JournalTOCs

Intensive Care Medicine
Journal Prestige (SJR): 3.293

Citation Impact (citeScore): 4
Number of Followers: 91

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1432-1238 - ISSN (Online) 0342-4642
Published by Springer-Verlag

[2468 journals]

Black holes and revelations
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  PubDate: 2025-04-17
Selection bias in the “TRAIN” randomized clinical trial: implications
for meta-analyses—Author's reply
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  PubDate: 2025-04-17
Should we move beyond the concept of fluid responsiveness'
Authors’ reply
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  PubDate: 2025-04-16
Correction: Liberal vs. restrictive transfusion strategies for acute brain
injury: a systematic review and frequentist-Bayesian meta-analysis
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  PubDate: 2025-04-16
Selection bias in the “TRAIN” randomized clinical trial:
implications for meta-analyses
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  PubDate: 2025-04-16
Contemporary review of critical illness following allogeneic hematopoietic
stem cell transplant in adults
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  Abstract: Significant advancements have been made in the care of the allogeneic hematopoietic stem cell (HCT) recipient. However, they remain one of the most vulnerable groups of patients who may be admitted to the ICU. On the one hand, they have been administered treatment with the goal of achieving cure for their underlying disease, yet their unique immunocompromised trajectory and treatment-associated toxicities continue to challenge the intensivist from a diagnostic and management perspective. While infectious disease, allogeneic HCT and critical care research have improved outcomes, there remain significant areas to advance critical care management to further increase the likelihood of bridging to an acceptable quality of life. This review focuses on care of the critically ill patient undergoing allogeneic HCT for hematologic malignancies, critical care conditions that may arise, contemporary practices in their management, and areas to focus future research.
  PubDate: 2025-04-16
Staircase strategy, tier-three therapies, and effects on outcome in
traumatic brain injured patients: the Triple-T TBI study
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  Abstract: Purpose To evaluate the clinical practice and timing of use of tier-three therapies (TTT) after traumatic brain injury (TBI), and to explore their association with intensive care unit (ICU) mortality and 3 months neurological outcome. Methods International multicenter, retrospective, observational, cohort study performed in 16 ICUs including 408 adult TBI patients requiring at least one of the TTT [i.e. metabolic suppression with barbiturates, secondary decompressive craniectomy (DC), and mild hypothermia] for the control of intracranial hypertension during the ICU stay. Results Among 408 adult TBI patients, secondary DC was the most frequent TTT utilized (n = 297, 72.8%), and was associated with reduced ICU mortality [Odds Ratio, OR 0.34 (95% Confidence Interval, CI 0.14–0.78) p = 0.012] and better neurological outcome (p = 0.047), whereas barbiturates were associated with increased ICU mortality [OR: 3.05 (95% CI 1.43–6.49); p = 0.004) and worse neurological outcome (p = 0.032). Two hundred and twenty-four (55%) patients received interventions in adherence to guidelines, which was associated with a non-significant trend towards better outcomes. Conclusions The staircase approach before the use of TTT was not often utilized after severe TBI. Secondary DC was performed more often than other treatments and its use was associated with improved mortality and neurological outcome. The benefits of adherence to guidelines before TTT prescription should be further evaluated.
  PubDate: 2025-04-14
Correction: Pulmonary herpes simplex virus and cytomegalovirus in patients
with acute respiratory distress syndrome related to COVID-19
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  PubDate: 2025-04-14
Continuous infusion of linezolid for critically ill patients: toward a new
standard of care
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  PubDate: 2025-04-12
Bridging the gap: implementing ESICM end-of-life care guidelines in
resource-limited settings
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  PubDate: 2025-04-10
Shortening antibiotic therapy duration for hospital-acquired bloodstream
infections in critically ill patients: a causal inference model from the
international EUROBACT-2 database
