Original Investigation  Caring for the Critically Ill Patient Development and Validation of the Sequential Organ Failure Assessment (SOFA)-2 Score Otavio T. Ranzani, Mervyn Singer, Jorge I. F. Salluh, et al JAMA Published Online: October 29, 2025 doi: 10.1001/jama.2025.20516 Key Points Question  Does an updated Sequential Organ Failure Assessment (SOFA)-2 score describe organ dysfunction in critically ill patients and its association wi...

Original Investigation  Caring for the Critically Ill Patient Sodium Bicarbonate for Severe Metabolic Acidemia and Acute Kidney Injury: The BICARICU-2 Randomized Clinical Trial Boris Jung, Mathieu Jabaudon, Audrey De Jong, et al JAMA Published Online: October 29, 2025 doi: 10.1001/jama.2025.20231 Key Points Question  For patients with severe metabolic acidosis and moderate to severe acute kidney injury, does sodium bicarbonate infusion ...

Original Investigation  Caring for the Critically Ill Patient Personalized Hemodynamic Resuscitation Targeting Capillary Refill Time in Early Septic Shock: The ANDROMEDA-SHOCK-2 Randomized Clinical Trial The ANDROMEDA-SHOCK-2 Investigators for the ANDROMEDA Research Network, Spanish Society of Anesthesiology, Reanimation and Pain Therapy (SEDAR), and Latin American Intensive Care Network (LIVEN) JAMA Published Online: October 29, 2025 doi: 10.1001/jama...

ORIGINAL ARTICLE Deferring Arterial Catheterization in Critically Ill Patients with Shock Grégoire Muller, Damien Contou, Stephan Ehrmann, et al N Engl J Med Published October 29, 2025 DOI: 10.1056/NEJMoa2502136 Abstract BACKGROUND In patients with shock, whether noninvasive blood-pressure monitoring is an effective alternative to the recommended use of an arterial catheter is uncertain. METHODS In this multicenter, open-label, noninferiority tr...

ORIGINAL ARTICLE A Pragmatic Trial of Glucocorticoids for Community-Acquired Pneumonia Ruth K. Lucinde, Henry Gathuri, B.Sc., Paul Mwaniki, et al N Engl J Med Published October 29, 2025 DOI: 10.1056/NEJMoa2507100 Abstract BACKGROUND Adjunctive glucocorticoids may reduce mortality among patients with severe community-acquired pneumonia (CAP) in well-resourced settings. Whether these drugs are beneficial in low-resource settings with limited diagnostic ...

ORIGINAL ARTICLE Selective Decontamination of the Digestive Tract during Ventilation in the ICU The SuDDICU Investigators for the Australia and New Zealand Intensive Care Society Clinical Trials Group and the Canadian Critical Care Trials Group N Engl J Med Published October 29, 2025 DOI: 10.1056/NEJMoa2506398 Abstract BACKGROUND Whether selective decontamination of the digestive tract (SDD) reduces mortality among patients undergoing mechanical venti...

Article Heterogeneity in the response to a high vs low mean arterial pressure target in patients with septic shock: a post hoc analysis of a randomized controlled trial Pirracchio R, Fong N, Legrand M. Intensive Care Med (2025). https://doi.org/10.1007/s00134-025-08104-8riginal Abstract Background The best blood pressure target in sepsis is a matter of debate. SEPSIS-PAM, a large multicenter pragmatic randomized controlled trial, compared two mean arteri...

Article Hemodynamic and neurological presentations of invasive meningococcal disease in adults: a nationwide study across 100+ French ICUs: The RETRO-MENINGO study Damien Contou, Benoit Painvin, Delphine Daubin, et al Intensive Care Med 2025; 51: 1587-1602 Abstract Purpose Invasive meningococcal disease (IMD) is a rare but potentially fatal infection caused by Neisseria meningitidis. In adults requiring admission to intensive care unit (ICU), I...

Articles Imbalance between muscle strength development and weight gain in children and young adults in China: serial cross-sectional evidence from 1.33 million students from five successive national surveys between 2000 and 2019 Xijie Wang, Huan Wang, Xin Yuan, et al Lancet Regional Health - Western Pacific 2025; 61: 101640 Summary Background Over the past decades, Chinese school-aged children and adolescents have experienced a rapid increase in overweig...

EDUCATION AND CLINICAL PRACTICE: ORIGINAL RESEARCH Impact of COVID-19 on Pulmonary Critical Care Fellows In-Training Exam Performance: A National Study Mahmoud Alwakeel, Paru Patrawalla, Brian Carlin, et al Chest 2025; 168: 710-718 Abstract Background Between 2020 and 2022, the COVID-19 pandemic disrupted health and education. Many training institutions modified trainees’ rotations, decreasing outpatient clinics while increasing inpatient and ICU time. U...