Amatoxin-related acute liver failure (AT-ALF) carries high mortality without liver transplantation (LTX). While therapeutic plasma exchange (PEX) might improve LTX-free survival in other ALF cases, its role in AT-ALF is unclear. Clinical practice varies, and, given the rarity of this ALF entity, the feasibility of conducting a randomized controlled trial to investigate PEX in AT...
While mortality for critically ill patients has decreased, many survivors face persistent physical, cognitive, and psychological impairments, collectively known as post-intensive care syndrome, which significantly reduce health-related quality of life (HRQoL). Nutrition is a crucial component of recovery, yet evidence-based strategies for post-intensive care unit (ICU...
Contrast-enhanced ultrasound (CEUS) is a promising tool to assess renal microcirculation. However, its reproducibility has never been formally assessed. We aimed to assess the reproducibility and precision of CEUS measurements in critically ill patients. We conducted an observational study in 20 critically ill patients in stable cardio-pulmonary condition. In group 1 (n = 10), to...
In hypoxemic patients, the respective effects of noninvasive respiratory support strategies on lung injury determinants remain unclear, primarily due to the difficulty of obtaining standardized measurements for all interventions within the same study. We conducted a systematic review and network meta-analysis to assess the effects of noninvasive strategies on transpulmonary...
Adjusting trunk inclination in patients with acute respiratory distress syndrome directly affects physiological variables such as respiratory mechanics and PaCO2 levels. These effects may vary according to the body mass index (BMI) due to differences in lung and chest wall mechanics, highlighting the need for further investigation to clarify the clinical relevance of body...
Sepsis-induced cardiomyopathy (SICM) is a transient cardiac dysfunction that occurs in a substantial proportion of patients with sepsis and is associated with poor prognosis. However, preventive strategies remain limited. This study aimed to assess whether baseline use of sodium-glucose co-transporter 2 inhibitors (SGLT2is) compared to dipeptidyl peptidase-4 inhibitors (DPP4is...
Sepsis is a life-threatening condition that stems from a dysregulated host response to an infection, leading to multi-organ dysfunction and death. Sepsis has a remarkably high global burden and accounts for 20% of all deaths worldwide. Nonetheless, possibilities for treatment are limited mainly to early administration of broad-spectrum antibiotics and providing fluid...
The Lower Limit Margin, defined as the difference between the autoregulation-informed optimal cerebral perfusion (CPP) target (CPPopt) and the lower limit of autoregulation (LLA), was recently introduced as a potential dynamic prognostic marker after traumatic brain injury (TBI). Conceptually, CPPopt marks the CPP associated with “optimal” autoregulatory function, while LLA...
Lactate, traditionally viewed as a biomarker of hypoxia and severity in critical illness, has recently emerged as a potential therapeutic agent. Its roles extend beyond energy metabolism to include anti-inflammatory and signaling functions. This review explores the evolving evidence supporting lactates therapeutic application in critical care settings. We synthesize current...
This study aimed to evaluate the safety and efficacy of inhaled pegylated adrenomedullin (PEG-ADM) for the management of acute respiratory distress syndrome in critically ill patients on mechanical ventilation. A Phase 2a/b randomised, double-blind, placebo-controlled multicentre trial was conducted. Patients with acute respiratory distress syndrome were assigned to receive PEG...
Terlipressin’s role as an adjunctive vasopressor in septic shock remains controversial. We aimed to evaluate the efficacy of terlipressin versus placebo as an additional vasopressor in refractory septic shock. We conducted a single-center, prospective, double-blind, randomized controlled trial in a medical intensive care unit. Adult patients with septic shock requiring...
Recognition of ventilator-induced lung injury has led to the development of lung-protective ventilation strategies, significantly influencing the management of acute respiratory distress syndrome (ARDS). By the end of the 20th century, five randomized controlled trials had compared the survival benefits of low tidal volume (VT) ventilation with those of traditional high VT...
During continuous renal replacement therapy (CRRT), preload-independent patients risk of becoming preload-dependent in case of excessive net ultrafiltration (UFNET). We aimed to evaluate the ability of a UFNET challenge to identify de novo preload-dependence in preload-independent patients undergoing CRRT. We conducted a single-center, randomized, cross-over trial, enrolling...
Intensive Care Unit (ICU) readmissions are associated with increased morbidity, mortality, and healthcare costs. Therefore, determining an appropriate timing of ICU discharge is critical. In this context, deep learning (DL) approaches have attracted significant attention. We conducted a systematic review of studies developing or validating DL models for ICU readmission prediction...
To assess heterogeneous treatment effects of high fresh frozen plasma (FFP) to red blood cell (RBC) transfusion ratios in patients with severe blunt trauma and to identify subgroups that derive the greatest survival benefit. This multicenter retrospective cohort study used data from the Japan Trauma Data Bank (2019–2023). Adults with severe blunt trauma (Injury Severity Score...
Although goal-concordant care is central to patient-centered medicine, determining treatment preferences for incapacitated patients remains a challenge. Nearly two decades ago, algorithms were proposed to estimate the most likely treatment preferences in the absence of advance directives, aiming to support surrogate decision-making. This idea has evolved into a race toward...
Combined nutrition and rehabilitation is a top research priority for ICU-acquired weakness, yet the optimal strategy and clinical benefits remain unclear. This study aimed to evaluate the independent and combined effects of resistance training (RT) and β-hydroxy-β-methylbutyrate (HMB) in critically ill adults. We conducted a multicenter, open-label, 2 × 2 factorial randomized...