
Newsletter 710 | July 20th, 2025

The First Trial to be Announced for CCR Down Under 2025 is RSI
Welcome to the 710th Critical Care Reviews Newsletter, bringing you the best critical care research and open access articles from across the medical literature over the past seven days.
The highlights of this week's edition are randomised controlled trials on inhaled isoflurane for the sedation of mechanically ventilated children in intensive care & the combined use of a multiplex PCR and serum procalcitonin to reduce antibiotic exposure in critically ill patients with community-acquired pneumonia; systematic reviews and meta analyses on the effect of blood pressure threshold on adverse outcomes in patients with acute spinal cord injury & intravenous bronchodilators in pediatric critical asthma; and observational studies on evaluating the generalisability of formulas used to set tidal volumes in mechanically ventilated patients & the epidemiology and outcomes of septic shock in Japan.
There are also guidelines on renal replacement therapy, nutrition, & community-acquired pneumonia; narrative reviews on post cardiac arrest brain injury & severe community-acquired pneumonia; editorials on spontaneous breathing trials & endothelial glycocalyx integrity as a prognostic key in sepsis; and commentaries on volatile agents & perioperative cardiac output monitoring.
If you only have time to read one review article this week, try this one on preventing acute kidney injury and its longer-term impact in the critically ill.
CCR Down Under 2025
The first trial to be announced for CCR Down Under 2025 is the RSI trial, comparing ketamine with etomidate for emergency tracheal intubation in critically ill adults. This is the latest major airway trial from the prolific American Pragmatic Critical Care Research Group, who have completed many major trials including PRE-OXI, DEVICE, & PREPARE II. Profs Jon Casey and Matthew Semler will be in Melbourne to present these results and discuss their implications. Will the long-standing controversy about etomidate-induced adrenal suppression finally be settled? Join us in Melbourne or online, December 9th and 10th (local time, UTC+11) to find out. Registration is open!
Research
Randomised Controlled Trials
- Miatello. Inhaled isoflurane for sedation of mechanically ventilated children in intensive care (IsoCOMFORT): a multicentre, randomised, active-control, assessor-masked, non-inferiority phase 3 trial. Lancet Respir Med 2025;epublished July 15th
- Voiriot. Combined use of a multiplex PCR and serum procalcitonin to reduce antibiotic exposure in critically ill patients with community-acquired pneumonia: the MULTI-CAP randomized controlled trial. Intensive Care Med 2025;epublished July 15th
- Ke. Early versus delayed catheter drainage for patients with necrotizing pancreatitis and early persistent organ failure (TIMING): a multicenter randomized controlled trial. Intensive Care Med 2025;epublished July 14th
- Peng. Distal versus conventional radial artery catheterization for hemodynamic monitoring in intensive care setting: a randomized, controlled, non-inferiority trial. BMC Anesthesiol 2025;25(1):348
- Minami. Comparison of the Incidence of Arterial Pressure Line Insufficiency Between Polyethylene and Polyurethane Catheters in the ICU: A Randomized Study. Crit Care Med 2025;epublished July 16th
- Maamar. Hypnosis for unplanned procedural pain in the intensive care unit: the HYPIC randomized clinical trial. Crit Care 2025;29:312
- Downey. Effect of In Vivo Administration of Fibrinogen Concentrate Versus Cryoprecipitate on Ex Vivo Clot Degradation in Neonates Undergoing Cardiac Surgery. Anesth Analg 2025;141(2):240-251
- Albrecht. Remote Ischemic Preconditioning to Prevent Delayed Cerebral Ischemia Due to Vasospasm in the Treatment of Patients with Aneurysmal Subarachnoid Hemorrhage. Neurocrit Care 2025;epublished July 15th
Systematic Review & Meta Analyses
