Critical Care
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Conservative vs Liberal Post‑Oxygenator Targets on VA‑ECMO: Feasibility Concerns and No Early Biomarker Benefit in a Pilot RCT
A pilot multicenter RCT comparing conservative vs liberal post-oxygenator oxygen targets during VA-ECMO for cardiogenic shock found the conservative approach difficult to maintain (target achieved 33% of time) and no difference in biomarker
ICU Structure and Care Processes Explain Much of VAP and CLABSI Variation in Brazilian ICUs: Findings from a 50‑Unit IMPACTO‑MR Nested Cohort
A 50‑ICU nested cohort from the IMPACTO‑MR platform links ICU-level structure and care processes to substantially different ventilator‑associated pneumonia and central line‑associated bloodstream infection rates, highlighting modifiable ins
Digital twins suggest APRV can lower mechanical power and tidal recruitment versus PCV in ARDS — modeling evidence and clinical implications
High-fidelity digital twins of 98 ARDS patients indicate APRV (Phigh 25/Plow 0, long Tinsp, short Tlow to 75% peak expiratory flow) reduced mechanical power by ~32% and tidal recruitment by ~34% versus recorded PCV, at the cost of controlle
Midline Paracentesis May Lower Bleeding Risk: Evidence From a 4,500‑Procedure Retrospective Review
A large single‑center retrospective review found zero hemorrhagic complications after midline ultrasound‑guided paracentesis versus 60 events after lateral approaches (0/230 vs 60/4,283; p=0.03), suggesting the midline (linea alba) approach
Platelet Transfusion in the ICU: Rare But Variable — A 30-Country Prospective Cohort Reveals Wide Practice Differences
An international prospective cohort found platelet transfusions were used in 6% of ICU patients, mostly for bleeding or prophylaxis, with wide variation in thresholds and adherence across geo-economic regions, highlighting need for stewards
Hemoglobin Rules in European PICUs: 12.8% of Children Received RBCs in 2023 — Many Transfused Above the 7 g/dL Threshold
A 28‑day point‑prevalence study across 44 European PICUs found 12.8% of children received red‑cell transfusions; hemoglobin was the dominant trigger, often above the recommended 7.0 g/dL threshold, and transfusion exposure correlated with 2
RBC Transfusions in Early Sepsis Resuscitation: Common, Complex, and Potentially Harmful Above a 10 g/dL Threshold
In a multicenter Korean sepsis cohort, early RBC transfusions were frequent and driven by illness severity. No overall 60‑day mortality difference was seen after propensity matching, but transfusion was associated with harm at hemoglobin ≥1
Five-Year Survival and Quality of Life After ECMO: Good Long-Term Outcomes but Persistent Functional Burden
A large prospective Dutch cohort reports 36% five-year survival after ECMO with generally satisfactory health-related quality of life (median EQ-5D 0.82) but ongoing problems with pain, mobility, activities, and work capacity.
Higher Mortality When Children on Mechanical Ventilation Are Cared for Outside ICUs: National Japanese Cohort Signals Need for Pediatric ICU Centralization
A national retrospective cohort of 129,375 mechanically ventilated children in Japan found most received care on general wards and that ward care was associated with higher in-hospital mortality than ICU care after propensity matching (6.4%
Targeting Tissue Perfusion and Lower MAP in Septic Shock Did Not Improve 30‑Day Perfusion-Free Survival: Results from the TARTARE-2S Randomized Trial
In the TARTARE-2S trial, a tissue-perfusion–guided resuscitation strategy that permitted lower MAP (50–65 mm Hg) did not increase days alive with normalized lactate and without vasopressors at 30 days versus standard-of-care MAP-guided trea
Phenylephrine Versus Norepinephrine in Acute Abdomen Surgery: Similar Clinical Outcomes but Different Early Renin Responses — Implications for Perioperative Hemodynamic Care
A randomized trial in 156 emergency acute-abdomen patients found phenylephrine and norepinephrine produced similar postoperative RAAS changes and complication rates; norepinephrine produced an early renin rise, while high preoperative renin
Frailty Amplifies Mortality Risk Across the PaO2/FiO2 Spectrum: Insights from a 497,185‑Patient ANZICS Cohort
In a 497,185‑patient registry study, frailty (CFS ≥5) was common and associated with substantially higher in‑hospital mortality across all severities of acute hypoxemic respiratory failure (AHRF). The relationship between PaO2/FiO2 and deat
Why Emergency Medicine Residents Rarely Choose Surgical Critical Care — A Nationwide Survey and a Roadmap to Increase EM-SCC Matriculation
A national survey of 111 emergency medicine trainees identifies limited exposure to surgical critical care, institutional and geographic factors, and program characteristics (ECMO, multidisciplinary teams) as key modifiable drivers of low E
Paracetamol Lowers Cerebral Temperature in Febrile Brain‑Injured Patients — NEUROTHERM RCT Shows a Modest, Clinically Relevant Effect
In the NEUROTHERM randomized pharmacodynamic trial, a single IV dose of paracetamol reduced intracerebral temperature by a mean 0.6°C in febrile brain‑injured patients and kept temperatures
Intermediate Care Units Associated With Lower ICU Mortality and Better ICU Efficiency in Japan: Nationwide Cohort Analysis
A nationwide Japanese cohort study of 2.28 million ICU admissions finds that hospitals with intermediate care units (IMCUs) had modestly lower ICU and in-hospital mortality, fewer readmissions, shorter ICU stays, and higher ICU throughput w
Automated Real‑Time Deterioration Alerts Cut In‑Hospital Cardiac Arrests — What Clinicians Need to Know
A systematic review and meta-analysis finds that real‑time automated clinical deterioration alert systems reduce in‑hospital cardiac arrests and may shorten ICU stay, but mortality benefits are uncertain and higher‑quality trials are needed
Paracetamol Lowers Cerebral Temperature Modestly but Meaningfully in Febrile Brain‑Injured Patients: Results of the NEUROTHERM Randomized Pharmacodynamic Trial
In a double‑blind RCT of 99 febrile brain‑injured patients with intracerebral thermal probes, a single IV dose of paracetamol reduced mean cerebral temperature by 0.6°C versus placebo and kept cerebral temperature
Fewer Post‑Traumatic ARDS Cases but Rising Mortality: A 2007–2019 NTDB Cohort Analysis
A 2007–2019 National Trauma Data Bank analysis found ARDS incidence among ventilated trauma patients fell substantially, yet ARDS remained independently associated with increased 30‑day mortality and crude ARDS mortality rose to nearly 30%.
Simple Discharge Subtypes Predict 3‑Month Mortality and 1‑Year Disability After Sepsis: Validation in the CLOVERS Cohort
A parsimonious discharge‑subtype algorithm applied to CLOVERS trial survivors stratified patients by 3‑month mortality and 12‑month functional outcomes, offering a pragmatic tool to target post‑hospital recovery resources.
Nurse-Led Family Communication in the ICU: Modest Gains in Communication Quality and Shorter Hospital Stays — What Works and What We Still Don’t Know
A 2025 systematic review of nurse-led ICU family communication interventions found modest improvement in communication quality (SMD 0.26) and reduced hospital LOS (~3.9 days), but limited effects on psychological distress, satisfaction, ICU
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