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/VR0DK Airway pressure and flow waveforms in volume-assist control ventilation give continuous bedside in...
11/03/2026

https://zurl.co/VR0DK Airway pressure and flow waveforms in volume-assist control ventilation give continuous bedside information on resistance, elastance and patient–ventilator interactions in passive patients. Conductive pressure, stress index and driving pressure help detect intrinsic PEEP, airway closure, intratidal recruitment or overdistension. A driving pressure above 14 cmH2O is associated with increased mortality.

https://zurl.co/aNuHI Eighty adult ECMO patients needing CRRT were randomised to integrated or separate circuits at tw...
11/03/2026

https://zurl.co/aNuHI Eighty adult ECMO patients needing CRRT were randomised to integrated or separate circuits at two Thai tertiary ICUs from May 2021 to March 2025. Median circuit lifespan was 72 h versus 71 h and 28-day mortality was 32.5% versus 35%. Access and return pressures were higher with integration, while transmembrane pressure, pressure drop, alarm frequency and serious adverse events were similar, with no air embolism.

https://zurl.co/zBPNA A secondary analysis of the TTM-2 trial linked pre-arrest frailty with more frequent withdrawal of...
10/03/2026

https://zurl.co/zBPNA A secondary analysis of the TTM-2 trial linked pre-arrest frailty with more frequent withdrawal of life-sustaining therapy, not always on neurological prognosis alone. Decisions also reflect comorbidity burden, baseline function, early non-neurological organ failure and patient values or caregiver input. In a registry study of over 2000 extracorporeal membrane oxygenation patients, 12.2% were frail yet frailty was not associated with greater 1-year mortality.

https://zurl.co/Ip5Ri Median proportional ABCDE bundle compliance was 97% in 566 critically ill adults recruited from 16...
10/03/2026

https://zurl.co/Ip5Ri Median proportional ABCDE bundle compliance was 97% in 566 critically ill adults recruited from 16 US medical centres from 2011 to 2017. Greater compliance was associated with lower 12-month Functional Activities Questionnaire scores and higher 12-month EuroQol-5D scores. No association was found with long-term cognition, mental health or survival.

https://zurl.co/ALgEQ Indirect bedside perfusion markers have limited ability to characterise tissue hypoxia mechanisms....
09/03/2026

https://zurl.co/ALgEQ Indirect bedside perfusion markers have limited ability to characterise tissue hypoxia mechanisms. Handheld vital microscopy enables bedside visualisation of microvascular blood flow and distinct shock patterns. Retinal optical coherence tomography angiography provides noninvasive maps of structure and perfusion with quantitative metrics.

https://zurl.co/PpLtq -Quizz Hepatic portal venous gas has surgical and non-surgical causes, with surgical cases ofte...
09/03/2026

https://zurl.co/PpLtq -Quizz Hepatic portal venous gas has surgical and non-surgical causes, with surgical cases often more benign. Differential diagnoses include intestinal ischaemia, GI infection, IBD, obstruction, endoscopy, surgery/trauma and bronchopneumonia. Intestinal ischaemia accounts for ~40% and has lower survival. Ultrasound may be more sensitive than CT, and point-of-care findings should trigger abdominal CT to identify the cause.

-Quizz A 39-year-old woman with undefined systemic autoinflammatory disease and pulmonary involvement was admitted to...
08/03/2026

-Quizz A 39-year-old woman with undefined systemic autoinflammatory disease and pulmonary involvement was admitted to the ICU with respiratory insufficiency from autoinflammatory pneumonitis exacerbation. She was intubated and treated with steroids, antibiotics and supportive care for paralytic ileus. On day 10, point-of-care lung ultrasound during clinical deterioration incidentally showed hepatic portal venous gas. What is the most likely cause?

https://zurl.co/k14De Observed immune profile changes occurred within 8-hour intervals and persisted across the ICU cour...
08/03/2026

https://zurl.co/k14De Observed immune profile changes occurred within 8-hour intervals and persisted across the ICU course. Reported transition rates were 41%, 39% and 22% across starting profiles. Limited temporal cohesion was reported with a Rand index of 0.65.

https://zurl.co/oxvH9 In 1555 patients with acute brain injury, higher time-varying dynamic driving pressure was linearl...
07/03/2026

https://zurl.co/oxvH9 In 1555 patients with acute brain injury, higher time-varying dynamic driving pressure was linearly associated with higher ICU, in-hospital and 6-month mortality. Severe brain injury or severe lung injury strengthened the association. Dynamic driving pressure was calculated as peak pressure minus set PEEP and required no inspiratory or expiratory holds.

https://zurl.co/diV4N Among 484,956 ICU admissions in Ontario from 2009–2021, 22% had AKI at admission. Compared with ...
07/03/2026

https://zurl.co/diV4N Among 484,956 ICU admissions in Ontario from 2009–2021, 22% had AKI at admission. Compared with no AKI, stage 1 had about 1.9-fold higher adjusted odds of 90-day death, while stages 2 and 3 had about 2.5-fold higher odds of similar magnitude. KRT dependence at 90 days among survivors increased from 0.3% with no AKI to 12.0% with stage 3 AKI. Median hospital stay among survivors increased from 8 to 15 days across the same range.

https://zurl.co/DHpOT Norepinephrine doses are titrated to arterial pressure targets, yet responses vary widely between ...
06/03/2026

https://zurl.co/DHpOT Norepinephrine doses are titrated to arterial pressure targets, yet responses vary widely between patients. Daily practice often involves either escalating norepinephrine alone or adding vasopressin earlier after reassessment of preload dependence and myocardial dysfunction. Hydrocortisone can reduce norepinephrine requirements at high doses, and angiotensin II lacks support for routine use.

https://zurl.co/YCCJb Observational data link mean arterial pressure below 60–70 mmHg to myocardial injury, acute kidney...
06/03/2026

https://zurl.co/YCCJb Observational data link mean arterial pressure below 60–70 mmHg to myocardial injury, acute kidney injury, and mortality after noncardiac surgery. Randomised trials show no outcome benefit from higher or individualised targets compared with routine care around 65 mmHg. Monitoring and automated vasopressor strategies reduce hypotension exposure, with outcome benefits unproven.

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