March 2026

Respiratory

Lung-protective ventilation strategy in acute respiratory distress syndrome: a critical reappraisal of current practice

Why This Article Matters For more than 20 years, lung-protective ventilation has been synonymous with a single number: 6 mL/kg predicted body weight (PBW). This target has been taught, audited, benchmarked, and enforced across ICUs worldwide. Yet despite near-universal endorsement, real-world adherence remains inconsistent—and outcomes have plateaued. This 2025 review asks an uncomfortable but necessary […]

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Miscellaneous

The metabolic response to stress in critical illness: updated review on the pathophysiological mechanisms, consequences, and therapeutic implications

Why this article matters Critical illness triggers a profound, highly coordinated metabolic stress response that extends far beyond “hypercatabolism.” This comprehensive review reframes how we understand energy metabolism, nutrition, endocrine signaling, immune function, and recovery across the acute, subacute, and chronic phases of critical illness. Importantly, it challenges long-standing assumptions around “early full feeding” and

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Pharmacological Insights in Critical Care

Corticosteroids and hospital-acquired pneumonia

1. Why This Article Matters — Why You Should Read This Corticosteroids are everywhere in critical care. ARDS. Septic shock. COVID-19. Refractory hypoxemia. But when it comes to hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), their role remains controversial, inconsistently applied, and poorly understood. This narrative review tackles a clinically uncomfortable reality: While steroids may

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Mechanical Ventilation, Respiratory

Invasive ventilator exhaust in critical care: aerosol transmission risks and management strategies-a narrative review

1. Why This Article Matters Invasive mechanical ventilation is the cornerstone of critical care. Yet, one major risk remains overlooked in daily practice: Ventilator exhaust can carry infectious aerosols, biofilm fragments, volatile anesthetics, and VOCs into the ICU environment — posing real risks for patients and staff. This review synthesizes decades of microbiology, aerosol physics,

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Invasive ventilator exhaust in critical care: aerosol transmission risks and management strategies-a narrative review Read Post »

Respiratory

Patient-specific prediction of regional lung mechanics in patients with ARDS with physics-based models: a validation study

1. Why This Study Matters — Why You Should Read This Physiology at the bedside is often guesswork. We titrate PEEP. We adjust driving pressure. We interpret compliance as a global signal, even though ARDS is intensely regional. But imagine if we had a patient-specific digital model — a “virtual twin” — that could simulate

Patient-specific prediction of regional lung mechanics in patients with ARDS with physics-based models: a validation study Read Post »

Mechanical Ventilation

Individualised treatment effects of enhanced early mobilisation in mechanically ventilated patients: a secondary analysis of the TEAM trial

1. Why This Study Matters — Why You Should Read This Early mobilization is one of the most widely endorsed ICU practices. We repeat it daily: “Mobilize early. Mobilize often.” But what if that guidance is too simple? This new secondary analysis of the landmark TEAM trial challenges one of the core assumptions in ICU

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Individualised treatment effects of enhanced early mobilisation in mechanically ventilated patients: a secondary analysis of the TEAM trial Read Post »

Respiratory

Balancing the Scales: Using Ventilator Time to Counter Mass Loading

Why This Study Matters — Why You Should Read This Obesity. Abdominal compartment syndrome. Massive chest wall load. We see these patients every day. We crank up PEEP, perform recruitment maneuvers, increase pressures…and yet the lung refuses to open. So what if the problem isn’t pressure at all? What if the missing variable is time?

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Balancing the Scales: Using Ventilator Time to Counter Mass Loading Read Post »

Cardiovascular

Crossing the line: blood transfusion thresholds in ECMO

1. Why this editorial matters — and why you should read it ECMO teams across the world ask the same question daily: “What hemoglobin level actually improves oxygen delivery in ECMO — and when does transfusion do more harm than good?” Despite decades of ECMO evolution, there is still no evidence-based transfusion threshold for ECMO

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Crossing the line: blood transfusion thresholds in ECMO Read Post »

Respiratory

The impact of PEEP-guided electrical impedance tomography on oxygenation and respiratory mechanics in moderate-to-severe ARDS: a randomized…..

Why this study deserves your click Every ARDS patient forces us to answer the same question: “How much PEEP is enough—and how much is too much?” We usually lean on ARDSNet tables, “PEEP ladders,” or our own bias. This trial asks a different question: What happens if we let the lung tell us the right

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The impact of PEEP-guided electrical impedance tomography on oxygenation and respiratory mechanics in moderate-to-severe ARDS: a randomized….. Read Post »

Respiratory

Peri-intubation Cardiovascular Collapse During Emergency Airway Management

Summary This comprehensive review explores why emergency airway management remains one of the most dangerous procedures in critical care medicine. Despite decades of improvement in first-pass success, the physiologic burden of induction and immediate transition to positive-pressure ventilation continues to precipitate hypotension, shock, and cardiac arrest in a large proportion of critically ill patients. The

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