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Intensive Care Medicine Journal

@intenscaremed.bsky.social

230 followers 34 following 520 posts

Intensive Care Medicine serves as the premier publication platform facilitating the communication and exchange of cutting-edge research and ideas within the field of intensive care medicine on a comprehensive scale. This platform is designed for profession

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Intensive Care Medicine Journal @intenscaremed.bsky.social · 10h

#VisualAbstract Post hoc analysis of SEPSIS-PAM found no baseline heterogeneity between low (65–70 mmHg) and high (80–85 mmHg) MAP targets in septic shock; higher targets may be harmful when high norepinephrine is needed or mottling persists. zurl.co/SgJ5R

Intensive Care Medicine Journal @intenscaremed.bsky.social · 18h

Serial lactate trends inform perfusion better than single values, as rises may reflect hypoperfusion, adrenergic drive or reduced clearance; pairing levels with bedside signs supports safer resuscitation. zurl.co/Hobw6

Intensive Care Medicine Journal @intenscaremed.bsky.social · 1d

Authors reaffirm that delayed P14 latency (>16 ms) in deeply sedated ICU patients is associated with 28-day mortality, independent of brain injury or sedative dose, and call for systematic bedside brainstem assessment. zurl.co/1iqw6

Intensive Care Medicine Journal @intenscaremed.bsky.social · 1d

Terminology confusion around delirium and encephalopathy hampers ICU care and research. Experts define acute encephalopathy as the brain process, with delirium or coma as phenotypes, and urge precise terms plus routine delirium screening. zurl.co/LrrAI

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Intensive Care Medicine Journal @intenscaremed.bsky.social · 2d

#1minutevideo In older patients with septic shock, targeting a MAP of 80–85 mmHg increased 90-day mortality and adverse events compared to standard care, with no clinical benefit observed in any subgroup, including those with chronic hypertension. zurl.co/fe9in

Intensive Care Medicine Journal @intenscaremed.bsky.social · 2d

An ICU follow-up model for family caregivers reduced PTSD symptoms at 6 months in a randomised trial of 196 participants, with strongest effects when the patient survived and benefits persisting at 12 months. zurl.co/g3KyS

Intensive Care Medicine Journal @intenscaremed.bsky.social · 3d

Commentators caution that hydropneumothorax recognition hinges on correct ultrasound presets. ‘Nerve’ or harmonic settings can mask lung sliding and B-lines, risking false pneumothorax; lung presets better reveal pleural signs. zurl.co/spqA1

Intensive Care Medicine Journal @intenscaremed.bsky.social · 3d

Across 426 ICU survivors, one in seven had amnesia and over a third reported delusional memories. Delusional memories—often without recognised delirium—were independently linked to higher PTSD at 3 and 12 months. zurl.co/VefgS

Intensive Care Medicine Journal @intenscaremed.bsky.social · 4d

#VisualAbstract A review of 388 studies found 218 outcome measures, mostly emotional, used to assess family members of critically ill patients. The findings highlight the need for a standardised core outcome set to guide future research. zurl.co/v3mzz

Intensive Care Medicine Journal @intenscaremed.bsky.social · 4d

Advanced causal modelling shows ventilator-associated events independently link to higher mortality, longer ICU stay, and delayed weaning, supporting VAEs as objective markers for surveillance and quality improvement. zurl.co/6kLS7

Intensive Care Medicine Journal @intenscaremed.bsky.social · 5d

A UK-endorsed ECMO emergency algorithm supports frontline staff: confirm arrest with MAP<30 mmHg, split into patient/device teams, restore flow via stepwise troubleshooting, and deliver structured resuscitation training. zurl.co/h3Haz

Intensive Care Medicine Journal @intenscaremed.bsky.social · 5d

#ICM-Quizz #MedEd Cannon A waves are sharp CVP spikes from atrial contraction against a closed tricuspid valve, often due to AV block. Recognising them via ECG-CVP synchrony helps diagnose rhythm issues and guide ICU management. zurl.co/9QEu8

Intensive Care Medicine Journal @intenscaremed.bsky.social · 6d

#ICM-Quizz #MedEd A 79-year-old male in the CSICU developed abnormal CVP waveforms and ECG signs of AV dissociation. Prominent waveform peaks suggested atrial contraction against closed valves. What is the most likely diagnosis?

