Purpose Acute hypoxemic respiratory failure (ARF) is a major challenge in immunocompromised patients, often complicated by severe respiratory distress and organ dysfunction. High-flow nasal oxygen (HFNO) therapy is the standard of care, but data on its effectiveness and outcomes are limited. This study evaluated the outcomes of HFNO in this population, predictors of invasive mechanical ventilation

Purpose Brain tissue hypoxia and metabolic dysfunction are common in patients with subarachnoid hemorrhage (SAH) and may worsen prognosis. We aimed to assess the impact of episodes of low brain tissue partial pressure of oxygen (PbtO2) and metabolic dysfunction (elevated lactate pyruvate ratio—LPR measured by cerebral microdialysis, CMD) on neurological outcome at 6 months. Methods This is a multicentric

Purpose To determine whether hydrocortisone improves mortality in severe community-acquired pneumonia (CAP). Methods In an international adaptive randomized controlled platform trial testing multiple interventions, adults admitted to the intensive care unit (ICU) with severe CAP were randomized to a 7-day course of intravenous hydrocortisone (50 mg every 6 h) or control (no corticosteroid). The primary

Purpose Despite optimal antimicrobial therapy, the treatment failure rate of hospital-acquired pneumonia (HAP) routinely reaches 40% in critically ill patients. Subphenotypes have been identified within sepsis and acute respiratory distress syndrome with important predictive and possibly therapeutic implications. We derived prognosis subphenotypes for HAP and explored whether they were associated with

Significant advancements have been made in the care of the allogeneic hematopoietic stem cell (HCT) recipient. However, they remain one of the most vulnerable groups of patients who may be admitted to the ICU. On the one hand, they have been administered treatment with the goal of achieving cure for their underlying disease, yet their unique immunocompromised trajectory and treatment-associated toxicities

Purpose To evaluate the clinical practice and timing of use of tier-three therapies (TTT) after traumatic brain injury (TBI), and to explore their association with intensive care unit (ICU) mortality and 3 months neurological outcome. Methods International multicenter, retrospective, observational, cohort study performed in 16 ICUs including 408 adult TBI patients requiring at least one of the TTT

Introduction Hospital-acquired bloodstream infections (HA-BSIs) are severe and require antibiotic therapy. In non-complicated BSIs, shortened therapy reduces side effects without compromising efficacy. The impact of shortened antibiotic therapy in HA-BSI critically ill patients without indication of prolonged therapy requires further evaluation. Methods Using the international prospective EUROBACT-2

Heterogeneity between critically ill patients with sepsis is a major barrier to the discovery of effective therapies. The use of machine learning techniques, coupled with improved understanding of sepsis biology, has led to the identification of patient subphenotypes. This exciting development may help overcome the problem of patient heterogeneity and lead to the identification of patient subgroups

Objective This European Society of Intensive Care Medicine (ESICM) guideline provides evidence-based recommendations on the volume of early resuscitation fluid for adult critically ill patients. Methods An international panel of experts developed the guideline, focusing on fluid resuscitation volume in adult critically ill patients with circulatory failure. Using the PICO format, questions were formulated

Purpose Machine learning has shown promise to detect useful subgroups of patients with sepsis from gene expression and protein data. This approach has rarely been deployed in metabolomic datasets. Metabolomic data are of interest as they capture effects from the genome, proteome, and environmental. We aimed to discover metabolic sub-phenotypes of septic shock, examine their temporal stability and association

Background There are recognized diagnostic criteria for a first ventilator-associated pneumonia (VAP) episode, but not for recurrences. Many randomized clinical trials (RCTs) have used the recurrence of VAP as a criterion for efficacy evaluation. Still, the different definitions used in RCTs make it difficult to compare studies. We aimed to develop a consensual definition of VAP recurrences and of

Rationale Critical illness threatens millions of lives annually. Electronic health record (EHR) data are a source of granular information that could generate crucial insights into the nature and optimal treatment of critical illness. Objectives Overcome the data management, security, and standardization barriers to large-scale critical illness EHR studies. Methods We developed a Common Longitudinal

Background High-risk acute pulmonary embolism (PE) is a life-threatening condition necessitating hemodynamic stabilization and rapid restoration of pulmonary perfusion. In this context, evidence regarding the benefit of advanced circulatory support and pulmonary recanalization strategies is still limited. Methods In this observational study, we assessed data of 1060 patients treated for high-risk acute

Purpose Current mechanical ventilation practices for patients with acute brain injury (ABI) are poorly defined. This study aimed to describe ventilator settings/parameters used in intensive care units (ICUs) and evaluate their association with clinical outcomes in these patients. Methods An international, prospective, multicenter, observational study was conducted across 74 ICUs in 26 countries, including

Purpose To evaluate the effect of discussing personalized predictions of long-term quality of life (QoL) on patient and family experiences and outcomes, and on experiences of ICU clinicians. Methods We conducted a randomized clinical trial in two Dutch hospitals, assigning adult ICU patients to receive usual care or the intervention: discussing the expected long-term QoL based on a validated prediction