Imaging and Pulmonary Function Techniques in ARDS In ICU Wed, 9 Jul 2025 Acute Respiratory Distress Syndrome (ARDS) is a complex and heterogeneous condition requiring precise diagnosis and personalised treatment based on a thorough assessment of lung structure and function. Traditional physiological measures, such as respiratory compliance, driving pressure, transpulmonary pressure, and mechanical power, offer valuable insights for guiding therapy. How...

JAMA Insights  Extracorporeal Life Support in Accidental Hypothermia Konrad Mendrala, Paweł Podsiadło, Tomasz Darocha JAMA Published Online: October 8, 2025 doi: 10.1001/jama.2025.14593 Definition, Classification, and Temperature Measurement Accidental hypothermia is defined as an unintentional core temperature of less than 35 °C (95 °F).1 Although commonly associated with exposure to extreme cold in outdoor settings, hypothermia can occur in a...

Longitudinal Ordinal Outcome for Clinical Trials in ECMO Patients In ICU Thu, 3 Jul 2025 Most critical care trials studying mortality have inconclusive results due to factors like ineffective interventions, small sample sizes, treatment heterogeneity, and unrealistic assumptions about effect sizes in power calculations. Determining sample size requires balancing statistical power with feasibility. Many ICU trials are underpowered, using mortality as th...

Prehospital Cricothyrotomy in Emergency Airway Management In ICU Thu, 3 Jul 2025 Cricothyrotomy, an emergency airway procedure through the cricoid membrane, has been used in emergency and prehospital settings since the 1980s. Due to its rarity and high risk of error, it is considered a high-risk, low-occurrence procedure. Understanding when EMS performs cricothyrotomy is crucial to improving training and prehospital airway care. Several studies have...

Environmental Sustainability in Intensive Care Medicine In ICU Thu, 3 Jul 2025 The climate crisis requires decarbonisation across all major emission sectors, including healthcare, which contributes 4–5% of global emissions due to its complex supply chains, high energy use, and waste. Ninety-three countries have committed under a WHO initiative to develop environmentally responsible health systems. Addressing healthcare emissions needs a multi-faceted e...

Reduced Plasma Volume Response to Crystalloid Fluid in Goal‑Directed Fluid Therapy In ICU Wed, 25 Jun 2025 Anaesthetists use fluids and drugs during surgery to maintain adequate tissue perfusion pressure and oxygenation. Goal-directed therapy (GDT) is a strategy aimed at optimising cardiovascular function and organ perfusion during the perioperative period by closely monitoring haemodynamic parameters such as cardiac output (CO), blood pressure, oxygen...

Pulse Oximetry for Predicting Clinical Deterioration in Sepsis In Sepsis Wed, 25 Jun 2025 Sepsis is a life-threatening condition caused by a dysregulated response to infection, leading to organ dysfunction and high mortality—about 10% overall and over 40% in septic shock cases. Early detection of patients at risk of deterioration in the emergency department (ED) is critical for timely treatment and appropriate patient disposition. Existing tools like t...

Editorial  A Revision to Organ Failure Assessment in Critically Ill Patients Christopher W. Seymour JAMA Published Online: October 29, 2025 doi: 10.1001/jama.2025.20255 Modern intensive care of critically ill patients is evolving. Nearly 1 in 5 hospitalized patients receive intensive care, and there are new diseases, treatments, and approaches to organ support. Many intensive care unit (ICU) patients develop acute, vital organ failure—a nefarious and u...

Editorial  Sodium Bicarbonate in Severe Acidemia and Acute Kidney Injury—Turning the Tide or Chasing a Myth? Prit Kusirisin, Fernando G. Zampieri, Sean M. Bagshaw JAMA Published Online: October 29, 2025 doi: 10.1001/jama.2025.20457 Severe acidemia commonly complicates critical illness.1 If unresolved or untreated, acidemia may exacerbate multiorgan dysfunction, prompt escalation in life support, and portend greater risk of adverse outcomes. Intravenous...

Editorial  Capillary Refill Time in Sepsis—Searching for the Holy Grail Flavia R. Machado, Matthew W. Semler JAMA Published Online: October 29, 2025 doi: 10.1001/jama.2025.20518 Almost 25 years ago, a landmark trial of early goal-directed therapy (EGDT) by Rivers and colleagues reshaped the care of septic shock by introducing the concept that “early” management was crucial.1 Although implementation has varied across high- and low-resource settings, the...