Pub Date : 2026-01-22DOI: 10.1016/j.jcrc.2026.155454
Yaojun Zhou, Hongling Zhu, Yanyuan Zhang, Shunsheng Wang
{"title":"Letter to the editor: “Different microcirculatory patterns in patients with COVID-19 and non-COVID-19 ARDS: A multicenter cross-sectional study”","authors":"Yaojun Zhou, Hongling Zhu, Yanyuan Zhang, Shunsheng Wang","doi":"10.1016/j.jcrc.2026.155454","DOIUrl":"10.1016/j.jcrc.2026.155454","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155454"},"PeriodicalIF":2.9,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1016/j.jcrc.2026.155463
Yujia Lai
Prendergast and colleagues developed a prediction rule for sedative-associated delirium in mechanically ventilated patients, with good discriminatory ability (AUROC 0.83 in derivation, 0.70 in validation). However, we suggest three improvements: First, the model should specify the decision timepoint, as sedation is frequently adjusted after intubation. Second, using cumulative doses alone may not fully reflect sedation strategies, and incorporating sedation depth (e.g., Richmond Agitation-Sedation Scale) could enhance its relevance. Third, the tool's transportability depends on the delirium assessment method. Recalibration methods, such as adjusting intercepts and slopes, should be considered to ensure consistent performance across settings. Incorporating sedation regimen choices, such as dexmedetomidine versus lorazepam, would also improve clinical applicability. These refinements could strengthen the model's role as a decision-support tool for individualized sedation management.
{"title":"Letter to the editor: Derivation and validation of a prediction rule for sedative-associated delirium during acute respiratory failure requiring mechanical ventilation","authors":"Yujia Lai","doi":"10.1016/j.jcrc.2026.155463","DOIUrl":"10.1016/j.jcrc.2026.155463","url":null,"abstract":"<div><div>Prendergast and colleagues developed a prediction rule for sedative-associated delirium in mechanically ventilated patients, with good discriminatory ability (AUROC 0.83 in derivation, 0.70 in validation). However, we suggest three improvements: First, the model should specify the decision timepoint, as sedation is frequently adjusted after intubation. Second, using cumulative doses alone may not fully reflect sedation strategies, and incorporating sedation depth (e.g., Richmond Agitation-Sedation Scale) could enhance its relevance. Third, the tool's transportability depends on the delirium assessment method. Recalibration methods, such as adjusting intercepts and slopes, should be considered to ensure consistent performance across settings. Incorporating sedation regimen choices, such as dexmedetomidine versus lorazepam, would also improve clinical applicability. These refinements could strengthen the model's role as a decision-support tool for individualized sedation management.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155463"},"PeriodicalIF":2.9,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-21DOI: 10.1016/j.jcrc.2026.155438
N.A. Shah , S. Kotwal , M. Ostermann , N. Hammond , M. Gallagher
Purpose
Acute kidney injury (AKI) affects ∼10–15% of hospital admissions in high-income countries and is associated with morbidity, mortality, and costs. Despite this burden, targeted therapies remain lacking, and randomised controlled trials have been slow to accommodate precision medicine. We evaluated temporal changes in the composition of kidney-related basic science research and the implications for AKI treatment development.
Materials and methods
We conducted a mapping review of kidney research publications indexed in EMBASE from 1 January 2013 to 31 December 2024. Publications were classified as basic science and further categorised as AKI-related, mechanistic, or therapeutic. Annual publication counts and proportions were summarised descriptively, and simple regression models were used to assess temporal trends.
Results
Total kidney research output increased over time (r = 0.86, r2 = 0.75, β1 = 1439.6, p < 0.001), while the proportion classified as basic science declined (r = −0.85, r2 = 0.72, β1 = −0.21, p < 0.001). In contrast, the share of AKI-focused basic science rose markedly (r = 0.99, r2 = 0.98, β1 = 0.54, p < 0.001), with substantial growth in mechanistic (r = 0.94, r2 = 0.89, β1 = 0.88, p < 0.001) and therapeutic studies (r = 0.96, r2 = 0.93, β1 = 0.96, p < 0.001).
Conclusions
Overall kidney research is expanding, with increasing emphasis on AKI discovery science and a growing mechanistic and therapeutic pipeline. These trends support investment in trial infrastructure—such as adaptive platform trials capable of testing multiple, biomarker-enriched therapies—to accelerate translation into clinical practice.
