide guidance for prompt diagnosis and management tailored to specific needs.</p><p><strong>Main body: </strong>Keywords relative to sepsis management (early recognition, antibiotic administration, selection of fluids, vasopressors and immunotherapy) were searched across PubMed database. Published evidence the last five years exists for heparin-binding protein (HBP), monocyte distribution width (MDW), interleukin-10 (IL-10), presepsin, procalcitonin and C-reactive protein (CRP) for early sepsis diagnosis; procalcitonin is the most well-studied biomarker for antibiotic guidance. Endothelial and cardiac biomarkers have been explored as tools to tailor circulatory support in sepsis, including fluid therapy, and the targeted use of vasopressors for vascular tone optimization.</p><p><strong>Conclusion: </strong>This review explored how biomarkers can optimize immunomodulatory therapies, guide vasopressor initiation, inform antibiotic stewardship, and aid in fluid resuscitation decisions, ultimately improving patient outcomes.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"15 1","pages":"103"},"PeriodicalIF":5.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How should spontaneous breathing trials be performed in the light of recent literature?","authors":"Arnaud W Thille, Gonzalo Hernández","doi":"10.1186/s13613-025-01507-2","DOIUrl":"10.1186/s13613-025-01507-2","url":null,"abstract":"","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"15 1","pages":"102"},"PeriodicalIF":5.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal replacement therapy in an intensive care unit: guidelines from the SRLF-GFRUP consensus conference.","authors":"Mercè Jourdain, Ines Gragueb Chatti, Brahim Housni, Pierre Jaquet, Mélissa Jezequel, Oumar Kane, Béatrice La Combe, Mickael Landais, Mehdi Marzouk, Etienne de Montmollin, Guillaume Mortamet, Mai-Anh Nay, Charlotte Salmon-Gandonnière, Sophie Perinel-Ragey, Jérôme Rambaud, Joanna Schmitt, Marie Simon, Julie Starck, Arnaud W Thille, Pierre-François Dequin","doi":"10.1186/s13613-025-01517-0","DOIUrl":"10.1186/s13613-025-01517-0","url":null,"abstract":"<p><strong>Background: </strong>Although largely used, the place of extracorporeal renal replacement therapy (RRT) in acute kidney injury (AKI) in intensive care unit (ICU) patients has yet to be clarified. The French Intensive Care Society (Société de Réanimation de Langue Française, SRLF) and the French Pediatric Group of Intensive Care and Emergency (Groupe Francophone de Réanimation et d'Urgence Pédiatrique, GFRUP) organized a consensus conference in November 2024.</p><p><strong>Methods: </strong>A committee, without any conflict of interest (CoI) on the subject, defined seven generic questions and drew up a list of sub questions according to the population, intervention, comparison and outcomes (PICO) model. An independent work group reviewed literature using predefined keywords. The quality of the data was assessed using the GRADE methodology. Eighteen experts in the field from both societies proposed their own answers in a public session and answered questions from the jury (a panel of 14 critical-care medicine physicians and a nurse) and the public. The jury then met for 48 h to write out and vote on its recommendations.</p><p><strong>Results: </strong>The panel provided 45 statements addressing seven questions. In patients, adults or children, admitted to the ICU with AKI (1) What are the indications for RRT, when should it be initiated, and within what timeframe? (2) What are the advantages/disadvantages of the different RRT modalities in ICU, and based on what criteria should they be chosen? (3) Which dose of dialysis should be prescribed for ICU patients? (4) How to prescribe, adjust and monitor each RRT technique? (5) Which vascular access technique should be preferred (insertion site, catheter type and length)? (6) How to prevent circuit thrombosis? (7) What are the criteria to consider weaning from RRT and how can it be achieved?</p><p><strong>Conclusions: </strong>These recommendations should optimize the prescription and use of RRT during AKI in ICUs for both adult and pediatric patients.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"15 1","pages":"100"},"PeriodicalIF":5.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroimaging for prognosis of central nervous system infections: a systematic review and meta-analysis.","authors":"Augustin Gaudemer, Netanel Covier, Marie-Cécile Henry-Feugeas, Jean-François Timsit, Philippa Catherine Lavallée, Etienne de Montmollin, Augustin Lecler, Antoine Khalil, Romain Sonneville, Camille Couffignal","doi":"10.1186/s13613-025-01516-1","DOIUrl":"10.1186/s13613-025-01516-1","url":null,"abstract":"<p><strong>Background: </strong>Central nervous system (CNS) infections carry a severe prognosis and often require intensive care unit (ICU) admission. This study evaluated the prognostic value of neuroimaging in patients with all-type CNS infections.