Intensive Care Medicine Journal @intenscaremed.bsky.social · 6d

IMPROVE–2 showed no benefit from intraoperative driving pressure–guided PEEP titration; with hypotension risks and neutral trials accumulating, authors urge rethinking high PEEP and redirecting research to more promising perioperative targets. zurl.co/miMQt

Intensive Care Medicine Journal @intenscaremed.bsky.social · 7d

ICU RCT meta-analysis: melatonin did not prevent delirium (RR 0.89 primary; 0.86 secondary) or reduce mortality. Trial-sequential analysis signalled futility, so further trials are unlikely to change this conclusion. zurl.co/KUagb

Intensive Care Medicine Journal @intenscaremed.bsky.social · 7d

AI amplifies centuries of medical knowledge and may surpass clinicians at prediction, yet trust, judgement and the human bond remain decisive as care risks de-humanisation. zurl.co/2eson

Intensive Care Medicine Journal @intenscaremed.bsky.social · 8d

#VisualAbstract An AI tool identified ARDS phenotypes over 30 days. Corticosteroids lowered mortality in hyperinflammatory patients but increased it in hypoinflammatory ones, highlighting the need for phenotype-guided treatment. zurl.co/Cstyi

Intensive Care Medicine Journal @intenscaremed.bsky.social · 8d

Parallels between Brazilian Jiu-Jitsu and intensive care highlight the value of strong fundamentals, humility, adaptable decision-making and teamwork, helping clinicians stay calm under pressure and learn from setbacks. zurl.co/le8m3

Intensive Care Medicine Journal @intenscaremed.bsky.social · 9d

AI is shifting from prediction to action in intensive care, but safe adoption hinges on solving the right problems, workflow fit, rigorous validation and clear governance, guided by lessons from real-world wins and setbacks. zurl.co/zersq

Intensive Care Medicine Journal @intenscaremed.bsky.social · 9d

Critical care trials often underrepresent women, older adults, minorities and disadvantaged groups. Better reporting, inclusive eligibility, diverse teams and patient partnership are needed to improve generalisability, equity and trust in findings. zurl.co/te0qo

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Intensive Care Medicine Journal @intenscaremed.bsky.social · 10d

#VisualAbstract ESICM recommends diuretics over usual care and advises against routine ultrafiltration for fluid removal in critically ill adults after resuscitation, based on low to moderate certainty of evidence and identified research gaps. zurl.co/aapRY

Intensive Care Medicine Journal @intenscaremed.bsky.social · 10d

Across 13 countries, 715 cancer patients with ARDS had high 90-day mortality (73%), rising to 82% in severe cases. ECMO did not improve survival. Older age, peripheral vascular disease, severe ARDS and acute kidney injury predicted worse outcomes. zurl.co/O3WNF

Intensive Care Medicine Journal @intenscaremed.bsky.social · 11d

RRT antibiotic dosing should look beyond plasma PK to infection-site exposure, recognise mixed findings on extended infusions, and better contextualise toxicity. Patient and pathogen factors, plus prospective validation, are needed. zurl.co/RLdt1

Intensive Care Medicine Journal @intenscaremed.bsky.social · 11d

In 1,023 septic shock patients over 20 years, monocyte HLA-DR <8000 AB/C from day 3–4 onward predicts higher mortality and ICU-acquired infections, supporting serial tracking to detect persistent immunosuppression. zurl.co/mZHjy

Intensive Care Medicine Journal @intenscaremed.bsky.social · 12d

#VisualAbstract Inconsistent norepinephrine labeling affects dosing accuracy and patient safety. National efforts like the US and French models aim to harmonise reporting based on the active base. zurl.co/FGTTn