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Intensive Care Medicine Journal @intenscaremed.bsky.social · 6h

AI amplifies centuries of medical knowledge and may surpass clinicians at prediction, yet trust, judgement and the human bond remain decisive as care risks de-humanisation. zurl.co/2eson

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Intensive Care Medicine Journal @intenscaremed.bsky.social · 22h

#VisualAbstract An AI tool identified ARDS phenotypes over 30 days. Corticosteroids lowered mortality in hyperinflammatory patients but increased it in hypoinflammatory ones, highlighting the need for phenotype-guided treatment. zurl.co/Cstyi

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Intensive Care Medicine Journal @intenscaremed.bsky.social · 1d

Parallels between Brazilian Jiu-Jitsu and intensive care highlight the value of strong fundamentals, humility, adaptable decision-making and teamwork, helping clinicians stay calm under pressure and learn from setbacks. zurl.co/le8m3

Intensive Care Medicine Journal @intenscaremed.bsky.social · 1d

AI is shifting from prediction to action in intensive care, but safe adoption hinges on solving the right problems, workflow fit, rigorous validation and clear governance, guided by lessons from real-world wins and setbacks. zurl.co/zersq

Intensive Care Medicine Journal @intenscaremed.bsky.social · 2d

Critical care trials often underrepresent women, older adults, minorities and disadvantaged groups. Better reporting, inclusive eligibility, diverse teams and patient partnership are needed to improve generalisability, equity and trust in findings. zurl.co/te0qo

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Intensive Care Medicine Journal @intenscaremed.bsky.social · 2d

#VisualAbstract ESICM recommends diuretics over usual care and advises against routine ultrafiltration for fluid removal in critically ill adults after resuscitation, based on low to moderate certainty of evidence and identified research gaps. zurl.co/aapRY

Intensive Care Medicine Journal @intenscaremed.bsky.social · 3d

Across 13 countries, 715 cancer patients with ARDS had high 90-day mortality (73%), rising to 82% in severe cases. ECMO did not improve survival. Older age, peripheral vascular disease, severe ARDS and acute kidney injury predicted worse outcomes. zurl.co/O3WNF

Intensive Care Medicine Journal @intenscaremed.bsky.social · 3d

RRT antibiotic dosing should look beyond plasma PK to infection-site exposure, recognise mixed findings on extended infusions, and better contextualise toxicity. Patient and pathogen factors, plus prospective validation, are needed. zurl.co/RLdt1

Intensive Care Medicine Journal @intenscaremed.bsky.social · 4d

In 1,023 septic shock patients over 20 years, monocyte HLA-DR <8000 AB/C from day 3–4 onward predicts higher mortality and ICU-acquired infections, supporting serial tracking to detect persistent immunosuppression. zurl.co/mZHjy

Intensive Care Medicine Journal @intenscaremed.bsky.social · 4d

#VisualAbstract Inconsistent norepinephrine labeling affects dosing accuracy and patient safety. National efforts like the US and French models aim to harmonise reporting based on the active base. zurl.co/FGTTn

Intensive Care Medicine Journal @intenscaremed.bsky.social · 5d

Acute respiratory failure revealed relapsing polychondritis with airway involvement. CT and bronchoscopy showed stenosis and loss of tracheal rings. Prompt corticosteroids with cyclophosphamide enabled weaning from ventilation and oxygen. zurl.co/kIuPO

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Intensive Care Medicine Journal @intenscaremed.bsky.social · 5d

In ventilated ICU adults, antibiotics with anaerobic coverage were linked to loss of butyrogenic anaerobes and expansion of pathobionts, while limited anaerobic coverage showed no such effect; SDD shifted communities towards commensals. zurl.co/iFICi

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Intensive Care Medicine Journal @intenscaremed.bsky.social · 6d

