Mechanical Ventilation, Respiratory

Revisiting Acute Respiratory Distress Syndrome ventilation management: Time for a paradigm shift focusing on tidal volume

Abstract: Merola and colleagues critically evaluate current Acute Respiratory Distress Syndrome (ARDS) ventilation strategies, emphasizing limitations inherent in universally applying low tidal volume (VT) strategies. They argue for personalized, physiology-driven ventilation approaches that incorporate mechanical power, compliance, and transpulmonary pressures. The authors highlight the complexity and heterogeneity of ARDS, suggesting the inadequacy of global parameters […]

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Respiratory

Physical and respiratory therapy in the critically ill patient with obesity: a narrative review

Abstract: Martínez-Camacho et al. discuss the critical aspects of physical and respiratory therapy for obese patients in the ICU, highlighting the complexities of obesity-related respiratory and metabolic disturbances. They emphasize the importance of early mobilization, meticulous ventilatory management, personalized nutritional support, and multidisciplinary collaboration as pivotal strategies to enhance functional outcomes and reduce complications in

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Neurology

Managing Intracranial Pressure Crisis

Abstract: Viarasilpa provides a comprehensive review of current strategies for managing intracranial pressure (ICP) crises, emphasizing critical care management, ICP monitoring, neuromonitoring, and evidence-based therapeutic approaches. The review integrates protocols from the Brain Trauma Foundation (BTF), Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC), and Consensus-based management protocol (CREVICE), advocating personalized, neuromonitoring-driven interventions to

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Cardiovascular

Management of cardiogenic shock: state-of-the-art

Abstract: Jung et al. provide a comprehensive review addressing current knowledge and contemporary practices in the management of cardiogenic shock (CS). Despite advancements, mortality remains high, and the complexity of patient care underscores the need for individualized treatments. The authors highlight recent evidence in pharmacological therapies, mechanical circulatory support (MCS), and the potential for personalized

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Sepsis

Efficacy of targeting high mean arterial pressure for older patients with septic shock (OPTPRESS): a multicentre, pragmatic, open-label, randomised…

Abstract: Endo et al. conducted the OPTPRESS trial, a multicenter randomized controlled trial in Japan, evaluating whether a higher mean arterial pressure (MAP) target (80–85 mmHg) reduces mortality in older patients (≥65 years) with septic shock compared to standard targets (65–70 mmHg). The trial was terminated early due to increased mortality and adverse events in

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Efficacy of targeting high mean arterial pressure for older patients with septic shock (OPTPRESS): a multicentre, pragmatic, open-label, randomised… Read Post »

Cardiovascular

Intraoperative extracorporeal support for lung transplant: a systematic review and network meta-analysis

Abstract: Pettenuzzo et al. conducted a systematic review and network meta-analysis evaluating the efficacy and safety of intraoperative extracorporeal supports—veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and cardiopulmonary bypass (CPB)—compared to off-pump strategies during lung transplantation (LT). Their analysis revealed that off-pump approaches generally offered better outcomes, while V-A ECMO, particularly as a default strategy, showed

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Pulmonary

Pulmonary shunt in critical care: a practical approach with clinical scenarios

Abstract: Raimondi Cominesi et al. deliver an extensive review on pulmonary shunt, a critical physiological phenomenon where venous blood bypasses alveolar gas exchange, leading to impaired oxygenation. The authors provide practical methods to assess and calculate pulmonary shunt in various critical care scenarios, highlighting its clinical importance, especially in complex conditions such as acute respiratory

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Miscellaneous

How we use ultrasound to support clinical decisions on fluid administration in critical ill patients

🩺 How Ultrasound Guides Fluid Administration in Critical Illness Abstract: Intravenous fluids are among the most frequently used therapies in critical care but must be considered drugs, carrying both benefits and risks. Critical care ultrasound (CCUS)—through echocardiography (CCE), lung ultrasound (LUS), and venous excess ultrasound (VExUS)—offers a structured way to assess the risks and benefits

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Pulmonary

Respiratory management of critically ill pneumocystis pneumonia patients: a multicenter retrospective study

🫁 Respiratory Management of Critically Ill Pneumocystis Pneumonia Patients Reizine F, Stiegler V, Lécuyer R, Tessoulin B, Gallais M, Camou F, Morio F, Cady A, Gabriel F, Canet E, Raffi F, Boutoille D, Issa N, Gaborit B, and the PRONOCYSTIS Study Group. Ann Intensive Care. 2025;15:114. doi:10.1186/s13613-025-01503-6 Abstract: Pneumocystis jirovecii pneumonia (PjP) is an emerging

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Respiratory

Lung electrical impedance tomography during positioning, weaning and chest physiotherapy in mechanically ventilated critically ill patients: a…

🫁 Lung EIT in Positioning, Weaning, and Chest Physiotherapy: A Narrative Review Abstract: Electrical impedance tomography (EIT) is a bedside, radiation-free imaging modality that measures ventilation and, with some techniques, perfusion. While most ICU studies have focused on ARDS and PEEP titration, this review explored EIT applications during positioning, weaning, and chest physiotherapy in intubated

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