Critical Care
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High-Dose Vitamin C After Cardiac Arrest: Promise Meets a Negative Signal in VITaCCA
In a multicenter phase 2 trial, early intravenous vitamin C did not improve post-cardiac arrest organ dysfunction and the 10 g dose was associated with worse outcomes, including renal, cardiac, and neurologic signals.
When Does an ICP Crisis Really Count? BOOST II Raises Questions About Bedside Detection in Severe TBI
A post hoc BOOST II analysis found that many bedside-labeled intracranial pressure crises were not confirmed by continuous electronic data, challenging current ICP episode definitions in severe traumatic brain injury.
When the ICU Trauma Lingers: How Family PTSD Symptoms Build Across the Critical Illness Journey
Qualitative interviews show family PTSD after ICU care is shaped by cumulative stressors across the illness trajectory, highlighting the need for continuous, family-centered communication and support.
A New Bedside Twist on Passive Leg Raising: PPV Change Predicts Fluid Responsiveness During Pressure Support Ventilation
In PSV patients, passive leg raising–induced PPV change predicted preload responsiveness, especially when inspiratory effort was low by P0.1.
Acute Brain Injury in New-Onset Refractory Status Epilepticus and Etiology-Defined Status Epilepticus
This study found that cryptogenic NORSE causes severe, rapidly rising neuroaxonal injury, measured by NfL, and that higher NfL predicts worse short-term outcome. S100B was not useful for distinguishing groups.
Remote Respiratory Therapy Safely Replaced Most Bedside Ventilator Care in a Donor Center ICU
A prospective study found that fully remote respiratory therapy in a donor care ICU was feasible, safe, and labor-saving, with minimal need for bedside support and favorable organ recovery outcomes.
Personalized Automatic Management of Tracheal Cuff Pressure and Subglottic Secretion Drainage to Prevent Pneumonia in Critically Ill Intubated Patients: The MICROINHALO Multicenter Randomized Controlled Trial
MICROINHALO found that automatic cuff pressure control plus subglottic secretion drainage did not reduce tracheal colonization, but it was linked to fewer ventilator-associated pneumonia cases in critically ill intubated patients.
European ECLS End-of-Life Practices Vary Widely, Exposing Gaps in Ethics and Palliative Support
A large European survey found major regional and cultural differences in how clinicians approach ECLS withdrawal, with limited access to ethics and palliative care support in many institutions.
Negative End-Expiratory Transpulmonary Pressure, Lung Collapse, and Non-Focal ARDS Drive Tidal Recruitment During Pressure Support Ventilation
In spontaneously breathing ARDS patients on pressure support ventilation, tidal recruitment/derecruitment was strongly linked to more negative end-expiratory transpulmonary pressure, greater collapse, and non-focal infiltrates, while EIT-gu
TNF-α–Driven Immune-Endothelial Injury Emerges as a Therapeutic Target in Severe Acute Pancreatitis
Single-cell analysis of human severe acute pancreatitis identifies TNF-α–induced CD8+ T-cell endothelial injury as a driver of pancreatic microcirculatory failure, supporting TNF-α blockade as a potential targeted therapy.
Impact of Appropriate Antimicrobial Therapy on ICU Patient Outcomes: Subanalysis of the DIANA Study Dataset
In critically ill ICU patients with confirmed bacterial infections, appropriate empiric antimicrobial therapy was common and independently linked to lower 28-day mortality and more antimicrobial-free days.
Enteral vs IV Magnesium Replacement in Critically Ill Patients: A Randomized Noninferiority Trial
A randomized ICU trial found oral/enteral magnesium was not proven noninferior to IV replacement for correcting mild-to-moderate hypomagnesemia, but it lowered urinary magnesium loss, cost, waste, carbon emissions, and IV fluid use.
Extracorporeal Cardiopulmonary Resuscitation for Pediatric Out-of-Hospital Cardiac Arrest
In selected children with out-of-hospital cardiac arrest, extracorporeal CPR was associated with higher one-month survival and better neurologic outcomes than continued conventional CPR, though the study was observational and estimates were
Avoiding Intensive Systolic Blood Pressure Lowering After Successful Thrombectomy May Improve 1-Year Stroke Recovery: The OPTIMAL-BP Extension
In OPTIMAL-BP 1-year follow-up, targeting systolic BP
Four Oxygenation Trajectories Define Reproducible Clinical Archetypes in Persistent Acute Respiratory Failure
A multi-cohort study identified four reproducible 14-day oxygenation trajectory classes in persistent acute hypoxemic respiratory failure, with distinct mortality, biomarker patterns, and links to ARDS and hyperinflammatory subphenotypes.
Liberal Transfusion Still Appears Favored in Myocardial Infarction With Anemia, Regardless of Critical Illness Status
A MINT trial subanalysis found no evidence that ICU status changes the relative effect of restrictive versus liberal transfusion in acute myocardial infarction with anemia.
Prone Positioning for Severe Hypoxemia Rose Sharply During COVID-19 but Was Not Sustained Across North American ICUs
In 37 North American hospitals, proning of eligible mechanically ventilated patients increased markedly during COVID-19, then fell post-pandemic, with substantial interhospital variation throughout.
Hospital-Acquired DRESS and Clinical Severity Strongly Predict ICU Admission in a 39-Centre Paris Cohort
In this multicentre cohort of 207 hospitalized adults with DRESS, 17% required ICU care. Hospital-acquired DRESS and greater clinical severity independently predicted ICU admission, while ICU mortality reached 20%.
Frequent Pre-Admission Ambulatory Visits May Flag Harmful Diagnostic Error Risk in High-Risk General Medicine Inpatients
In a retrospective cohort of high-risk medical inpatients, frequent ambulatory care use before admission emerged as a predictor of harmful diagnostic error, highlighting a potentially actionable EHR-based signal for hospital diagnostic safe
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