- Tanvir. Effect of blood pressure threshold on adverse outcomes in patients with acute spinal cord injury: a systematic review and meta-analysis. Crit Care 2025;29:308
- Abu‐Sultaneh. Intravenous Bronchodilators in Pediatric Critical Asthma: A Systematic Review and Network Meta‐Analysis. Pediatr Pulmonol 2025;60:e71192
- Bruschettini. Sustained versus standard inflations during neonatal resuscitation to prevent mortality and improve respiratory outcomes. Cochrane Database Syst Rev 2025;7(7):CD004953
- Rose. Automated versus non-automated weaning for reducing the duration of mechanical ventilation for critically ill adults and children. Cochrane Database Syst Rev 2025;7(7):CD009235
- Leong. A systematic review and meta-analysis of noradrenaline compared to adrenaline in the management of septic shock. Afr J Emerg Med 2025;15(3):100881
- Romantsik. Midazolam for sedation of infants in the neonatal intensive care unit. Cochrane Database Syst Rev 2025;7(7):CD002052
- Tang. Melatonin Use in the ICU: A Systematic Review and Meta-Analysis. Crit Care Med 2025;epublished July 15th
- Jiang. Factors Influencing Quality of Life After Intensive Care: A Systematic Review and Meta-Analysis. Crit Care Med 2025;epublished July 15th
- Pereira. Methadone for critically ill patients under mechanical ventilation in the intensive care unit: a systematic review. Crit Care Sci 2025;37:e20250396
Observational Studies
- Sarma. Evaluating the generalisability of formulas used to set tidal volumes in mechanically ventilated patients: an observational, multicohort, retrospective study. Lancet Respir Med 2025;epublished July 15th
- Tangchitthavorngul. Epidemiology and long-term outcomes of critically ill patients with severe AKI in India and Southeast Asia. Intensive Care Med 2025;epublished July 14th
- Ostadal. Cardiac index, SvO2 or pCO2 gap may determine benefit from ECMO in cardiogenic shock: post-hoc analysis of the multicenter, randomized ECMO-CS trial. Crit Care 2025;29:303
- Gross. Mortality and antibiotic timing in deep learning-derived surviving sepsis campaign risk groups: a multicenter study. Crit Care 2025;29:302
- Smalcova. The significance of possible non-occlusive mesenteric ischemia in relation to neurological outcomes in patients with refractory cardiac arrest - Secondary analysis of the Prague OHCA study. Resuscitation 2025;epublished May 15th
- Meunier. Transcranial Doppler goal-directed therapy after cardiac arrest (GOODYEAR): a feasibility study. Resusc Plus 2025;25:101001
- Imaeda. Epidemiology and outcomes of septic shock in Japan: a nationwide retrospective cohort study from a medical claims database by the Japan Sepsis Alliance (JaSA) study group. Crit Care 2025;29:309
- Tabah. Source control in bloodstream infections in patients with sepsis, septic shock, or requiring ICU admission: a scoping review with recommendations for standardizing research. Intensive Care Med 2025;epublished July 15th
Protocols
- Li. Multicentre open-label randomised controlled trial comparing the efficacy and safety of colistin-based combination therapy with the best available therapy for treating hospital-acquired pneumonia or bloodstream infections caused by carbapenem-resistant Enterobacteriaceae (COUNT-CRE): a study protocol. BMJ Open 2025;15:e092157
- Chabanne. Prevention of extubation failure in neurocritical care patients with residual disorder of consciousness: the Brain-Injured Patients Extubation Readiness (BIPER) study protocol for a stepped-wedge cluster-randomised controlled trial. BMJ Open 2025;15(7):e104897
Guidelines
- Jourdain. Renal replacement therapy in an intensive care unit: guidelines from the SRLF-GFRUP consensus conference. Ann. Intensive Care 2025;15:100
- Expert consensus‑based clinical practice guidelines for nutritional support in the intensive care unit: the French Intensive Care Society (SRLF) and the French-Speaking Group of Pediatric Emergency Physicians and Intensivists (GFRUP). Ann Intensive Care 2025;15:99
