In PEEP-PIC data, similar PEEP increases were linked to smaller ICP rises in traumatic brain injury than in non-traumatic acute brain injury. zurl.co/sdS1h

#ICM-Quizz #MedEd Nonketotic hyperglycemic hemichorea is a rare basal ganglia disorder from uncontrolled type 2 diabetes. CT or T1-MRI supports diagnosis, and treating hyperglycemia, often with clonazepam, can resolve involuntary movements. zurl.co/Vd3Rk

#ICM-Quizz #MedEd An 81-year-old woman developed sudden right-sided involuntary movements and confusion. Glucose was 21.97 mmol/L without ketones. CT showed left lentiform hyperdensity with matching T1 MRI hyperintensity. What's your diagnosis?

EEG burst suppression during anaesthesia or ICU sedation can signal oversedation and is associated with postoperative delirium and increased mortality, supporting processed EEG monitoring to avoid unnecessary cerebral suppression. zurl.co/BS421

Acute brain injury spans traumatic brain injury, intracerebral haemorrhage, subarachnoid haemorrhage and ischaemic stroke, and PEEP can affect intracranial pressure, cerebral perfusion pressure and cerebral blood flow. zurl.co/NRUL0

#VisualAbstract Pre-arrest frailty was linked to higher mortality and poorer functional outcomes after out-of-hospital cardiac arrest, with frail survivors more likely to report functional decline and lower health status. zurl.co/XFFGB

Stepwise fluid therapy balances correction of hypoperfusion against the risk of fluid overload through resuscitation, optimisation, stabilisation and de-resuscitation. zurl.co/dSepj

Intermittent haemodialysis declined while continuous renal replacement therapy became increasingly common in French ICUs between 2008 and 2019. zurl.co/T3d1q

#VisualAbstract Current management of septic shock combines early recognition, judicious balanced crystalloid resuscitation, timely vasopressors and antibiotics, source control and strategies to limit long-term physical, cognitive and psychological sequelae. zurl.co/41xXm

Older adults have accounted for more than half of ICU patient-days for the past 25 years. Frailty, disability in functional activities and multimorbidity are more strongly associated with ICU and post-ICU outcomes than chronological age. zurl.co/uDvbi

Kidney biomarkers for early AKI detection and RRT prediction show uncertain bedside value under standardised RRT criteria. zurl.co/ZzKIj

ARDS care centres on early recognition, lung-protective ventilation with individualised PEEP and prone positioning, with close monitoring and selective use of non-invasive supports, neuromuscular blockade, steroids and conservative fluids. zurl.co/j1JDG

#VisualAbstract A six-step ICU roadmap for acute disorders of consciousness covers recognition, confounder management, serial behavioural assessment, supportive care and early rehabilitation, multimodal prognostication and family communication. zurl.co/F15Is

Ventilator weaning was longer in Guillain–Barré syndrome than in myasthenia gravis, with high reintubation but mortality below 10%. zurl.co/hCIVo

In-hospital mortality among ICU patients with sepsis in Australia and New Zealand fell from 28% in 2000 to 13% in 2023, with a nadir of 11% in 2020. zurl.co/G97yH

Pv-aCO2 and Pv-aCO2/Ca-vO2-guided resuscitation showed no outcome benefit in trials and can be costly and logistically burdensome in resource-limited ICUs. zurl.co/1fX8m

#ICM-Quizz #MedEd Fungus balls are mycelial clumps in the bladder, ureter or renal pelvis. They can obstruct urine and cause acute kidney injury. Diagnosis is imaging-based; treatment combines endoscopic/surgical removal with systemic antifungals. zurl.co/HEWTi

#ICM-Quizz #MedEd Which of the following statements is true regarding urinary fungus balls?

Non-infectious causes can mimic CAP in the ICU, and BAL cytology can aid diagnosis. zurl.co/2j24z

A four-week ICU communication bundle reduced reported burnout to 52.2% versus 63.3% with usual care. zurl.co/7yLAR

Proton pump inhibitors and H2-receptor antagonists reduce upper gastrointestinal bleeding risk in critically ill ICU adults, with little to no difference in mortality or nosocomial infections. zurl.co/t4PeA

Composite ICU endpoints combining agitation, delirium and intubation can obscure which pathway drives an observed treatment effect. zurl.co/dnvrD

Multimodal haemodynamic assessment is emphasised for circulatory shock using capillary refill time, oxygenation variables, dynamic fluid responsiveness indices and echocardiography. zurl.co/RxHUT

A six-step ICU roadmap for acute disorders of consciousness covers recognition, confounder management, serial behavioural assessment, supportive care and early rehabilitation, multimodal prognostication and family communication. zurl.co/6tP5s

Digital twins of acute hypoxemic respiratory failure and sepsis showed bi-flow high-flow nasal cannula (50/30 L/min) reduced pleural pressure swing and lowered lung stress and mechanical power versus uni-flow 30 or 50 L/min. zurl.co/z1M29

Modified cardiac power output using pulse pressure rather than mean arterial pressure predicts successful weaning from veno-arterial ECMO in cardiogenic shock more accurately than conventional cardiac power output. zurl.co/Ou48c

