Intensive Care Medicine

Intensive Care Medicine The official page for ICM, Intensive Care Medicine.

ICM is an international peer-reviewed medical journal intended for all those who are involved in intensive care medicine. ''Intensive Care Medicine'' is the publication platform for the communication and exchange of current work and ideas in intensive care medicine. The journal publishes original research papers, reviews, as well as discussions on technology, methods, new apparatus and modifications of standard techniques and correspondence concerning matters of topical interest or relating to published material. Official journal of The European Society of Intensive Care Medicine and The European Society of Paediatric and Neonatal Intensive Care.
12 issues per year.

https://zurl.co/FP46Z Severe community-acquired pneumonia has high short-term and one-year mortality and can lead to acu...
27/01/2026

https://zurl.co/FP46Z Severe community-acquired pneumonia has high short-term and one-year mortality and can lead to acute and long-term sequelae. Pathogen identification often remains negative, but multiplex PCR and urinary antigens can accelerate targeted therapy and support antibiotic stewardship. Corticosteroid trial results conflict, with benefit appearing linked to high initial CRP and harm suggested in influenza.

https://zurl.co/8s6l0 Among 295 adults with fulminant myocarditis on V-A ECMO and/or Impella, 44% died or required heart...
26/01/2026

https://zurl.co/8s6l0 Among 295 adults with fulminant myocarditis on V-A ECMO and/or Impella, 44% died or required heart transplantation or long-term LVAD within 1 year, with myocarditis confirmed by histology or cardiac MRI in 69%. Giant cell myocarditis, older age, ECMO during cardiopulmonary resuscitation and endomyocardial biopsy after 2 days were associated with higher risk. Event-free survival did not differ between biopsy within 2 days and no biopsy.

https://zurl.co/6ZZK7 Mortality from ARDS remains high, and the Global ARDS definition enables earlier identification....
26/01/2026

https://zurl.co/6ZZK7 Mortality from ARDS remains high, and the Global ARDS definition enables earlier identification. Global hospital mortality is estimated at 35% in mild, 40% in moderate and 46% in severe ARDS. Management uses low tidal volume ventilation at 6 (4–8) ml/kg PBW with plateau pressure below 30 cmH2O, oxygen targets of SpO2 90–95% or PaO2 60–80 mmHg and early prone positioning when PaO2/FiO2 is below 150 mmHg.

https://zurl.co/751ei In two academic ICUs, 120 patient–caregiver dyads completed FS-ICU-24 after 3 days. English-speaki...
16/01/2026

https://zurl.co/751ei In two academic ICUs, 120 patient–caregiver dyads completed FS-ICU-24 after 3 days. English-speaking caregivers had higher decision-making scores than Spanish speakers (90.8 vs 85.6). FAM-CAM participation was associated with higher overall satisfaction (91.9 vs 84.4) and higher scores when delirium occurred (90.9 vs 80.3).

https://zurl.co/NaJGV Intensive care staff determine how controlled donation after circulatory death is identified, disc...
16/01/2026

https://zurl.co/NaJGV Intensive care staff determine how controlled donation after circulatory death is identified, discussed, and delivered at end of life. Persistent cognitive, emotional, and practical barriers have remained consistent across countries and over time. Clear protocols, education, and emotional support are associated with stronger staff confidence and programme integrity.

https://zurl.co/2b0Bf Community-acquired pneumonia diagnosed in the ICU may reflect diverse infectious and non-infectiou...
15/01/2026

https://zurl.co/2b0Bf Community-acquired pneumonia diagnosed in the ICU may reflect diverse infectious and non-infectious conditions. Invasive respiratory testing does not consistently improve diagnostic yield over non-invasive strategies, while bronchoscopy carries safety concerns in hypoxaemic patients. Clinical and microbiological criteria remain central to decision-making.

https://zurl.co/EWPKi In a prospective randomised cross-over trial of 88 critically ill patients requiring continuous ...
15/01/2026

https://zurl.co/EWPKi In a prospective randomised cross-over trial of 88 critically ill patients requiring continuous veno-venous haemofiltration with regional citrate anticoagulation, low bicarbonate replacement fluid (22 mmol/l) produced significantly fewer pH and bicarbonate excursions than high bicarbonate fluid (30 mmol/l), while achieving comparable normalisation of acidosis over 96 hours of treatment and no fluid-related serious adverse events.

https://zurl.co/C9Nz9 PAO2 cannot be measured directly and is calculated from FIO2, barometric pressure, PaCO2 and the r...
14/01/2026

https://zurl.co/C9Nz9 PAO2 cannot be measured directly and is calculated from FIO2, barometric pressure, PaCO2 and the respiratory exchange ratio. Low PAO2 suggests reduced inspired oxygen pressure or hypoventilation, while a widened A–a gradient indicates ventilation–perfusion mismatch or right-to-left shunt. Altitude exposure and extracorporeal CO2 removal can mislead PaO2/FIO2 interpretation when PB or RER is not considered.

https://zurl.co/VxrlQ Peripheral ECMO cannula-site infection was defined by isolation of a pathogen from local sampling ...
14/01/2026

https://zurl.co/VxrlQ Peripheral ECMO cannula-site infection was defined by isolation of a pathogen from local sampling with purulent discharge or local inflammatory signs. When suspected, local sampling and peripheral blood cultures were recommended, with swabs or aspiration of purulent drainage preferred. Chlorhexidine-impregnated or transparent semipermeable polyurethane dressings were kept until day 7 unless soiled, and routine antibiotic prophylaxis was discouraged.

https://zurl.co/KhmxZ PEEP can raise PaO2 while reducing global oxygen delivery when cardiac output falls. In ARDS it en...
13/01/2026

https://zurl.co/KhmxZ PEEP can raise PaO2 while reducing global oxygen delivery when cardiac output falls. In ARDS it enlarges the baby lung by recruiting dependent regions but can also overdistend already aerated units and stabilise airways above the airway opening pressure. Its haemodynamic effects alter venous return, right ventricular afterload and left ventricular afterload, influencing end-organ perfusion.

https://zurl.co/46Rgz -Quizz Streptobacillus moniliformis, a fastidious Gram-negative rod linked to rodents, caused s...
13/01/2026

https://zurl.co/46Rgz -Quizz Streptobacillus moniliformis, a fastidious Gram-negative rod linked to rodents, caused septic shock with cervical and lumbar spondylodiscitis and compressive epiduritis. Growth occurred in anaerobic blood culture bottles; identification used MALDI-TOF and 16S rRNA PCR from the vertebral site. Aortic valve thickening suggested endocarditis. Severe presentation and precarious living conditions guided prompt targeted therapy.

-Quizz A 59-year-old homeless man presented in septic shock with extensive spondylodiscitis at C3–C4 and L5–S1. He ha...
12/01/2026

-Quizz A 59-year-old homeless man presented in septic shock with extensive spondylodiscitis at C3–C4 and L5–S1. He had no significant medical history and no prior medication use. Two anaerobic blood cultures became positive after 70 hours. MRI and microscopy findings are shown, and transoesophageal echocardiography revealed aortic valve thickening. What's your diagnosis?

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