- Neurosurgical management of the acute phase of adult and pediatric traumatic brain injury: 2025 guidelines of the French Society of Neurosurgery. Neurochirurgie 2025 Jul;71(4):101686
- Diagnosis and Management of Community-acquired Pneumonia. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med 2025;epublished July 18th
- Nelson-Piercy. Pregnancy-associated acute kidney injury — consensus report of the 32nd Acute Disease Quality Initiative workgroup. Nat Rev Nephrol 2025;epublished
- Levy. Prehospital blood transfusion coalition clinical practice guideline for civilian emergency medical services. Trauma Surg Acute Care Open 2025;10:e001931
- Lagares. Consensus on the management of traumatic brain injury in older adults: Results from a Delphi study. Brain Spine 2025;5:104319
- Considerations of Intraoperative Transesophageal Echocardiography During Adult Cardiac Surgery: A Scientific Statement From the American Heart Association. Circulation 2025;152(2):129-145
- Azoulay. Thrombotic thrombocytopenic purpura: early diagnosis and effective treatment in 2025. Intensive Care Med 2025;epublished July 3rd
Reviews
Clinical
Neurological
- Cardona-Collazos. Cerebral Edema in Traumatic Brain Injury. Biomedicines 2025;13:1728
- Grabarczyk. Advances in Neuromuscular Monitoring Techniques in Anesthesiology: A 2025 Perspective. Med Sci Monit 2025;31:e948980
- Suehiro. Minimally Invasive and Proactive Approaches for Treatment of Acute Traumatic Brain Injury in Elderly Patients. J Clin Med 2025;14(14):5028
Circulatory
- Singla. Biomarkers in Cardiac Arrest: A Narrative Review. Ther Adv Pulm Crit Care Med 2025;epublished June 4th
- Kenny. Jugular Venous Doppler Ultrasound as a Non-Invasive Window to Right Heart Hemodynamics: A Narrative Review and Future Perspective. Ther Adv Pulm Crit Care Med 2025;epublished July 16th
- Mak. Non-invasive imaging in acute and chronic pulmonary embolism. BJR Open 2025;7(1):tzaf005
- Romanò. Heart Failure Syndromes: Different Definitions of Different Diseases—Do We Need Separate Guidelines? A Narrative Review. J Clin Med 2025;14(14):5090
- Perna. Beyond Standard Shocks: A Critical Review of Alternative Defibrillation Strategies in Refractory Ventricular Fibrillation. J Clin Med 2025;14(14):5016
- Chaudhari. Cardiac Imaging in the Diagnosis and Management of Heart Failure. J Clin Med 2025;14(14):5002
Resuscitaton
Respiratory
- Martin-Loeches. Severe community-acquired pneumonia (sCAP): advances in management and future directions. Thorax 2025;80:565-575
- Li. Crosstalk between lung and extrapulmonary organs in sepsis-related acute lung injury/acute respiratory distress syndrome. Ann Intensive Care 2025;15:97
- Zimnoch. Non-Invasive Ventilation: When, Where, How to Start, and How to Stop. J Clin Med 2025;14(14):5033
- Adrião. Ventilator-Associated Pneumonia: An Update on the Role of Lung Ultrasound in Adult, Pediatric, and Neonatal ICU Practice. Ther Adv Pulm Crit Care Med 2025;epublished June 12th
- Hopkins. Advances in gas-exchange physiology and pathophysiology. ERS Monogr 2025;2025:12–31
- Singh. Role of artificial intelligence in enhancing mechanical ventilation – A peek into the future. Indian J Anaesth 2025;69(7):722-728
Nutrition
Hepatobiliary
Renal
Endocrine
- Dhatariya. Development of insulin and its pharmacology and perioperative use: a narrative review. Br J Anaesth 2025;135(2):309-321
- Riachi. Understanding Insulin Actions Beyond Glycemic Control: A Narrative Review. J Clin Med 2025;14(14):5039
Sepsis & Infectious Diseases
- Tedesco. Necrotizing soft tissue infections: a surgical narrative review. Updates Surg 2025;77(4):1239–1251
- Wang. Research Progress of Biomarkers for Sepsis and Precision Medicine. Emerg Med Int 2025;2025:4585495
Trauma
Toxicology
Paediatrics & Neonatology
- Manzoni. Expert review of CLABSI prevention in the NICU: supporting the transition of investigational drugs into clinical practice. Eur J Pediatr 2025;184(8):492
- de Almeida. The Challenges of Diagnosing, Managing, and Preventing Pediatric Delirium. Children 2025;12:918
Miscellaneous
Pre-Clinical
