Pub Date : 2026-03-13DOI: 10.1186/s13054-026-05865-6
Thomas Volpé, Nolan Hassold, Etienne de Montmollin, Claire Dupuis, Benjamine Sarton, Bertrand Guidet, Fabrice Bruneel, Charline Sazio, Russell Chabanne, Noelle Brulé, Ahmed El Kalioubie, Mikael Alves, Jean-Marc Tadié, Giuseppe Citerio, Raimund Helbok, Janneke Horn, Sophie Demeret, Pierre Bailly, Aurélien Frérou, Omar Ben Hadj Salem, Nicolas Engrand, Daniel da Silva, Jean-François Timsit, Romain Sonneville, Pierre Jaquet
{"title":"Herpes simplex virus type 2 encephalitis in critically ill adults: A retrospective analysis of EURECA and Herpetics cohort studies.","authors":"Thomas Volpé, Nolan Hassold, Etienne de Montmollin, Claire Dupuis, Benjamine Sarton, Bertrand Guidet, Fabrice Bruneel, Charline Sazio, Russell Chabanne, Noelle Brulé, Ahmed El Kalioubie, Mikael Alves, Jean-Marc Tadié, Giuseppe Citerio, Raimund Helbok, Janneke Horn, Sophie Demeret, Pierre Bailly, Aurélien Frérou, Omar Ben Hadj Salem, Nicolas Engrand, Daniel da Silva, Jean-François Timsit, Romain Sonneville, Pierre Jaquet","doi":"10.1186/s13054-026-05865-6","DOIUrl":"10.1186/s13054-026-05865-6","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-13DOI: 10.1186/s13054-026-05883-4
Baptiste Lafont Rapnouil, Marika Rudler, Laurent Renard Triché, Maxime Gasperment, Stéphane Gaudry, Philippe Ichai, Frédéric Pène, Arnaud Fekkar, Marion Blaize, Hafid Ait-Oufella, Marie Lecronier, Julien Mayaux, Valérie Pourcher, Alexandre Demoule, Maxens Decavèle
{"title":"Pneumocystis jirovecii pneumonia as an underrecognized cause of acute respiratory failure in severe alcohol-related hepatitis patients.","authors":"Baptiste Lafont Rapnouil, Marika Rudler, Laurent Renard Triché, Maxime Gasperment, Stéphane Gaudry, Philippe Ichai, Frédéric Pène, Arnaud Fekkar, Marion Blaize, Hafid Ait-Oufella, Marie Lecronier, Julien Mayaux, Valérie Pourcher, Alexandre Demoule, Maxens Decavèle","doi":"10.1186/s13054-026-05883-4","DOIUrl":"10.1186/s13054-026-05883-4","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"30 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-13DOI: 10.1186/s13054-025-05818-5
Charlotte Linz, Kristiyana Tsenova, Katja Dettmer, Lisa Ellmann, Peter J Oefner, Wolfram Gronwald, Fedja Farowski, Alina M Rüb, Daniel E Freedberg, Philipp Koehler, Jorge Garcia Borrega, Jan-Hendrik Naendrup, Maria J G T Vehreschild, Boris Böll
{"title":"Integrating intestinal microbiome and urinary metabolome data to predict secondary infection in critically ill patients.","authors":"Charlotte Linz, Kristiyana Tsenova, Katja Dettmer, Lisa Ellmann, Peter J Oefner, Wolfram Gronwald, Fedja Farowski, Alina M Rüb, Daniel E Freedberg, Philipp Koehler, Jorge Garcia Borrega, Jan-Hendrik Naendrup, Maria J G T Vehreschild, Boris Böll","doi":"10.1186/s13054-025-05818-5","DOIUrl":"https://doi.org/10.1186/s13054-025-05818-5","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-13DOI: 10.1186/s13054-026-05956-4
R M Roy, J J MacDonald, P M Dark, J P Paily, B G Keevil, D J Marshall, P A Kalra, D Green
{"title":"Ask not for whom the bell tolls: a meditation on the utility of serum creatinine on Critical Care.","authors":"R M Roy, J J MacDonald, P M Dark, J P Paily, B G Keevil, D J Marshall, P A Kalra, D Green","doi":"10.1186/s13054-026-05956-4","DOIUrl":"10.1186/s13054-026-05956-4","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"30 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12988626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-13DOI: 10.1186/s13054-026-05953-7
Felippe Leopoldo Dexheimer Neto, Flávia Gabe Beltrami, Antoine Villa, Eric Maury
{"title":"Correction: Revisiting subclavian access in the ultrasound era: are we comparing sites or techniques?","authors":"Felippe Leopoldo Dexheimer Neto, Flávia Gabe Beltrami, Antoine Villa, Eric Maury","doi":"10.1186/s13054-026-05953-7","DOIUrl":"10.1186/s13054-026-05953-7","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"30 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12988627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-12DOI: 10.1186/s13054-026-05861-w
