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

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 · 20h

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 · 1d

#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 · 1d

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 · 2d

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 · 2d

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 · 3d

#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 · 3d

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 · 4d

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 · 4d

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 · 5d

#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 · 5d

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 · 6d

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 · 6d

#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

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

#ICM-Quizz #MedEd Which of these panels is consistent with the cutaneous manifestations of invasive meningococcal disease?

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

Very low tidal volume ventilation with PEEP during bypass did not change postoperative immune or pulmonary outcomes. Recruitment manoeuvres may explain the lack of effect. Studies in patients with lung disease are needed. zurl.co/zqMdT

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

Proning brain-injured patients with ARDS is feasible but demands close ICP monitoring, tailored haemodynamic targets, and positioning that preserves jugular drainage, guided by invasive or non-invasive neuromonitoring. zurl.co/RVCgd

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

ICU melatonin trial limitations: only 0.3 and 3 mg tested, half on 0.3 mg underexposed; 14-day course may be short; >80% restraints could confound sleep and delirium. Future research: lower or individualised dosing and restraint-minimised protocols. zurl.co/3powT

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

#VisualAbstract Optimising antibiotic therapy in severe infections means balancing early treatment with avoiding overuse. Rapid diagnostics, de-escalation, and tailored dosing improve outcomes, reduce harm, and fight the rise of resistant pathogens. zurl.co/oxehV

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

A simple colouring poster in a MICU waiting room invites families to add colour and messages, easing anxiety and building shared support. When full, it is preserved in ICU corridors, and a new blank canvas keeps the quiet transformation going. zurl.co/s3VoC

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

A 17-year-old with persistent hiccups and syncope suffered cardiac arrest from bradycardia. MRI revealed area postrema involvement in neuromyelitis optica spectrum disorder, and treatment led to full recovery. zurl.co/SOlYq

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

The IMPROVE-2 trial highlights challenges in personalising ventilation for surgical patients. Commentary raises concerns over driving pressure thresholds, protocol adherence, and the need for more nuanced approaches. zurl.co/Nh1vn

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

#VisualAbstract VV ECMO supports selected adults with very severe ARDS, potentially improving survival. ECCO2R enables ultra-protective ventilation but lacks proven mortality benefit and is not advised outside research settings. zurl.co/nJxIv

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

The TIMING trial on early versus delayed drainage in severe acute pancreatitis faces limitations from low statistical power and inconsistent definitions of organ failure, leaving its conclusions uncertain for ICU practice. zurl.co/Wd787

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

In a multicentre study of 1,094 ICU patients, ventilator-associated events 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/jVRIW