#VisualAbstract ICU-acquired weakness is common; protocolised active rehabilitation helps, while higher enteral protein alone shows no outcome benefit. Priorities include early prognostic markers, better diagnostics and personalised care. zurl.co/tHuMp

Transcriptomic phenotyping of Ugandan sepsis cohorts reveals a high-risk immune activation pattern that nearly doubles 60-day mortality and supports development of simple gene panels for precision sepsis care in resource-limited settings. zurl.co/XuqCT

Melatonin shows biological promise for ICU delirium, but large trials such as DEMEL, Pro-MEDIC and MELLOW report no reduction in delirium incidence during mechanical ventilation. zurl.co/7XZ36

Pre-arrest frailty strongly predicts mortality and poor long-term outcomes after out-of-hospital cardiac arrest, yet decisional bias and withdrawal of life-sustaining therapy may turn frailty assessment into a self-fulfilling prophecy. zurl.co/v47D4

#ICM-Quizz #MedEd Hypervirulent Klebsiella pneumoniae can cause liver abscesses, sepsis and endophthalmitis, often in newly diagnosed diabetics. Delayed recognition risks irreversible blindness and high mortality. zurl.co/NWjcS

#ICM-Quizz #MedEd A 55-year-old man with new-onset diabetes is admitted to the ICU in septic shock after three days of fever and sudden left-eye blindness. Imaging shows lung and liver lesions with signs of endophthalmitis. What’s your diagnosis?

The authors reaffirm the value of MAKE as a composite endpoint after severe AKI, highlighting substantial chronic kidney disease progression and new-onset CKD, while recognising competing-risk and kidney-specific analyses as complementary tools. zurl.co/Jh7FW

Current management of septic shock combines early recognition, judicious balanced crystalloid resuscitation, timely vasopressors and antibiotics, source control and strategies to limit long-term physical, cognitive and psychological sequelae. zurl.co/L4ftY

Protective ventilation strategies that limit driving pressure, optimise PEEP, use prone positioning and reduce ventilatory frequency aim to minimise atelectrauma in severe ARDS. zurl.co/w5LQD

#VisualAbstract Across nine ICUs, a double-blind RCT found dexmedetomidine beat placebo in non-intubated hyperactive delirium, improving a composite outcome and shortening agitation by about one hour. zurl.co/tRrmF

The authors outline ten ethical challenges in donation after circulatory death and offer practical recommendations to support transparent, compassionate and ethically robust DCD practice for patients, families and intensive care teams. zurl.co/hhQf1

Biomarker-based immune profiles in sepsis show frequent reclassification within hours, challenging the reliability of discrete endotypes for targeted treatment. zurl.co/CcweP

Cardiogenic shock is reframed as a heterogeneous, time-critical syndrome, where multimodal assessment, careful use of mechanical circulatory support and biomarker-guided phenotyping aim to enable more precise, outcome-focused critical care. zurl.co/Bkx5h

#VisualAbstract A German population-wide cohort shows that older ICU survivors have higher five-year mortality and greater risk of functional decline than their peers, with the greatest impact seen in previously fit adults aged 60–79 years. zurl.co/nn6dQ

The authors highlight contrasting weaning challenges in Guillain–Barré syndrome and myasthenia gravis, stressing the importance of timing, repeated vital capacity assessment and tailored spontaneous breathing trials. zurl.co/rNbjm

In French ICUs, use of renal replacement therapy for acute kidney injury declined over 12 years, while overall ICU mortality fell and practice shifted from intermittent to continuous modalities. zurl.co/xpSnE

#ICM-Quizz #MedEd Relapsing polychondritis is a rare, immune-mediated disease marked by recurrent inflammation of cartilage, with airway involvement that may become life-threatening and complicate early diagnosis for intensivists. zurl.co/PvgeL

#ICM-Quizz #MedEd A 50-year-old woman with severe asthma, tracheal stenosis and diffuse airway inflammation was admitted to ICU for acute respiratory failure. Imaging and bronchoscopy revealed significant airway involvement. What's your diagnosis?

Researchers highlight clinical biomarkers as tools to diagnose delirium after cardiac surgery, reporting three neuronally expressed proteins linked to postoperative delirium and an international cohort study to confirm their diagnostic value. zurl.co/9Jk9Q

Large language models can speed up screening and data extraction in critical care systematic reviews, reducing workload while keeping clinicians in charge of complex judgements and ethical oversight. zurl.co/dkIg7

Reduced monocyte HLA-DR in septic shock is linked to mortality and ICU-acquired infections, especially when it persists beyond the first days, supporting its use for severity stratification and guiding immunomodulatory strategies. zurl.co/N7Guo

#VisualAbstract ESICM’s 2025 guidance delivers 50 statements on shock diagnosis and monitoring, highlighting capillary refill, serial venous oxygenation, fluid responsiveness, arterial lines, cardiac output tracking and first-line echocardiography. zurl.co/invjr

A calcium-free dialysate technique provides regional anticoagulation for high bleeding risk ICU patients needing intermittent hemodialysis, with low circuit clotting rates and an alternative to heparin-coated membranes or systemic heparin. zurl.co/J7Tty

Low-dose norepinephrine at extubation appears safe in obese and non-obese ICU patients, challenging the practice of delaying weaning until all vasopressors are stopped. zurl.co/8nE3A