</p><p><strong>Methods: </strong>Using a predefined strategy, we first conducted a systematic search of PubMed/MEDLINE, PubMed Central, Embase, Cochrane and Google Scholar. Eligible studies published between January 1st, 2000, and June 1st, 2023, were included. We considered randomized controlled trials, non-randomized trials, cohort studies, excluding abstracts, cost-effectiveness analyses, letters, conference proceedings, systematic reviews, and meta-analyses. Two authors independently screened publications and extracted data. The meta-analysis was performed using a random-effects model. The main outcomes were (1) unfavorable outcome, defined as severe functional disability or death, and (2) mortality. Pooled odds ratios (OR) and 95% confidence intervals (95%CI) were calculated for each neuroimaging feature. We performed prespecified subgroup analyses depending on type of CNS infection (bacterial meningitis, CNS tuberculosis, CNS cryptococcosis, viral encephalitis, and brain abscess), country income, and ICU admission status.</p><p><strong>Results: </strong>Of 7,864 studies identified, 83 met the inclusion criteria, with 48 studies (6,434 patients) included in the meta-analysis. Abnormal MRI (OR: 3.55; 95%CI: 1.81-6.96; I²=0%), brain ischemia (OR: 4.65; 95%CI: 3.14-6.88; I²=28.5%), and hydrocephalus (OR: 4.56; 95%CI: 2.49-8.36; I²=61.5%) were significantly associated with unfavorable outcome. Hydrocephalus (OR, 3.99; 95%CI 1.83-8.70; I²=61%) and brain ischemia (OR, 3.51; 95%CI, 2.22-5.54; I²=16.4%) were associated with mortality. These associations remained consistent in patients with bacterial meningitis and in patients with CNS tuberculosis, but not in other CNS infections. Subgroup analyses depending on country income and ICU admission status revealed similar findings.</p><p><strong>Conclusion: </strong>Neuroimaging provides essential prognostic information in patients with CNS infections. Abnormal MRI findings, cerebral ischemia, and hydrocephalus are associated with unfavorable outcome, particularly in bacterial meningitis and CNS tuberculosis. These neuroimaging features should be considered when discussing prognosis in affected patients.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"15 1","pages":"101"},"PeriodicalIF":5.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert consensus‑based clinical practice guidelines for nutritional support in the intensive care unit: the French Intensive Care Society (SRLF) and the French-Speaking Group of Pediatric Emergency Physicians and Intensivists (GFRUP).","authors":"Jean Reignier, Benedicte Gaillard-Le Roux, Pierre François Dequin, Valeria A Bertoni Maluf, Julien Bohe, Michael P Casaer, Agathe Delbove, Claire Dupuis, Eric Fontaine, Prescillia Gamon, Coralie Grange, Nicholas Heming, Melissa Jezequel, Adam Jirka, Corinne Jotterand Chaparro, Michael Landais, Nolwenn Letouze, Claire Morice, Olivier Pantet, Julie Pellecer, Gael Piton, Shancy Rooze, Julie Starck, Jean-Marc Tadie, Fabienne Tamion, Ronan Thibault, Frédéric Valla, Thierry Vanderlinden, Arnaud W Thille, Nadia Aissaoui","doi":"10.1186/s13613-025-01509-0","DOIUrl":"10.1186/s13613-025-01509-0","url":null,"abstract":"<p><p>The objective of this work was to develop guidelines for nutritional support in critically ill adults and children (excluding neonates and burn patients) unable to maintain an adequate oral intake. We aimed to provide up-to-date recommendations based on high-level evidence including the results of recent landmark randomized controlled trials. Experts from the French Intensive Care Society (SRLF), the French Society of Clinical Nutrition and Metabolism (SFNCM), and the French-Speaking Group of Pediatric Emergency Physicians and Intensivists (GFRUP) used the GRADE methodology to develop the guidelines. Twenty-four Patient Intervention Comparator Outcome (PICO) questions were identified, resulting in 34 adult and 29 pediatric recommendations. Of the 34 recommendations for adults, three were based on high-level evidence, 12 on moderate-level evidence, and 19 on expert opinion. The corresponding numbers for the 29 pediatric recommendations were one, five, and 23. All recommendations achieved strong agreement among the experts. These guidelines emphasize the importance of individualized nutritional support strategies that incorporate recent high-quality evidence to optimize the outcomes of critically ill patients.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"15 1","pages":"99"},"PeriodicalIF":5.5,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}