Pub Date : 2026-03-12DOI: 10.1186/s13054-026-05946-6
Melanie Petrier, Debajyoti Sinha, Florian P Martin, Cecile Poulain, Delphine Flattres Duchaussoy, Athanasios Ziogas, Boris Novakovic, Laura Hurtado-Navarro, Anaísa V Ferreira, Joost H A Martens, Despoina Koulenti, Laia Fernández-Barat, Antoni Torres, Emmanuel Montassier, Mihai G Netea, Jeremie Poschmann, Antoine Roquilly
Aim: Our objective was to increase our understanding of the effects of the time course of metabolic alterations on the risk of hospital-acquired pneumonia (HAP) and response to treatment in critically ill patients.
Methods: We first studied the blood metabolome at day 1, day 3-4 and day 6-7 of patients from a prospective, observational cohort of brain-injured patients in two French centres. We classified the metabolic response by unsupervised longitudinal consensus clustering. To evaluate the robustness of metabolic patterns, a Fast-and-Frugal Tree trained on the discovery cohort was applied to a replication dataset from the PREV-HAP randomised clinical trial testing interferon gamma-1b for the prevention of HAP in critically ill patients. The primary outcome was the association of metabolic response patterns with HAP.
Findings: Of the 128 patients analysed (330 samples), 57 (45%) had developed HAP and 21 (16%) acute respiratory distress syndrome (ARDS). Based on metabolites involved in fatty acid metabolism, we identified three metabolic response patterns associated with the risks of HAP (24%, 60% and 78% of HAP, respectively) and ARDS (6%, 16% and 43%, respectively). In a replication dataset (315 samples from 105 patients), we found similarities regarding blood metabolite temporal courses and associations with HAP (18%, 28% and 40% of HAP, respectively). Moreover, the probability of being discharged alive from the ICU with interferon gamma-1b was decreased in patients with low-risk metabolic response patterns and increased in patients with high-risk metabolic response patterns.
Conclusions: Longitudinal clustering classified metabolic response patterns into low-, moderate-, and high-risk groups for HAP and can help identify responders and non-responders to interferon gamma-1b after a single treatment injection.
Trial registration: Number clinicaltrial.gov NCT02003196 and NCT04793568.
{"title":"Identification of a robust metabolic signature associated with hospital-acquired pneumonia and response to interferon-gamma treatment in critically ill patients.","authors":"Melanie Petrier, Debajyoti Sinha, Florian P Martin, Cecile Poulain, Delphine Flattres Duchaussoy, Athanasios Ziogas, Boris Novakovic, Laura Hurtado-Navarro, Anaísa V Ferreira, Joost H A Martens, Despoina Koulenti, Laia Fernández-Barat, Antoni Torres, Emmanuel Montassier, Mihai G Netea, Jeremie Poschmann, Antoine Roquilly","doi":"10.1186/s13054-026-05946-6","DOIUrl":"https://doi.org/10.1186/s13054-026-05946-6","url":null,"abstract":"<p><strong>Aim: </strong>Our objective was to increase our understanding of the effects of the time course of metabolic alterations on the risk of hospital-acquired pneumonia (HAP) and response to treatment in critically ill patients.</p><p><strong>Methods: </strong>We first studied the blood metabolome at day 1, day 3-4 and day 6-7 of patients from a prospective, observational cohort of brain-injured patients in two French centres. We classified the metabolic response by unsupervised longitudinal consensus clustering. To evaluate the robustness of metabolic patterns, a Fast-and-Frugal Tree trained on the discovery cohort was applied to a replication dataset from the PREV-HAP randomised clinical trial testing interferon gamma-1b for the prevention of HAP in critically ill patients. The primary outcome was the association of metabolic response patterns with HAP.</p><p><strong>Findings: </strong>Of the 128 patients analysed (330 samples), 57 (45%) had developed HAP and 21 (16%) acute respiratory distress syndrome (ARDS). Based on metabolites involved in fatty acid metabolism, we identified three metabolic response patterns associated with the risks of HAP (24%, 60% and 78% of HAP, respectively) and ARDS (6%, 16% and 43%, respectively). In a replication dataset (315 samples from 105 patients), we found similarities regarding blood metabolite temporal courses and associations with HAP (18%, 28% and 40% of HAP, respectively). Moreover, the probability of being discharged alive from the ICU with interferon gamma-1b was decreased in patients with low-risk metabolic response patterns and increased in patients with high-risk metabolic response patterns.</p><p><strong>Conclusions: </strong>Longitudinal clustering classified metabolic response patterns into low-, moderate-, and high-risk groups for HAP and can help identify responders and non-responders to interferon gamma-1b after a single treatment injection.</p><p><strong>Trial registration: </strong>Number clinicaltrial.gov NCT02003196 and NCT04793568.</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":"147442503","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 : 2026-03-11DOI: 10.1186/s13054-026-05940-y
Moritz Flick, Sebastian Schmid, Fabian Müller-Graf, Amelie Zitzmann, Bettina Jungwirth, Kristina Fuest, Catherina Bubb, Maria Fischer, Thorsten Annecke, Lilay Kidane, Dominik Jarczak, Linda Krause, Sebastian Rehberg, Bernd Saugel, Daniel A Reuter
