Intensive Care Medicine

Intensive Care Medicine The official page for ICM, Intensive Care Medicine.

ICM is an international peer-reviewed medical journal intended for all those who are involved in intensive care medicine. ''Intensive Care Medicine'' is the publication platform for the communication and exchange of current work and ideas in intensive care medicine. The journal publishes original research papers, reviews, as well as discussions on technology, methods, new apparatus and modifications of standard techniques and correspondence concerning matters of topical interest or relating to published material. Official journal of The European Society of Intensive Care Medicine and The European Society of Paediatric and Neonatal Intensive Care.
12 issues per year.

-Quizz A 62-year-old woman with several prior abdominal surgeries presented with abdominal pain, acute renal failure ...
24/02/2026

-Quizz A 62-year-old woman with several prior abdominal surgeries presented with abdominal pain, acute renal failure (creatininaemia 621 μmol/L) and abundant ascites. Ultrasound showed no renal abnormality; paracentesis found transudative fluid. Ascites resolved after bladder catheter insertion but recurred after removal. CT revealed a bladder leak, later repaired surgically. What are the correct propositions?

https://zurl.co/dgkuT Postoperative delirium affects up to 40% of patients over 65, and postoperative cognitive dysfunct...
24/02/2026

https://zurl.co/dgkuT Postoperative delirium affects up to 40% of patients over 65, and postoperative cognitive dysfunction occurs in 10–30% at 3 months. Perioperative stroke occurs in 0.7–1% in non-cardiac surgery, and MRI detects new asymptomatic ischaemic lesions in 7–10% of high-risk patients. Near-infrared spectroscopy is influenced by skin pigmentation, skull thickness and extracranial contamination, and normoxaemia of PaO₂ 80–150 mmHg is recommended.

https://zurl.co/9RMrH Mitochondria are the endpoint of oxygen transport, with tissue pO2 typically below 40 mmHg. Alveol...
23/02/2026

https://zurl.co/9RMrH Mitochondria are the endpoint of oxygen transport, with tissue pO2 typically below 40 mmHg. Alveolar oxygen depends on inspired oxygen concentration, barometric pressure, water vapour pressure and oxygen uptake, not on CO2 partial pressure via gas displacement. Hypercapnia with hypoventilation reflects reduced oxygen delivery, whereas increased metabolic demand raises VO2 without matching ventilation, and ECCO2R has no proportional positive effect on oxygenation.

https://zurl.co/rQhqv Haemoglobin does not reflect tissue oxygenation or anaemia tolerance in non-bleeding critically ...
23/02/2026

https://zurl.co/rQhqv Haemoglobin does not reflect tissue oxygenation or anaemia tolerance in non-bleeding critically ill patients. Central venous oxygen saturation and oxygen extraction ratio are bedside measures that show significant changes after transfusion when abnormal. A multimodal approach including comorbidities, clinical signs, ECG changes, biochemical markers and microcirculatory assessment may optimise timing, but routine integration needs more evidence.

https://zurl.co/YHcbX Eighty adult ECMO patients needing CRRT were randomised to integrated or separate circuits at two ...
22/02/2026

https://zurl.co/YHcbX Eighty adult ECMO patients needing CRRT were randomised to integrated or separate circuits at two Thai tertiary ICUs from May 2021 to March 2025. Median circuit lifespan was 72 h versus 71 h and 28-day mortality was 32.5% versus 35%. Access and return pressures were higher with integration, while transmembrane pressure, pressure drop, alarm frequency and serious adverse events were similar, with no air embolism.

https://zurl.co/gPmdB Mechanical insufflation raises intrathoracic and transpulmonary pressures, altering venous return ...
22/02/2026

https://zurl.co/gPmdB Mechanical insufflation raises intrathoracic and transpulmonary pressures, altering venous return and pulmonary vascular resistance. Pulse pressure variation predicts fluid responsiveness when applicable, but fails with spontaneous breathing, arrhythmias or tidal volume below 8 mL/kg. During weaning, negative inspiratory intrathoracic pressure can increase RV and LV afterload and trigger weaning-induced pulmonary oedema.

https://zurl.co/NXQjD Sorbent-based hemadsorption may, in theory, suit certain highly protein-bound toxins, but a large ...
21/02/2026

https://zurl.co/NXQjD Sorbent-based hemadsorption may, in theory, suit certain highly protein-bound toxins, but a large volume of distribution can restrict extracorporeal elimination. Compared with haemodialysis, these devices can be less available, at least 25 times more expensive and may be linked to cartridge saturation and adverse events such as thrombocytopenia and hypoglycaemia. Meaningful toxicokinetic advantage and improved clinical outcomes remain to be shown.

https://zurl.co/4AHzk -Quizz Systematic pelvic imaging, including CT or MRI, is crucial for detecting ovarian teratom...
21/02/2026

https://zurl.co/4AHzk -Quizz Systematic pelvic imaging, including CT or MRI, is crucial for detecting ovarian teratomas in young women with anti-NMDAR encephalitis, even when no gynecologic symptoms are present. Early laparoscopic resection of these teratomas can lead to faster weaning from mechanical ventilation, shorter ICU stays, and improved neurological outcomes.

-Quizz A 26-year-old woman with psychiatric symptoms, refractory seizures, and coma was diagnosed with anti-NMDAR enc...
20/02/2026

-Quizz A 26-year-old woman with psychiatric symptoms, refractory seizures, and coma was diagnosed with anti-NMDAR encephalitis. Pelvic CT revealed bilateral ovarian teratomas, the trigger. After laparoscopic removal, seizures ceased, and she fully recovered in 6 months. Which imaging modality is most critical for identifying the underlying trigger?

https://zurl.co/uA8hw Among 484,956 ICU admissions in Ontario from 2009–2021, 22% had AKI at admission. Compared with no...
20/02/2026

https://zurl.co/uA8hw Among 484,956 ICU admissions in Ontario from 2009–2021, 22% had AKI at admission. Compared with no AKI, stage 1 had about 1.9-fold higher adjusted odds of 90-day death, while stages 2 and 3 had about 2.5-fold higher odds of similar magnitude. KRT dependence at 90 days among survivors increased from 0.3% with no AKI to 12.0% with stage 3 AKI. Median hospital stay among survivors increased from 8 to 15 days across the same range.

https://zurl.co/MIi6o Ineffective efforts arise when inspiratory effort does not overcome intrinsic PEEP and the trigger...
19/02/2026

https://zurl.co/MIi6o Ineffective efforts arise when inspiratory effort does not overcome intrinsic PEEP and the trigger threshold. They are more frequent in pressure-support ventilation, often with over-assistance, low P0.1 and alkalosis or with COPD, very high intrinsic PEEP, high P0.1 and acidosis. Reverse-triggering is prevalent and was related to 34% of double-cycling in one study.

https://zurl.co/l1rgz Among 295 adults with fulminant myocarditis on V-A ECMO and/or Impella, 44% died or required hea...
19/02/2026

https://zurl.co/l1rgz Among 295 adults with fulminant myocarditis on V-A ECMO and/or Impella, 44% died or required heart transplantation or long-term LVAD within 1 year, with myocarditis confirmed by histology or cardiac MRI in 69%. Giant cell myocarditis, older age, ECMO during cardiopulmonary resuscitation and endomyocardial biopsy after 2 days were associated with higher risk. Event-free survival did not differ between biopsy within 2 days and no biopsy.

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