{"title":"Eye on AKI - Are shifting trends the cue for a platform clinical trial?","authors":"N.A. Shah , S. Kotwal , M. Ostermann , N. Hammond , M. Gallagher","doi":"10.1016/j.jcrc.2026.155438","DOIUrl":"10.1016/j.jcrc.2026.155438","url":null,"abstract":"<div><h3>Purpose</h3><div>Acute kidney injury (AKI) affects ∼10–15% of hospital admissions in high-income countries and is associated with morbidity, mortality, and costs. Despite this burden, targeted therapies remain lacking, and randomised controlled trials have been slow to accommodate precision medicine. We evaluated temporal changes in the composition of kidney-related basic science research and the implications for AKI treatment development.</div></div><div><h3>Materials and methods</h3><div>We conducted a mapping review of kidney research publications indexed in EMBASE from 1 January 2013 to 31 December 2024. Publications were classified as basic science and further categorised as AKI-related, mechanistic, or therapeutic. Annual publication counts and proportions were summarised descriptively, and simple regression models were used to assess temporal trends.</div></div><div><h3>Results</h3><div>Total kidney research output increased over time (<em>r</em> = 0.86, r<sup>2</sup> = 0.75, β1 = 1439.6, <em>p</em> < 0.001), while the proportion classified as basic science declined (<em>r</em> = −0.85, r<sup>2</sup> = 0.72, β1 = −0.21, <em>p</em> < 0.001). In contrast, the share of AKI-focused basic science rose markedly (<em>r</em> = 0.99, r<sup>2</sup> = 0.98, β1 = 0.54, <em>p</em> < 0.001), with substantial growth in mechanistic (<em>r</em> = 0.94, r<sup>2</sup> = 0.89, β1 = 0.88, p < 0.001) and therapeutic studies (<em>r</em> = 0.96, r<sup>2</sup> = 0.93, β1 = 0.96, p < 0.001).</div></div><div><h3>Conclusions</h3><div>Overall kidney research is expanding, with increasing emphasis on AKI discovery science and a growing mechanistic and therapeutic pipeline. These trends support investment in trial infrastructure—such as adaptive platform trials capable of testing multiple, biomarker-enriched therapies—to accelerate translation into clinical practice.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155438"},"PeriodicalIF":2.9,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-21DOI: 10.1016/j.jcrc.2026.155437
Laura Przybylski , Rafaela Rech , Duane Mocellin , Gabriela Soares Rech , Aline Paula Miozzo , Jennifer de Souza Menna Barreto , Emelyn de Souza Roldão , Rosa da Rosa Minho dos Santos , Marciane Maria Rover , Gabriel Pozza Estivalete , Raíne Fogliati de Carli Schardosin , Christian Moraes Soares , Hellen Luiza Moreira dos Santos , Geraldine Trott , Gabrielle Nunes da Silva , Denise de Souza , Carolina Rothmann Itaqui , Vanessa Maziero Oliveira , Rafael de Souza , Cesar Eduardo Pimentel Ferreira , Regis Goulart Rosa
Purpose
To evaluate the incidence and factors associated with oropharyngeal dysphagia (OD) three months after intensive care unit (ICU) discharge in patients who underwent invasive mechanical ventilation (IMV).
Methods
This was a post-hoc analysis of a prospective multicenter cohort study conducted across ten clinical–surgical ICUs in Brazil. Adult survivors (age > 18 years) with ICU stays ≥72 h and who needed IMV were included. The primary outcome was the incidence of OD, assessed by the Functional Oral Intake Scale (FOIS) during structured telephone interviews. Secondary outcomes included quality of life, measured by the Short Form Health Survey version 2, and rehospitalization.
Results
Among 360 patients, the incidence of OD 3 months after ICU discharge was 24.17%. Educational attainment (adjusted risk ratio [aRR] per 1 year increase, 0.95; 95% confidence interval [CI] 0.92–0.99), risk of death at ICU admission (aRR per 1% increase, 1.99; 95% CI, 1.06–3.77), acute respiratory distress syndrome [ARDS] diagnosis at ICU admission (aRR, 0.21; 95% CI, 0.06–0.71), and length of mechanical ventilation (aRR per 1 day increase, 1.02; 95%CI, 1.01–1.03) were associated with OD. Patients with OD reported significantly worse physical and mental quality-of-life scores. The incidence of rehospitalization did not differ significantly between patients with and without OD.
Conclusions
OD 3 months after ICU discharge is a common condition among ICU survivors who required IMV. Educational level, severity of illness at ICU admission, ARDS diagnosis at ICU admission, and length of mechanical ventilation are key associated variables.