General Interest
Editorials
- Thille. How should spontaneous breathing trials be performed in the light of recent literature?. Ann Intensive Care 2025;15:102
- Arabi. Venous thromboprophylaxis in the ICU: navigating evidence, risk, and practice gaps. Intensive Care Med 2025;epublished July 16th
- Fernández-Sarmiento. Endothelial Glycocalyx Integrity as a Prognostic Key in Sepsis: New Insights from the CLOVERS Trial. Am J Respir Crit Care Med 2025;epublished July 9th
- Honore. Kidney replacement therapy in critically ill obese patients: an urgent call for precision and evidence-based practice!. Intensive Care Med 2025;epublished July 14th
Commentaries
- Soussi. Cardiogenic shock syndrome unraveled: understanding the different layers of heterogeneity. Intensive Care Med 2025;epublished July 14th
- Beil. Understanding patient preferences: a crucial component of caring for older adults with critical conditions. Intensive Care Med 2025;epublished July 10th
- Open-access. Global insights into traumatic brain injury. The low- and middle-income countries’ perspective. Crit Care Sci 2025;37
- Arias López. SATI-Q Registry: 20 years of experience with quality benchmarking in intensive care units. Crit Care Sci 2025;37:20250033-2
- Hidalgo. The Sepsis Chain of Survival: A Comprehensive Framework for Improving Sepsis Outcomes. Crit Care Med 2025;epublished July 16th
- Michard. Perioperative cardiac output monitoring for the many. Intensive Care Med 2025;epublished July 15th
- Omar. When medicine meets borders: a story of hope, and heartbreak, in the skies. Intensive Care Med 2025;epublished July 10th
- Guidet. Balancing our art with our performance. Intensive Care Med 2025;epublished July 7th
- Bracco. Less is more. Atmospheric and environmental stakes - sedate with care. Intensive Care Med 2025;epublished July 14th
- Lanius. Realizing the benefits of the estimand framework when reporting and communicating clinical trial results—some recommendations. Trials 2025;26:241
Correspondence
- Huang. When blood purification meets cardiogenic shock: exploring new perspectives on inflammatory clearance from CLEAN ECMO's null results. Crit Care 2025;29:306
- Añón. Volatile agents: when generalization doesn’t help. Crit Care 2025;29:305
- Zhang. Reconsidering the symmetric assumption in CPP–PRx modeling for traumatic brain injury. Crit Care 2025;29:304
- Goury. Vascular hyporesponsiveness to norepinephrine is a major but not exclusive determinant of mortality in septic shock. Ann Intensive Care 2025;15:96
- Ling. Missing the target in target trial emulation: the authors reply. Crit Care 2025;29(1):311
- Sauteur. Mycoplasma pneumoniae: re-emergence and beyond. Lancet Microbe 2025;epublished July 16th
- Girard. Lung Ultrasound Elastography: New Tools to Personalize Mechanical Ventilation. Am J Respir Crit Care Med 2025;epublished July 16th
- Sun. Neuromuscular Blockade Efficacy in High Elastance ARDS: Signal or Statistical Noise? Am J Respir Crit Care Med 2025;epublished July 18th
- Fandino. Confused with confounders? Understanding the role of directed acyclic graphs in observational research. Crit Care 2025;29:307
Case Reports
- Maramattom. Dry and Wet at the Same Time. Acute Polyneuritic Beriberi Complicated by Heart Failure (Shoshin Beriberi). Neurol India 2025;73(1):173-176
- Reardon. Troubleshooting Severe Airflow Obstruction With a Pressure-Limited Transport Ventilator: Lessons From Two Cases. Crit Care Explor 2025;7(7):e1285
- Utley. Daptomycin and acute lung injury: recognising drug-induced eosinophilic pneumonia. BMJ Case Rep 2025;18(7):e266295
- Frederix. A cerebrovascular event turning pericarditis into vasculitis. Neth Heart J 2025;33:246–247
- Deng. Ethylene glycol poisoning: A case report and review of the literature. World J Clin Cases 2025;13(20):103842
- Alley. An Incidental Embolism. J Am Coll Emerg Physicians Open 2025;6(4):100216
I hope you find this newsletter useful.
Until next week
Rob
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