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.

https://zurl.co/pU6zm Clinical timing alone was insufficient to compare melatonin effects across trials. Methodological ...
15/04/2026

https://zurl.co/pU6zm Clinical timing alone was insufficient to compare melatonin effects across trials. Methodological homogeneity was prioritised over statistical heterogeneity. Conflicting results between negative and positive trials require closer analysis before any new trial is considered.

https://zurl.co/1QxMl Delirium is an acquired form of neurological organ failure that is common in the ICU. It is associ...
14/04/2026

https://zurl.co/1QxMl Delirium is an acquired form of neurological organ failure that is common in the ICU. It is associated with mortality and long-term cognitive impairment. Prevention and mitigation rely on measures such as light sedation, avoidance of benzodiazepines, routine screening and early rehabilitation, while pharmacological management remains inconclusive.

https://zurl.co/loWcN -Quizz An 85-year-old man with Waldenström macroglobulinemia presented with acute neurological ...
14/04/2026

https://zurl.co/loWcN -Quizz An 85-year-old man with Waldenström macroglobulinemia presented with acute neurological impairment and marked spontaneous echo contrast in all four cardiac chambers despite preserved left ventricular ejection fraction, normal cardiac output and normal haemostatic parameters. Serum viscosity was markedly elevated at 10.56 cSt, supporting plasma hyperviscosity syndrome. The contrast completely resolved after therapeutic plasma exchange.

-Quizz An 85-year-old man with Waldenström macroglobulinemia was admitted for acute neurological impairment. After co...
13/04/2026

-Quizz An 85-year-old man with Waldenström macroglobulinemia was admitted for acute neurological impairment. After correction of bradycardia and hypotension, echocardiography showed marked spontaneous echo contrast in all four cardiac chambers despite preserved left ventricular ejection fraction, normal cardiac output and normal haemostatic parameters. Serum protein electrophoresis revealed a monoclonal IgM peak of 27 g/L. What’s your diagnosis?

https://zurl.co/vVR9u Family members of people admitted to critical care can experience long-term mental health problems...
13/04/2026

https://zurl.co/vVR9u Family members of people admitted to critical care can experience long-term mental health problems, yet evidence on how to improve outcomes remains inconclusive. A structured caregiver intervention showed benefit in distress at 6 months but not at 3 or 12 months. Participation patterns and language restrictions highlighted risks of exclusion and limits on broader applicability.

https://zurl.co/SUb82 An ICU vignette shows how advanced support can continue despite limited physiological justificatio...
12/04/2026

https://zurl.co/SUb82 An ICU vignette shows how advanced support can continue despite limited physiological justification and increasing burden for the patient. Proportionality, bedside judgment and regular reassessment support care that preserves dignity, personhood and meaningful recovery alongside physiological treatment.

https://zurl.co/y52NE A prospective cohort included 444 adults with community-onset sepsis enrolled within 6 hours of ...
12/04/2026

https://zurl.co/y52NE A prospective cohort included 444 adults with community-onset sepsis enrolled within 6 hours of emergency department arrival. Blood and urine biomarkers were grouped into host resistance, disease tolerance, and damage signatures. Greater damage was associated with higher 90-day mortality, while differences across sepsis subtypes were most pronounced for disease tolerance and damage.

https://zurl.co/gzbdR A five-round Delphi process with 56 expert panellists reached consensus on clinical criteria for...
11/04/2026

https://zurl.co/gzbdR A five-round Delphi process with 56 expert panellists reached consensus on clinical criteria for refractory septic shock. Persistently elevated lactate and/or prolonged capillary refill time were retained in patients with septic shock who are fluid unresponsive and require norepinephrine base equivalent doses above 0.5 µg/kg/min. Critical care ultrasonography was retained to assess alternative causes of shock.

https://zurl.co/7QZXY In critically ill adults undergoing rapid sequence intubation, ketamine was associated with a high...
11/04/2026

https://zurl.co/7QZXY In critically ill adults undergoing rapid sequence intubation, ketamine was associated with a higher lowest mean arterial pressure in the first 10 minutes than propofol. The mean arterial pressure difference was not sustained over the first hour, and severe hypotension rates were similar. Cardiovascular collapse was less frequent with ketamine, while mortality was numerically higher at day 7, in the ICU and in hospital.

https://zurl.co/hYFVb Beta-lactam therapy in critically ill patients with renal dysfunction requires rapid attainment of...
10/04/2026

https://zurl.co/hYFVb Beta-lactam therapy in critically ill patients with renal dysfunction requires rapid attainment of effective exposure and careful later adjustment. Nomograms can reduce early underdosing, while therapeutic drug monitoring and model-informed approaches support secondary dose decisions. Extended or continuous infusion can improve target attainment, particularly during renal replacement therapy.

https://zurl.co/rJS1W -Quizz Continuous-flow LVADs can generate high-frequency artefact on bedside ECG and telemetry,...
10/04/2026

https://zurl.co/rJS1W -Quizz Continuous-flow LVADs can generate high-frequency artefact on bedside ECG and telemetry, making rhythm assessment difficult in ICU patients after implantation. In a model using a running HeartMate 3 pump, an ECG simulator and a patient monitor, the dominant noise frequency rose with pump speed. A 40-Hz low-pass filter provided the most robust suppression across speeds and restored rhythm interpretability.

-Quizz A 54-year-old man with a continuous-flow HeartMate 3 LVAD deteriorated hemodynamically on postoperative day 3,...
09/04/2026

-Quizz A 54-year-old man with a continuous-flow HeartMate 3 LVAD deteriorated hemodynamically on postoperative day 3, prompting urgent 12-lead ECG assessment. The ECG showed a prominent high-frequency oscillatory signal across multiple leads, obscuring rhythm assessment. What is the most likely explanation for the ECG appearance?

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