{"title":"Factors associated with oropharyngeal dysphagia 3 months after ICU discharge in patients undergoing invasive mechanical ventilation: A post-hoc analysis of a Brazilian multicenter prospective cohort study","authors":"Laura Przybylski , Rafaela Rech , Duane Mocellin , Gabriela Soares Rech , Aline Paula Miozzo , Jennifer de Souza Menna Barreto , Emelyn de Souza Roldão , Rosa da Rosa Minho dos Santos , Marciane Maria Rover , Gabriel Pozza Estivalete , Raíne Fogliati de Carli Schardosin , Christian Moraes Soares , Hellen Luiza Moreira dos Santos , Geraldine Trott , Gabrielle Nunes da Silva , Denise de Souza , Carolina Rothmann Itaqui , Vanessa Maziero Oliveira , Rafael de Souza , Cesar Eduardo Pimentel Ferreira , Regis Goulart Rosa","doi":"10.1016/j.jcrc.2026.155437","DOIUrl":"10.1016/j.jcrc.2026.155437","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the incidence and factors associated with oropharyngeal dysphagia (OD) three months after intensive care unit (ICU) discharge in patients who underwent invasive mechanical ventilation (IMV).</div></div><div><h3>Methods</h3><div>This was a post-hoc analysis of a prospective multicenter cohort study conducted across ten clinical–surgical ICUs in Brazil. Adult survivors (age > 18 years) with ICU stays ≥72 h and who needed IMV were included. The primary outcome was the incidence of OD, assessed by the Functional Oral Intake Scale (FOIS) during structured telephone interviews. Secondary outcomes included quality of life, measured by the Short Form Health Survey version 2, and rehospitalization.</div></div><div><h3>Results</h3><div>Among 360 patients, the incidence of OD 3 months after ICU discharge was 24.17%. Educational attainment (adjusted risk ratio [aRR] per 1 year increase, 0.95; 95% confidence interval [CI] 0.92–0.99), risk of death at ICU admission (aRR per 1% increase, 1.99; 95% CI, 1.06–3.77), acute respiratory distress syndrome [ARDS] diagnosis at ICU admission (aRR, 0.21; 95% CI, 0.06–0.71), and length of mechanical ventilation (aRR per 1 day increase, 1.02; 95%CI, 1.01–1.03) were associated with OD. Patients with OD reported significantly worse physical and mental quality-of-life scores. The incidence of rehospitalization did not differ significantly between patients with and without OD.</div></div><div><h3>Conclusions</h3><div>OD 3 months after ICU discharge is a common condition among ICU survivors who required IMV. Educational level, severity of illness at ICU admission, ARDS diagnosis at ICU admission, and length of mechanical ventilation are key associated variables.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155437"},"PeriodicalIF":2.9,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hidden Markov Model and long short-term memory models for therapy response prediction in septic patients using routinely collected sequential data","authors":"Camilla Volterra , Marta Carrara , Diletta Guberti , Riccardo Asnaghi , Manuela Ferrario","doi":"10.1016/j.jcrc.2025.155382","DOIUrl":"10.1016/j.jcrc.2025.155382","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155382"},"PeriodicalIF":2.9,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-19DOI: 10.1016/j.jcrc.2025.155379
Konstantinos Kalpakis , Shiming Yang , William Teeter , Xiangxiang Kong , Meagan Watkins , Bradford Burdette , Kathalyn Urquizo , Timm Dickfeld , Bradley A. Maron , Peter Hu
{"title":"Predicting ventricular tachycardia in ICU patients using a timeseries foundation model and multimodal waveforms","authors":"Konstantinos Kalpakis , Shiming Yang , William Teeter , Xiangxiang Kong , Meagan Watkins , Bradford Burdette , Kathalyn Urquizo , Timm Dickfeld , Bradley A. Maron , Peter Hu","doi":"10.1016/j.jcrc.2025.155379","DOIUrl":"10.1016/j.jcrc.2025.155379","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155379"},"PeriodicalIF":2.9,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-19DOI: 10.1016/j.jcrc.2025.155377
Seth A. Schobel , Ninh Vu , Sreya Mukerjee , Daniel C. Thompson , Eric Elster
{"title":"Leveraging RNA-Seq data to identify molecular distinctions in patients with complex traumatic injuries: Foundations for advanced clinical support","authors":"Seth A. Schobel , Ninh Vu , Sreya Mukerjee , Daniel C. Thompson , Eric Elster","doi":"10.1016/j.jcrc.2025.155377","DOIUrl":"10.1016/j.jcrc.2025.155377","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155377"},"PeriodicalIF":2.9,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-19DOI: 10.1016/j.jcrc.2025.155369
Ayush Ranjan , Venkatesh Kareenhalli
{"title":"Identification of patient states in sepsis and septic shock","authors":"Ayush Ranjan , Venkatesh Kareenhalli","doi":"10.1016/j.jcrc.2025.155369","DOIUrl":"10.1016/j.jcrc.2025.155369","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155369"},"PeriodicalIF":2.9,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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