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...

Original Investigation  Critical Care Medicine Outcomes of Critically Ill Adult Patients With Acute Encephalitis Romain Sonneville, Camille Couffignal, Bertrand Souweine, et al JAMA Netw Open 2025;8;(9):e2532478. doi:10.1001/jamanetworkopen.2025.32478 Key Points Question  What are the long-term functional outcomes of adults with severe encephalitis, and how do recovery trajectories differ by cause of ence...

Cluster-randomized Controlled Trial of Enhanced Carbapenem-resistant Enterobacterales Prevention Program in General Medicine Wards, Siriraj Hospital Apiradee Taweesuk, Pinyo Rattanaumpawan, Siriporn Rachakhom, et al Clin Infect Dis ciaf523, https://doi.org/10.1093/cid/ciaf523 Published: 22 September 2025 Abstract Background Carbapenem-resistant Enterobacterales (CRE) colonization is a major risk factor for infection. Most Infection Prevention and Control...

Research Letter  Initial Antibiotic Selection Strategy and Subsequent Antibiotic Use—Insights From the INSPIRE Trials Shruti K. Gohil, Edward Septimus, Ken Kleinman, et al JAMA 2025;334;(12):1107-1109 doi:10.1001/jama.2025.11256 Four cluster-randomized trials have demonstrated that a stewardship bundle including real-time computerized provider order entry (CPOE) prompts safely reduced initial extended-spectrum antibiotic use by 17% to 35% among adult p...