{"title":"Impaired tissue perfusion in high-risk patients having major abdominal surgery: a multicenter observational study.","authors":"Moritz Flick, Sebastian Schmid, Fabian Müller-Graf, Amelie Zitzmann, Bettina Jungwirth, Kristina Fuest, Catherina Bubb, Maria Fischer, Thorsten Annecke, Lilay Kidane, Dominik Jarczak, Linda Krause, Sebastian Rehberg, Bernd Saugel, Daniel A Reuter","doi":"10.1186/s13054-026-05940-y","DOIUrl":"https://doi.org/10.1186/s13054-026-05940-y","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431318","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 : 2026-03-11DOI: 10.1186/s13054-026-05933-x
Imran Khawaja, Naga Sumanth R Gopireddy, Sahil Grover, Gwyndolyn Radford, Mony Fraer, Jonathan M Nizar, Benjamin R Griffin
{"title":"Albumin-corrected calcium ratios for citrate accumulation increase detection and improve mortality prediction in continuous kidney replacement therapy.","authors":"Imran Khawaja, Naga Sumanth R Gopireddy, Sahil Grover, Gwyndolyn Radford, Mony Fraer, Jonathan M Nizar, Benjamin R Griffin","doi":"10.1186/s13054-026-05933-x","DOIUrl":"10.1186/s13054-026-05933-x","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"30 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431305","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 : 2026-03-11DOI: 10.1186/s13054-026-05900-6
Hergen Buscher, Le Thi Phuong Thao, Gennaro Martucci, Johannes Gratz, Georg Trummer, Matthieu Schmidt, Melchior Gautier, Alexis Serra, Koji Takeda, Jan-Steffen Pooth, Kevin Rahn, Florian Geismann, Matthias Lubnow, Andrew Retter, Priya Nair, Ruan Vlok, Maithri Siriwardena, James Winearls, James Walsham, David Gattas, Anders Aneman, Bentley Fulcher, Sally Newman, Claire Reynolds, Anthonio Arcadipane, Kiran Shekar, Zoe McQuilten, Carol Hodgson, Vincent Pellegrino, Thomas Mueller, Daniel Brodie
{"title":"Major haemorrhage and blood product utilisation in patients receiving VA ECMO for cardiogenic shock: a multicentre observational study (OBLEX).","authors":"Hergen Buscher, Le Thi Phuong Thao, Gennaro Martucci, Johannes Gratz, Georg Trummer, Matthieu Schmidt, Melchior Gautier, Alexis Serra, Koji Takeda, Jan-Steffen Pooth, Kevin Rahn, Florian Geismann, Matthias Lubnow, Andrew Retter, Priya Nair, Ruan Vlok, Maithri Siriwardena, James Winearls, James Walsham, David Gattas, Anders Aneman, Bentley Fulcher, Sally Newman, Claire Reynolds, Anthonio Arcadipane, Kiran Shekar, Zoe McQuilten, Carol Hodgson, Vincent Pellegrino, Thomas Mueller, Daniel Brodie","doi":"10.1186/s13054-026-05900-6","DOIUrl":"https://doi.org/10.1186/s13054-026-05900-6","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431276","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 : 2026-03-10DOI: 10.1186/s13054-026-05948-4
Toufik Kamel, Thierry Boulain
{"title":"Augmenting the Simplified Acute Physiology Score II for intensive care unit mortality prediction and benchmarking: a French nationwide study.","authors":"Toufik Kamel, Thierry Boulain","doi":"10.1186/s13054-026-05948-4","DOIUrl":"https://doi.org/10.1186/s13054-026-05948-4","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431238","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 : 2026-03-10DOI: 10.1186/s13054-026-05941-x
Mattia M Müller, Sascha David
{"title":"Challenging the citrate challenge: why we need global criteria to define citrate accumulation.","authors":"Mattia M Müller, Sascha David","doi":"10.1186/s13054-026-05941-x","DOIUrl":"10.1186/s13054-026-05941-x","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"30 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12977412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431335","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 : 2026-03-10DOI: 10.1186/s13054-026-05930-0
Joaquin Pérez, Javier H Dorado, Ramiro Bragagnolo, Ana Rivera, Matias Accoce, Laurent Brochard
{"title":"End-inspiratory pause enhances ventilation efficiency without increasing autoPEEP in patients with COPD during controlled ventilation.","authors":"Joaquin Pérez, Javier H Dorado, Ramiro Bragagnolo, Ana Rivera, Matias Accoce, Laurent Brochard","doi":"10.1186/s13054-026-05930-0","DOIUrl":"https://doi.org/10.1186/s13054-026-05930-0","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431330","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 : 2026-03-09DOI: 10.1186/s13054-026-05897-y
Megan E Chung, Ashley E Choi, Louise Y Sun
{"title":"Perception of sex and race diversity in critical care medicine by generative AI: biases, measurement and implications.","authors":"Megan E Chung, Ashley E Choi, Louise Y Sun","doi":"10.1186/s13054-026-05897-y","DOIUrl":"10.1186/s13054-026-05897-y","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"30 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375785","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 : 2026-03-09DOI: 10.1186/s13054-026-05943-9
H W Zijlstra, F Sombogaard, W-P Manubulu-Choo
{"title":"Vancomycin trough levels: it's not one-size-fits-all.","authors":"H W Zijlstra, F Sombogaard, W-P Manubulu-Choo","doi":"10.1186/s13054-026-05943-9","DOIUrl":"10.1186/s13054-026-05943-9","url":null,"abstract":"","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"30 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389684","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}
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