July 2025

Uncategorized

Prognostic implication of venoarterial extracorporeal membrane oxygenation in acute myocardial infarction-related cardiogenic shock

Summary This retrospective study aimed to evaluate clinical outcomes in patients receiving veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock (CS), comparing acute myocardial infarction-related cardiogenic shock (AMI-CS) with non-AMI-CS. Analysis of data from 667 patients treated between 2008 and 2023 showed that AMI-CS was associated with significantly lower in-hospital mortality compared to non-AMI-CS. Independent […]

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Uncategorized

The Zentensivist Manifesto. Defining the Art of Critical Care

Summary This perspective piece introduces the concept of “zentensivism,” a minimalist and holistic approach to critical care medicine that seeks to counteract the harmful tendency towards excessive medical interventions. Combining Zen philosophy with the core principles of evidence-based medicine, zentensivism advocates for careful clinical reasoning, thoughtful inaction, and patient-centered care. The authors discuss the necessity

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Miscellaneous

Acid–Base Status in Critically Ill Patients: Physicochemical vs. Traditional Approach

Summary Ciabattoni et al. conducted a prospective observational study to evaluate the prevalence and progression of acid–base disturbances in mechanically ventilated ICU patients using traditional (standard base excess—SBE) and physicochemical (Stewart method) approaches. They found significant differences in diagnostic accuracy between the two methods, with poor agreement, highlighting the Stewart method’s potential superiority in capturing

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Cardiovascular

Fluid balance and outcome in cardiac arrest patients admitted to intensive care unit

Summary Renaudier et al. conducted a multicenter study to evaluate the impact of fluid balance on outcomes in patients admitted to intensive care units (ICUs) after out-of-hospital cardiac arrest (OHCA). The study found that a positive fluid balance was consistently associated with increased mortality, highlighting potential benefits of restrictive fluid management in this patient group.

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Uncategorized

Prone positioning during veno-venous extracorporeal membrane oxygenation: a systematic review and meta-analysis

Summary Pettenuzzo et al. conducted a comprehensive systematic review and meta-analysis evaluating the effects of prone positioning during veno-venous extracorporeal membrane oxygenation (V-V ECMO) in patients with acute hypoxemic respiratory failure. Analyzing data from 22 studies (3,465 patients), the review concluded that prone positioning is associated with significantly improved 28-day and hospital mortality rates despite

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Cardiovascular

Navigating Hemorrhagic Shock: Biomarkers, Therapies, and Challenges in Clinical Care

Summary Hemorrhagic shock remains a leading cause of preventable death globally, characterized by a complex, time-sensitive inflammatory response that evolves from hyperinflammation to immunosuppression. This review explores the pathophysiology, progression, and systemic consequences of hemorrhagic shock, emphasizing the interplay between tissue injury, endothelial dysfunction, coagulopathy, and metabolic derangements. The article outlines established and emerging biomarkers,

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Sepsis

Sepsis-Associated Acute Kidney Injury

Summary Acute kidney injury (AKI) is a common complication of sepsis and significantly increases patient morbidity and mortality. Nearly two-thirds of patients with septic shock develop AKI, resulting in a six- to eightfold increase in mortality. Despite progress in understanding its pathophysiology and biomarkers, there are still limited effective therapies. This review outlines the epidemiology,

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Circulatory, Respiratory

High-risk pulmonary embolism: the significance and perspectives of pulmonary reperfusion

Summary This editorial explores the current landscape of pulmonary reperfusion strategies in patients with high-risk pulmonary embolism (PE). It underscores the centrality of rapid hemodynamic stabilization and reperfusion in managing high-risk PE and analyzes recent data from a large target trial emulation by Stadlbauer et al. The authors conclude that while systemic thrombolysis (SYS) remains

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Uncategorized

ARDS Ventilation, The Man Behind the Evolution

Summary This commentary highlights the significant advancements made in the management of Acute Respiratory Distress Syndrome (ARDS) since its initial description by Ashbaugh et al. in 1967. Central to these advancements is Prof. Luciano Gattinoni, whose groundbreaking contributions, particularly the concepts of the “baby lung,” ventilator-induced lung injury, and prone positioning, transformed ARDS management. The

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Pharmacological Insights in Critical Care

Vasopressin use across shock states: international insights from an international ESICM-endorsed survey: the PRESS Survey

Summary This international survey, endorsed by the European Society of Intensive Care Medicine (ESICM), assessed the current clinical use of vasopressin and terlipressin in patients with septic shock. The survey included 1,919 intensivists from 124 countries, highlighting significant variability in vasopressin availability, clinical indications, dosing strategies, and discontinuation practices. Results underscore the heterogeneity of current

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