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Muller G, Contou D, Ehrmann S, Martin M, Andreu P, Kamel T, et al. Deferring Arterial Catheterization in Critically Ill Patients with Shock. N Engl J Med. 2025 Nov 13;393(19):1875–88. Background Is the reflexive, almost ritualistic, early insertion of an arterial line truly indispensable in the care of the critically ill? Arterial catheters are ubiquitous in the…...
Introduction Metabolic acidosis may lead to adverse consequences among critically ill patients, including impaired myocardial function, refractory shock, catecholamine resistance, and pulmonary vasoconstriction leading to right heart dysfunction. Besides, it might worsen cerebral edema and impair diaphragmatic function (1,2). Previous studies had asked the question – does t...
Introduction Resuscitation strategies in septic shock and their relation to clinical outcomes have been the focus of critical care research over the years. However, the optimal administration of intravenous fluid and titration of vasoactive agents remain uncertain. Randomized controlled trials (RCTs) that assessed the impact of a restrictive compared with a liberal resuscitation...
Naorungroj T, et al. Restrictive fluid management with early de-escalation versus usual care in critically ill patients (reduce trial): a feasibility randomized controlled trial. Crit Care. 2025 Sept 25;29(1):405. Background Although fluid resuscitation is the cornerstone of management in acute circulatory shock, how far to go and when to cut back has been a contentious…
Introduction Conventional partial support modes of ventilation provide inspiratory assistance at a fixed level, regardless of the intensity of patient effort. For instance, in the pressure support mode, the breath is delivered to a pre-set pressure. Such modes carry the likelihood of inappropriate levels of support that may be excessive or fall short of patient… href="https:/...