Julia Almeida Oliveira, Fernanda Klein, Natália Godoy Guzatti, Ana Paula Fernandes Kojoroski, Herika de Vargas Ciello, David Junior da Silva, Jéssica Locatelli, Letícia Fiorelli da Silva, Marcella Parise, Arthur Vacchi Spörr, Wan Cley Rabuske, Gustavo Bruno Rático, Silvano Altair do Nascimento, Diego de Carvalho, João Rogério Nunes Filho, Antuani Rafael Baptistella
Background: Extubation failure occurs in 10-30% of critically ill patients who successfully complete a spontaneous breathing trial (SBT) and is associated with worse clinical outcomes. The Extubation Predictive Score (ExPreS) was developed to assist clinicians in identifying patients at risk for extubation failure; however, its effectiveness as a decision-support tool has not yet been evaluated in a randomized controlled trial. We aimed to determine whether the use of ExPreS reduces reintubation within 48 h in mechanically ventilated adults.
Methods: We conducted a single-center, parallel-group, prospective, randomized, controlled superiority trial in two ICUs of a Brazilian university hospital (November 2021-December 2024). Adults ventilated ≥ 24 h who passed an SBT were randomized (1:1) to extubation guided by a standard protocol or by the ExPreS algorithm (score range 0-100; eight clinical variables). The primary outcome was extubation failure, defined as reintubation within 48 h. Secondary outcomes included duration of mechanical ventilation, ICU length of stay, and ICU mortality.
Results: A total of 540 patients were randomized (267 control, 273 ExPreS). In the intention-to-treat analysis, extubation failure within 48 h occurred in 13.0% of patients in the control group and 8.0% in the ExPreS group (absolute risk reduction 5.0%; relative reduction 38%; p = 0.070). In the per-protocol analysis, extubation failure occurred in 12.9% of controls and 7.3% of ExPreS patients (absolute risk reduction 5.6%; relative reduction 43%; p = 0.042). In a post-hoc analysis excluding airway obstruction, failure was further reduced with ExPreS (3.4% vs. 9.1%; p = 0.011). No differences were observed in duration of mechanical ventilation, ICU length of stay, or ICU mortality.
Conclusion: In this randomized controlled trial, use of the Extubation Predictive Score (ExPreS) was associated with numerically lower rates of reintubation within 48 h compared with standard care, although the primary intention-to-treat analysis did not reach statistical significance. Secondary and exploratory analyses showed a consistent direction of effect. These findings should be interpreted cautiously and warrant confirmation in larger multicenter studies.
Trial registration: registered in ClinicalTrials.gov on October 07, 2021(NCT05085457).
背景：成功完成自主呼吸试验（SBT）的危重患者中有10-30%出现拔管失败，并且与较差的临床结果相关。开发拔管预测评分（ExPreS）是为了帮助临床医生识别有拔管失败风险的患者；然而，其作为决策支持工具的有效性尚未在随机对照试验中进行评估。我们的目的是确定使用express是否能减少机械通气成人48小时内的再插管次数。方法：我们于2021年11月至2024年12月在巴西某大学医院的两个icu进行了一项单中心、平行组、前瞻性、随机、对照优势试验。通过SBT的通气≥24 h的成人随机（1:1）在标准方案或express算法指导下拔管（评分范围0-100；8个临床变量）。主要结局是拔管失败，定义为48小时内重新插管。次要结局包括机械通气持续时间、ICU住院时间和ICU死亡率。结果：共540例患者被随机分组（对照组267例，快速组273例）。意向治疗分析中，对照组和ExPreS组48 h内拔管失败发生率分别为13.0%和8.0%（绝对风险降低5.0%，相对风险降低38%，p = 0.070）。在每个方案分析中，12.9%的对照组和7.3%的express患者拔管失败（绝对风险降低5.6%，相对风险降低43%，p = 0.042）。在排除气道阻塞的事后分析中，ExPreS进一步减少了失败（3.4% vs. 9.1%; p = 0.011）。在机械通气时间、ICU住院时间或ICU死亡率方面没有观察到差异。结论：在这项随机对照试验中，与标准治疗相比，拔管预测评分（ExPreS）的使用与48小时内再插管率的数值降低相关，尽管主要意向治疗分析没有达到统计学意义。二次分析和探索性分析显示了一致的影响方向。这些发现应谨慎解释，并在更大规模的多中心研究中得到证实。试验注册：于2021年10月7日在ClinicalTrials.gov注册（NCT05085457）。