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  Abstract: Introduction Hospital-acquired bloodstream infections (HA-BSIs) are severe and require antibiotic therapy. In non-complicated BSIs, shortened therapy reduces side effects without compromising efficacy. The impact of shortened antibiotic therapy in HA-BSI critically ill patients without indication of prolonged therapy requires further evaluation. Methods Using the international prospective EUROBACT-2 cohort, we compared shortened (7–10 days) versus long (14–21 days) treatment durations in ICU patients eligible for shortened therapy. Patients without antibiotic therapy within 3 days after HA-BSI occurrence or requiring prolonged therapy (due to infection source, microorganism, or clinical deterioration) were excluded. Treatment failure, defined as death, persistent infection, or subsequent infectious complications by Day 28, was assessed using an inverse-probability of treatment weighted (IPTW) logistic regression. Results Among 2600 patients, 550 were eligible for shortened treatment, 213 received short, and 337 received long treatment. The most common infection source was intravascular catheters (33%), most common microorganisms were Enterobacterales (39%). Patients with long treatment were more frequently infected with Staphylococcus aureus (11% vs. 5.6%, p = 0.025) or difficult-to-treat microorganisms (23% vs. 7%, p
  PubDate: 2025-04-07
Diastolic dysfunction in septic patients: an alice-in-wonderland
perspective on mortality impact
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  PubDate: 2025-04-07
Through the looking glass: lessons from the inside
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  PubDate: 2025-04-03
Supporting the bereaved child in the adult ICU: let’s take the first
step! Author’s reply
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  PubDate: 2025-04-03
Correspondence on “Management of adult sepsis in resource-limited
settings: global expert consensus statements using a Delphi method”
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  PubDate: 2025-04-03
Personalized strategies for high-risk acute pulmonary embolism: addressing
the “catastrophic” subgroup
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  PubDate: 2025-04-03
Delirium in ICU and the Macbeth’s dagger
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  PubDate: 2025-04-03
Correction: A common longitudinal intensive care unit data format (CLIF)
for critical illness research
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  PubDate: 2025-03-31
High-risk pulmonary embolism: the significance and perspectives of
pulmonary reperfusion
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  PubDate: 2025-03-31
Metabolic septic shock sub-phenotypes, stability over time and association
with clinical outcome
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  Abstract: Purpose Machine learning has shown promise to detect useful subgroups of patients with sepsis from gene expression and protein data. This approach has rarely been deployed in metabolomic datasets. Metabolomic data are of interest as they capture effects from the genome, proteome, and environmental. We aimed to discover metabolic sub-phenotypes of septic shock, examine their temporal stability and association with clinical outcome. Methods Analysis was performed in two double-blind randomized trials in septic shock (LeoPARDS (1402 samples from 470 patients) and VANISH (493 samples from 173 patients)). Patients were included soon after the onset of shock and had serum collected at up to four time points. Metabolic clusters were identified from 474 metabolites using k-means clustering in LeoPARDS and predicted in VANISH with an elastic net classifier. Results Three sub-phenotypes were found. The main determinants of cluster membership were lipid species, especially lysophospholipids. Low lysophospholipid sub-phenotypes were associated with higher circulating cytokine levels. Persistence of low lysophospholipid sub-phenotypes was associated with higher mortality compared to the high lysophospholipid sub-phenotype (LeoPARDS: cluster 2 odds ratio 3.66 (95% CI 1.88–7.20), p = 0.0001, cluster 3 2.49 (1.29–4.81), p = 0.006; VANISH: cluster 2 4.13 (1.17–15.61), p = 0.03), cluster 3 3.22 (1.09–9.92), p = 0.04, vs cluster 1). We found no heterogeneity of treatment effect for any of the trial interventions by baseline metabolic sub-phenotype. Conclusion Three metabolic subgroups exist in septic shock which evolve over time. Persistence of low lysophospholipid sub-phenotypes is associated with mortality. Monitoring these subgroups could help identify patients at risk of poor outcome and direct novel therapies such as lysophospholipid supplementation. Registration Clinicaltirals.gov Identifiers, VANISH: ISRCTN 20769191, LeoPARDS: ISRCTN12776039.
  PubDate: 2025-03-31

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