Imaging showed a lung abscess, an 11×8 cm liver abscess and endophthalmitis; cultures confirmed hypervirulent Klebsiella pneumoniae. Treatment included systemic antibiotics and intravitreal ceftazidime; vision loss can progress rapidly. zurl.co/CfbCU

Intensive Care Medicine Journal @intenscaremed.bsky.social · 6d

#VisualAbstract In a multicentre study of 1,094 ICU patients, VAEs were linked to higher 30-day mortality, longer ICU and hospital stays, and delayed recovery, supporting their role as indicators of poor prognosis in critical care. zurl.co/0iYC6

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Intensive Care Medicine Journal @intenscaremed.bsky.social · 7d

PEEP improves oxygenation yet may disturb intracranial dynamics in acute brain injury, outlining brain–heart–lung interplay, key determinants of tolerance, and an individualised strategy to balance lung protection with cerebral perfusion. zurl.co/34zbw

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Intensive Care Medicine Journal @intenscaremed.bsky.social · 7d

Two weeks after pacemaker implantation, dyspnoea led to detection of a 7.6×5.5 cm right-heart mass around the leads. Multimodal imaging and pathology identified diffuse large B-cell lymphoma, not a device-associated thrombus. zurl.co/gTmJu

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Intensive Care Medicine Journal @intenscaremed.bsky.social · 8d

Targeting driving pressure to individualise PEEP lowered intraoperative DP but did not reduce postoperative pulmonary complications in at-risk patients, with signals of harm and plausible physiological explanations. zurl.co/Uck9k

Intensive Care Medicine Journal @intenscaremed.bsky.social · 8d

#1minutevideo A 7-day course of hydrocortisone in severe community-acquired pneumonia was unlikely to reduce 90-day mortality and may pose potential harm, despite a possible reduction in shock duration. zurl.co/95rMB

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Intensive Care Medicine Journal @intenscaremed.bsky.social · 9d

Serum sickness may appear 7–14 days after antivenoms, vaccines or monoclonal antibodies, with rash, fever, joint pain and shock. Management is resuscitation, drug withdrawal and corticosteroids if needed. zurl.co/fD3Tw

Intensive Care Medicine Journal @intenscaremed.bsky.social · 9d

Acute brain injury care prioritises limiting secondary damage through tiered intracranial pressure strategies and seizure detection with continuous EEG, supported by multimodal monitoring, biomarkers, and imaging. zurl.co/xtUKi

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Intensive Care Medicine Journal @intenscaremed.bsky.social · 10d

Post hoc analysis of SEPSIS-PAM found no baseline heterogeneity between low (65–70 mmHg) and high (80–85 mmHg) MAP targets in septic shock; higher targets may be harmful when high norepinephrine is needed or mottling persists. zurl.co/5MwT4

Intensive Care Medicine Journal @intenscaremed.bsky.social · 10d

#VisualAbstract A personalised PEEP strategy targeting driving pressure below 13 cmH₂O did not reduce respiratory failure or death and was linked to more reintubation or need for non-invasive ventilation after emergency abdominal surgery. zurl.co/2JI5m

Intensive Care Medicine Journal @intenscaremed.bsky.social · 11d

ICU professionals generally support donation after circulatory death, but ethical tensions and organisational barriers persist. Clear protocols, targeted training and emotional support are needed to safeguard compassionate, ethical care. zurl.co/XYMq2

Intensive Care Medicine Journal @intenscaremed.bsky.social · 11d

Echocardiography supports ICU atrial fibrillation care, from onset to rhythm or rate control. It assesses ventricular and valvular function, stratifies cardioversion chances, guides drug choice, monitors recovery, and informs anticoagulation decisions. zurl.co/wkd1A

Intensive Care Medicine Journal @intenscaremed.bsky.social · 12d

#ICM-Quizz #MedEd Purpura in meningococcal disease may be absent or appear late. It progresses rapidly and can be hard to detect on dark skin. PCR from biopsy aids diagnosis even after antibiotics. Careful skin checks are essential. zurl.co/TXSUk