Critical Care Medicine

Objectives: To describe psychoactive medication (PM) prescribing in the 30 days after an ICU admission requiring mechanical ventilation not supported by a documented diagnosis in American adults not prescribed a PM before ICU admission. This nondiagnostically supported PM prescribing was explored in patient subgroups and for up to 2 years. Design, Setting, and Patients: This retrospective cohort …

OBJECTIVE: To evaluate the mechanistic specificity of capillary leak clinical indices by testing their performance in a heart failure population as a negative control. DESIGN: Retrospective observational study. SETTING: Tertiary-care academic medical center. PATIENTS: Adults with chronic heart failure (both stable outpatients and those with acute decompensation) undergoing clinically indicated bl…

OBJECTIVES: To investigate the association between net ultrafiltration (NUF) rate and fluid balance changes with 28-day mortality in critically ill patients receiving continuous renal replacement therapy (CRRT). DESIGN: Multicenter retrospective observational study. SETTING: Data from two European mixed medical-surgical ICUs: University Hospital Bern, Switzerland, and Amsterdam University Medical…

OBJECTIVES: Acute hypoxemic respiratory failure (AHRF) is a leading cause of ICU admission and is associated with significant morbidity and mortality. Yet, epidemiological data on AHRF remain limited, and current management strategies largely derive from studies on acute respiratory distress syndrome (ARDS). We examined the prevalence of AHRF among ICU patients receiving supplemental oxygen or re…

OBJECTIVES: Staff in neurocritical care units (NCCUs) are particularly vulnerable to burnout, negatively affecting team dynamics and education. We evaluated the impact of several stakeholder-led, resilience-building interventions on staff burnout and team dynamics in the NCCU. DESIGN: Participatory, stakeholder-led, quality improvement intervention-based project with serial cross-sectional survey…

OBJECTIVES: Postintensive care frailty impairs quality of life in survivors of severe illness. While anabolic hormone deficiency and prolonged inflammation are considered key physiologic mechanisms, specific features associated with frailty progression remain unclear. This study aimed to elucidate clinical characteristics associated with frailty deterioration following recovery from septic shock …

OBJECTIVES: To update data from 2001 to 2019 to evaluate how hospital and ICU admission patterns for children changed after the onset of the COVID-19 pandemic and to characterize regionalization of pediatric critical care over time. DESIGN: Retrospective cohort study. SETTING: Healthcare Cost and Utilization Project's State Inpatient Databases from 21 U.S. states over 6 years between 2001 and 202…

OBJECTIVES: Expanded coverage for telehealth during the COVID-19 pandemic allowed providers to bill for telemedicine services that were previously not reimbursable, including telemedicine critical care (TCC) services for critically ill patients. We aimed to characterize TCC billing practices among Medicare beneficiaries before, during, and after the COVID-19 pandemic. DESIGN, SETTING, AND PATIENT…

OBJECTIVES: To identify biological findings underlying skeletal muscle dysfunction in adults with critical illness and meta-analyze myofiber cross-sectional area and protein turnover variables. DATA SOURCES: Six databases were electronically searched from inception to January 2025. STUDY SELECTION: We included original studies reporting biological findings obtained from skeletal muscle biopsies o…

IMPORTANCE: Timely access to advanced care is critical for patients with cardiogenic shock (CS), yet the impact of regional disparities in hospital arrival time on mortality remains unclear. OBJECTIVES: To investigate whether regional disparities in hospital arrival time are associated with in-hospital and long-term mortality among patients with CS. DESIGN: Population-based, nationwide cohort stu…

OBJECTIVE: To evaluate the feasibility of conducting a trial comparing targeted temperature management (TTM) at 35°C-37°C in intubated heatstroke patients, while collecting preliminary data on safety and clinical outcomes. DESIGN: Pilot multicenter randomized clinical trial (June to December 2024). SETTING: Ten tertiary ICUs in China. PATIENTS: Thirty-five intubated adults (18 yr or older) with h…

OBJECTIVES: Acute kidney injury (AKI) is associated with central neurologic complications, notably in critical care, the mechanisms of which are poorly understood. Blood-brain barrier (BBB) disruption is a central mechanism associated with cognitive impairment in chronic kidney disease. The objectives of this study were to characterize the influence of AKI on brain alteration and BBB permeability…

A structured daily program that combines mobility, verticalization, and resistance exercises during ECMO was feasible and safe. More time in sessions was associated with better functional performance. Larger controlled studies are needed to determine effects on recovery and long-term outcomes.

In patients presenting with intermediate-risk PE, timing of mechanical thrombectomy did not influence in-hospital mortality. EI may result in greater reductions in pulmonary artery pressures and decreased incidence of intubation compared with DI.

Objectives: To develop a comprehensive checklist, define critical actions, and establish a minimal passing standard for adult and pediatric critical care clinicians as well as other clinicians to facilitate formative and summative assessment of brain death/death by neurologic criteria (BD/DNC) determination. Design: A prespecified three-round modified Delphi consensus process to define checklist …