Intensive Care Medicine

Intensive Care Medicine The official page for ICM, Intensive Care Medicine.
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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/2tXLu During a chikungunya outbreak on La Réunion Island, a 17-year-old patient developed toxic epiderma...
24/09/2025

https://zurl.co/2tXLu During a chikungunya outbreak on La Réunion Island, a 17-year-old patient developed toxic epidermal necrolysis with nearly 100% skin detachment, extensive mucosal necrosis, and septic shock. Despite severe infections including bacteremia and fungemia, intensive supportive treatment led to gradual healing, highlighting an exceptional infectious cause of this normally drug-induced condition.

https://zurl.co/VBstM Among 2,192 critically ill obese patients admitted to ICU over 15 years, 13.5% required kidney r...
23/09/2025

https://zurl.co/VBstM Among 2,192 critically ill obese patients admitted to ICU over 15 years, 13.5% required kidney replacement therapy (KRT). KRT was independently associated with higher 90-day and 1-year mortality. While the incidence of acute kidney injury declined, KRT rates remained stable. Persistent kidney dysfunction and dialysis dependence were more common in KRT recipients, underscoring the need for optimised care in this high-risk group.

https://zurl.co/ejAVY Invasive meningococcal disease presents with diverse purpuric skin manifestations, from petechiae ...
23/09/2025

https://zurl.co/ejAVY Invasive meningococcal disease presents with diverse purpuric skin manifestations, from petechiae to extensive necrosis. Illustrated cases include patients with serogroup B or Y infections, showing patterns such as violaceous patches, necrotic plaques, or pinpoint lesions. Despite these signs, half of patients may exhibit no purpura, with sepsis manifesting solely as purpura-free shock.

https://zurl.co/h3n22 Early and appropriate antibiotic therapy is crucial in severe infections, but overuse fuels resist...
22/09/2025

https://zurl.co/h3n22 Early and appropriate antibiotic therapy is crucial in severe infections, but overuse fuels resistance and increases harm. Optimising treatment requires rapid diagnostics, timely de-escalation, and personalised dosing. Multidisciplinary collaboration and stewardship can improve outcomes, reduce toxicity, and help preserve antibiotics against the rising threat of multidrug-resistant pathogens.

https://zurl.co/Ytq22 King Lear’s downfall illustrates the toll of allostatic overload, as betrayal and loss strip him o...
22/09/2025

https://zurl.co/Ytq22 King Lear’s downfall illustrates the toll of allostatic overload, as betrayal and loss strip him of control, identity, and dignity. Amid decline, Cordelia’s return embodies compassionate palliative care, offering presence and solace rather than invasive treatment. Her tenderness reflects how true healing often lies in human connection, easing suffering and restoring meaning even when cure is no longer possible.

21/09/2025

https://zurl.co/ytjfK The INHALE WP3 trial assessed ICU-based rapid syndromic PCR testing for hospital-acquired and ventilator-associated pneumonia. It found a 21% improvement in antibiotic stewardship in absolute terms but did not demonstrate non-inferiority in clinical cure rates at 14 days. Secondary outcomes showed mixed results, with trends in mortality and organ dysfunction favoring the control group. Further research is required to evaluate the clinical impact and implementation of rapid PCR diagnostics.

https://zurl.co/ILs1u An ICU eco-audit found that changing from 1% to 2% propofol for sedation halved greenhouse gas emi...
21/09/2025

https://zurl.co/ILs1u An ICU eco-audit found that changing from 1% to 2% propofol for sedation halved greenhouse gas emissions, reduced waste, and lowered costs, while patient characteristics and drug use remained unchanged. Annual savings reached €14,780 and 6,214 kg CO2e, equivalent to over seven Paris–New York flights. Optimising drug concentration shows strong potential for advancing environmental sustainability in critical care.

https://zurl.co/wj8hs Venous thromboembolism prophylaxis in intensive care varies widely, with compliance often limited ...
20/09/2025

https://zurl.co/wj8hs Venous thromboembolism prophylaxis in intensive care varies widely, with compliance often limited by absent policies, bleeding concerns, or perceived low risk, particularly in low-income settings. Guidelines must reflect contextual challenges, while research should focus on vulnerable groups such as pregnant patients and ECMO recipients. Ultrasound remains central to diagnosis, demanding structured training for accuracy.

https://zurl.co/jQoZk Intravenous fluids are essential in critical care but may cause harm if used inappropriately. Crit...
20/09/2025

https://zurl.co/jQoZk Intravenous fluids are essential in critical care but may cause harm if used inappropriately. Critical care ultrasound offers a structured approach to decision-making, using echocardiography, lung ultrasound and VExUS to assess hypovolaemia, cardiac conditions, pulmonary or systemic congestion, and fluid responsiveness. This integration supports safer and more individualised fluid therapy in critically ill patients.

https://zurl.co/Sg6i6 In critically ill patients receiving renal replacement therapy, antibiotic dosing with meropenem...
19/09/2025

https://zurl.co/Sg6i6 In critically ill patients receiving renal replacement therapy, antibiotic dosing with meropenem and piperacillin/tazobactam should be guided by RRT intensity, duration, and urine output. Extended or continuous infusions improve target attainment and reduce toxicity risk. Dosing nomograms were developed from robust population pharmacokinetic models to optimise therapy.

https://zurl.co/g3lPT Sepsis survivors face lasting challenges, with health-related quality of life measured by RAND-36 ...
19/09/2025

https://zurl.co/g3lPT Sepsis survivors face lasting challenges, with health-related quality of life measured by RAND-36 consistently below population norms and highly variable. Functional recovery is limited, particularly among working-age patients. Findings suggest pre-existing comorbidities and health status may affect outcomes as much as, or more than, intensive care factors, leaving many survivors struggling to return to work.

https://zurl.co/ciQie Early intervention in necrotising pancreatitis remains controversial. Current evidence supports de...
18/09/2025

https://zurl.co/ciQie Early intervention in necrotising pancreatitis remains controversial. Current evidence supports delaying invasive procedures and using a step-up approach, as early drainage shows no clear benefit and may cause harm. Despite limitations, recent trials reinforce postponement to minimise complications and reduce procedural burden. For most patients, conservative management remains the safest initial strategy.

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