Abstract: The approach to renal replacement therapy (RRT) in critically ill patients has evolved from early, empirical use to more individualized, evidence-based practice. Large randomized controlled trials (RCTs) now support delayed initiation unless urgent complications arise, and new data inform decisions on modality, dose, and discontinuation. This review summarizes the key updates and current standards […]
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Extracorporeal Membrane Oxygenation (ECMO) and Beyond in Near-Fatal Asthma Abstract: Near-fatal asthma (NFA) is a life-threatening condition that sometimes proves refractory to conventional therapies, including mechanical ventilation. This comprehensive review examines the role of extracorporeal membrane oxygenation (ECMO) and extracorporeal CO₂ removal (ECCO₂R) as rescue therapies in NFA. It synthesizes registry data, observational studies, and
Abstract: This study investigated whether discrepancies between venous-to-arterial carbon dioxide pressure (ΔPCO₂) and content differences (ΔCCO₂) during endotoxemic shock are primarily influenced by hydrogen ion accumulation (acidosis) or hemoglobin oxygen saturation (Haldane effect). Using a porcine endotoxemia model, researchers induced and resuscitated shock with fluids and norepinephrine, measuring systemic and mesenteric CO₂ parameters. Key Insights:
Serum Biomarkers of Delirium in Critical Illness Abstract: Delirium is a frequent and serious complication of critical illness, with up to 80% of ventilated ICU patients affected. This systematic review synthesized evidence from 28 studies assessing 54 serum biomarkers related to delirium, grouped into six mechanistic categories: CNS injury, immune activation, hormonal dysregulation, neurotransmission, coagulation,
ARDS: Pathophysiological Insights, Subphenotypes, and Precision Medicine Abstract: ARDS is a syndrome of hypoxemic respiratory failure caused by alveolo-capillary barrier dysfunction, dysregulated inflammation, and mechanical injury. Despite 60 years of research, mortality remains near 40%. The heterogeneity of ARDS has driven interest in subphenotypes—biological, clinical, physiological, and radiographic—that may explain variable responses to therapies. This
The Role of Respiratory Viruses in Severe Acute Respiratory Failure Abstract: Respiratory viruses contribute substantially to severe acute respiratory failure (ARF) and ICU admissions. With the widespread use of multiplex PCR (mPCR), viruses are now identified in up to 30–40% of community-acquired pneumonia (CAP) cases. Influenza viruses and Pneumoviridae (RSV, hMPV) are the leading culprits,
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Organ Crosstalk in Sepsis-Related ALI/ARDS: New Insights into Lung–System Interactions Abstract: Sepsis-related ALI/ARDS remains highly lethal (>30% mortality), and most research has historically focused only on the lung. This review highlights organ crosstalk as a central mechanism in sepsis pathophysiology. The authors differentiate pulmonary sepsis-associated ALI/ARDS (PSA) from extrapulmonary sepsis-associated ALI/ARDS (ESA), outline systemic inflammation,
NAVA vs PSV in Obese ICU Patients: First Evidence of Safety and Benefit Abstract: This randomized crossover study is the first to test Neurally Adjusted Ventilatory Assist (NAVA) in critically ill obese patients. Twenty-one ventilated patients (10 obese, 11 non-obese) underwent 30 minutes of NAVA and PSV each. Researchers assessed safety, patient-ventilator synchrony, oxygenation, and
ECMOVENT: Comparing Two Ultraprotective Ventilation Strategies on VV-ECMO Abstract: The optimal ventilatory strategy for ARDS patients on VV-ECMO remains debated. This single-center, before-and-after study compared two ultraprotective approaches: VT1 strategy: Assist-controlled volume mode, VT 1 ml/kg PBW, RR 5/min, Pplat 20–25 cmH₂O. ΔP8 strategy: Pressure-controlled mode, ΔP 8 cmH₂O, PEEP 14 cmH₂O, RR 10/min. Among
Simplifying Mechanical Power: Can the mM Equation Work During Spontaneous Breathing. Abstract: Mechanical power (MP) quantifies the energy delivered to the lungs during ventilation, integrating pressures, volumes, and rates. The minute ventilation–mean airway pressure (mM) equation was designed as a simple surrogate for MP. This study used 3,000 simulated scenarios (PCV & VCV, with/without spontaneous