Section
A large-scale target trial emulation demonstrates that de-escalating anti-MRSA and anti-pseudomonal therapy on day 4 of sepsis treatment is safe, associated with fewer antibiotic days, and leads to shorter hospital stays compared to continu
A 15-year observational study of over 45,000 TBI patients reveals a significant increase in hospital mortality and a tripling of life-sustaining therapy withdrawal, alongside rising rates of hypoxaemia, raising urgent questions about ethica
This article evaluates the optimal timing and indications for caffeine initiation in preterm neonates, analyzing its impact on chronic lung disease, mortality, and neurodevelopmental outcomes based on the latest 2025 Cochrane evidence.
This article explores recent evidence comparing ketamine and etomidate for rapid sequence intubation. While new cohort data suggests a mortality benefit for ketamine, meta-analyses of randomized trials show clinical equipoise, highlighting
The large-scale RSI randomized trial found no significant difference in 28-day mortality between ketamine and etomidate for intubating critically ill adults, though ketamine was associated with a higher risk of cardiovascular collapse.
Recent trials and meta-analyses challenge assumptions about optimal initial oxygen levels for preterm resuscitation.
Recent multicenter studies show earlier and more frequent epinephrine in pediatric in‑hospital cardiac arrest increases ROSC and shortens CPR, but does not consistently improve survival to discharge or favorable neurologic outcome. Evidence
Recent multicenter studies show declining intra‑arrest intubation, no clear harm from intubation after time‑dependent matching, unclear benefit of epinephrine before defibrillation, and no survival gain from intensive point‑of‑care CPR trai
A multicenter cohort study of 555 patients with severe TBI who underwent prehospital rapid sequence induction found postintubation hypotension (SBP <90 mmHg within 10 minutes) in 19.1%, which was associated with higher 30‑day mortality (
In a randomized, blinded trial of 74 mechanically ventilated ICU patients, adding early NMES to an early mobilization program started within 48 hours improved functional status, independence, mobility, and quality of life up to 6 months aft
A predictive model combining bedside nurse ICDSC items and clinical variables (ventilation, SOFA) substantially improves agreement with researcher CAM-ICU assessments, enabling more accurate, scalable delirium ascertainment in ICU research
A large multicenter Brazilian cohort found that ICU-level structure and process measures — staffing, prevention protocols, hand hygiene training, visitation policies, and specific clinical roles — explain substantial between-hospital variab
A systematic review and meta-analysis found early enteral nutrition (EEN) in critically ill children associated with lower mortality (adjusted OR 0.36) and improvements in several clinical outcomes, but evidence certainty is very low due to
Automated closed-loop ventilation improves ventilation quality but does not increase ventilator-free days at day 28 compared to protocolized conventional ventilation in critically ill adults, with benefits in safety profiles and caregiver w
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
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
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
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
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
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