{"title":"Effect of the extubation predictive score (ExPreS) on reintubation in the ICU: a randomized controlled trial.","authors":"Julia Almeida Oliveira, Fernanda Klein, Natália Godoy Guzatti, Ana Paula Fernandes Kojoroski, Herika de Vargas Ciello, David Junior da Silva, Jéssica Locatelli, Letícia Fiorelli da Silva, Marcella Parise, Arthur Vacchi Spörr, Wan Cley Rabuske, Gustavo Bruno Rático, Silvano Altair do Nascimento, Diego de Carvalho, João Rogério Nunes Filho, Antuani Rafael Baptistella","doi":"10.1186/s13054-026-05861-w","DOIUrl":"https://doi.org/10.1186/s13054-026-05861-w","url":null,"abstract":"<p><strong>Background: </strong>Extubation failure occurs in 10-30% of critically ill patients who successfully complete a spontaneous breathing trial (SBT) and is associated with worse clinical outcomes. The Extubation Predictive Score (ExPreS) was developed to assist clinicians in identifying patients at risk for extubation failure; however, its effectiveness as a decision-support tool has not yet been evaluated in a randomized controlled trial. We aimed to determine whether the use of ExPreS reduces reintubation within 48 h in mechanically ventilated adults.</p><p><strong>Methods: </strong>We conducted a single-center, parallel-group, prospective, randomized, controlled superiority trial in two ICUs of a Brazilian university hospital (November 2021-December 2024). Adults ventilated ≥ 24 h who passed an SBT were randomized (1:1) to extubation guided by a standard protocol or by the ExPreS algorithm (score range 0-100; eight clinical variables). The primary outcome was extubation failure, defined as reintubation within 48 h. Secondary outcomes included duration of mechanical ventilation, ICU length of stay, and ICU mortality.</p><p><strong>Results: </strong>A total of 540 patients were randomized (267 control, 273 ExPreS). In the intention-to-treat analysis, extubation failure within 48 h occurred in 13.0% of patients in the control group and 8.0% in the ExPreS group (absolute risk reduction 5.0%; relative reduction 38%; p = 0.070). In the per-protocol analysis, extubation failure occurred in 12.9% of controls and 7.3% of ExPreS patients (absolute risk reduction 5.6%; relative reduction 43%; p = 0.042). In a post-hoc analysis excluding airway obstruction, failure was further reduced with ExPreS (3.4% vs. 9.1%; p = 0.011). No differences were observed in duration of mechanical ventilation, ICU length of stay, or ICU mortality.</p><p><strong>Conclusion: </strong>In this randomized controlled trial, use of the Extubation Predictive Score (ExPreS) was associated with numerically lower rates of reintubation within 48 h compared with standard care, although the primary intention-to-treat analysis did not reach statistical significance. Secondary and exploratory analyses showed a consistent direction of effect. These findings should be interpreted cautiously and warrant confirmation in larger multicenter studies.</p><p><strong>Trial registration: </strong>registered in ClinicalTrials.gov on October 07, 2021(NCT05085457).</p>","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-12DOI: 10.1186/s13054-025-05753-5
Holly Jackson, Ana Catalina Hernandez Padilla, Lisanne E M Vintcent, Aleksandra Barac, Olaf Cremer, Thomas Daix, Jan J De Waele, Lorena Forcelledo, Olivier Barraud, Marc J M Bonten, Stephan Harbarth, Bruno Francois, C H van Werkhoven, Marlieke E A de Kraker
{"title":"Perpetual observational study of the clinical and microbiological epidemiology of ventilator-associated pneumonia in Europe.","authors":"Holly Jackson, Ana Catalina Hernandez Padilla, Lisanne E M Vintcent, Aleksandra Barac, Olaf Cremer, Thomas Daix, Jan J De Waele, Lorena Forcelledo, Olivier Barraud, Marc J M Bonten, Stephan Harbarth, Bruno Francois, C H van Werkhoven, Marlieke E A de Kraker","doi":"10.1186/s13054-025-05753-5","DOIUrl":"10.1186/s13054-025-05753-5","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"30 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号