Welcome to This Week in Critical Care. This week we're covering 10 notable papers spanning fluid and kidney management in the sickest patients, cardiac arrest and ventilator liberation, and the softer but no less consequential science of how we make and communicate high-stakes decisions. Let's dive in.

This week's papers:

1. Impact of pre-ICU balanced crystalloids versus saline on mortality in sepsis: a propensity score-matched multicenter cohort study. — Chest 2026
2. Multicomponent Pulmonary Rehabilitation for Prolonged Mechanical Ventilation in Patients Aged 80 Years or Older: A Randomized Controlled Trial. — Chest 2026
3. Comparative Effectiveness of Lidocaine and Amiodarone for Refractory VF/pVT in Adult In-Hospital Cardiac Arrest: Insights from a Nationwide Multicenter Chinese Registry. — Chest 2026
4. A multicenter randomized, double-blinded placebo-controlled phase 2 trial to evaluate safety and efficacy of ilofotase alfa in patients at risk for kidney injury following open heart surgery. — Intensive Care Medicine 2026
5. Epidemiology of Critically Ill Patients With Cirrhosis Undergoing Continuous Renal Replacement Therapy: A Contemporaneous Parallel Analysis of the HRS-HARMONY and CRRTnet Registries. — Critical Care Medicine 2026
6. Alveolar Ventilation Efficiency Assessed via Capnography is Associated with Improved Outcomes in Pediatric Cardiac Arrest. — American Journal of Respiratory and Critical Care Medicine 2026
7. Lymphopenia and mortality in adult sepsis: A systematic review and focused meta-analysis of prognostic evidence. — Journal of Critical Care 2026
8. Epilepsy After Antipsychotic Prescription in Survivors of Traumatic Brain Injury: A Population-Based Cohort Study. — Critical Care Medicine 2026
9. The Role of Regret in Extracorporeal Membrane Oxygenation Candidacy Decision-Making. — Chest 2026
10. Social Media and Crisis Care Principles During Pandemics and Disasters: A Consensus Report From a Subgroup of the Task Force for Mass Critical Care. — Chest 2026

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Welcome to This Week in Critical Care. This week we're covering 10 notable papers spanning resuscitation and mechanical circulatory support, the shifting evidence around sepsis targets and phenotype-guided therapy, and a cluster of studies on mechanical ventilation, organ support and long-term recovery. Let's dive in.

This week's papers:

1. Intravenous or Intraosseous Vascular Access in Cardiac Arrest: An Individual Participant Data Meta-Analysis. — Resuscitation 2026
2. Distinct weaning phenotypes in patients unsuccessful in weaning from invasive mechanical ventilation: a secondary analysis of the WEAN SAFE cohort. — Intensive Care Medicine 2026
3. Phenotype-guided polymyxin B haemoadsorption in abdominal septic shock: a 2015-2026 evidence synthesis and proposed clinical pathway. — Shock 2026
4. Mortality Effect of Peripheral Perfusion-Guided Resuscitation in Vasodilatory Shock: A Systematic Review and Dual Frequentist-Bayesian Meta-Analysis of Randomized Trials. — Critical Care Medicine 2026
5. Rehabilitation and the post-intensive care syndrome across the recovery continuum: a narrative review. — Intensive Care Medicine 2026
6. Sepsis identification and bundle delivery in US emergency departments, 2012-2022: A nationally representative analysis. — Journal of Critical Care 2026
7. Epidemiology of continuous renal replacement therapy in critically ill adults on ECMO: A multicenter cohort study. — Journal of Critical Care 2026
8. Landscape of Biomarker Use in Critically Ill Patients: Systematic Evidence Map of Acute Kidney Injury and Implications for Practice. — Critical Care Medicine 2026
9. Between-hospital variation in liberation from invasive mechanical ventilation: Consequences of ignoring death as a competing risk. — Journal of Critical Care 2026
10. In-Hospital Cardiac Arrest in Impella-Supported Cardiogenic Shock: Insights From the J-PVAD Registry. — Resuscitation 2026

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Welcome to This Week in Critical Care. This week we're covering 10 notable papers spanning sedation and liberation from mechanical ventilation, bedside physiology for shock and kidney injury, resuscitation rhythms and phenomena, and the shifting epidemiology of severe viral illness. Let's dive in.

This week's papers:

1. Ketamine for Analgosedation in Mechanically Ventilated Adults: A Double-Blind Randomized Trial. — Critical Care Medicine 2026
2. Extracorporeal CO2 elimination for acute exacerbation of severe COPD requiring invasive mechanical ventilation: a randomized controlled trial (the X-COPD trial). — Critical Care 2026
3. Serially measured diaphragmatic thickening fraction, but not diaphragmatic excursion, was associated with subsequent intubation during high-flow nasal cannula therapy: a prospective repeated-measures cohort study. — Journal of Critical Care 2026
4. Feasibility and Operator-Reported Utility of Transesophageal Lung Ultrasound As an Adjunct to Resuscitative Transesophageal Echocardiography in the Evaluation of Shock: A Multicenter Observational Study. — Critical Care Medicine 2026
5. Early renal perfusion phenotypes and renal recovery in critically ill patients with or at risk for acute kidney injury: a prospective multicenter cohort study. — Shock 2026
6. Early Arterial pH Changes as Strong Predictors of Mortality in Sepsis: A Multicenter Cohort Study. — Shock 2026
7. Pulseless electrical activity versus asystole as initial pulseless rhythm in children: challenging convention regarding non-shockable rhythms. — Resuscitation 2026
8. Trends in the incidence and outcomes of cardiopulmonary resuscitation-induced consciousness in out-of-hospital cardiac arrest: a retrospective study. — Resuscitation 2026
9. Predictors of Critical Illness During Different COVID-19 Pandemic Periods Compared With Seasonal Influenza. — Critical Care Medicine 2026
10. Temporal trends in critical care burden and outcomes of Andes virus-associated hantavirus cardiopulmonary syndrome: a national Chilean cohort. — Intensive Care Medicine 2026

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Welcome to This Week in Critical Care. This week we're covering 10 notable papers spanning mechanical circulatory support and resuscitation, hemodynamic assessment and vasoactive management, and the metabolic and microbial side of critical illness — from protein delivery to the glycocalyx. Let's dive in.

This week's papers:

1. Left ventricular unloading during VA-ECMO for refractory cardiogenic shock: a target trial emulation multicenter analysis. — Critical Care 2026
2. Long-Term Mortality and Functional Outcomes After Extracorporeal Membrane Oxygenation in Critically Ill Adults: A Systematic Review and Meta-Analysis. — Critical Care Medicine 2026
3. The Microbiome in Critical Illness. — Critical Care Medicine 2026
4. Septic shock after allogeneic hematopoietic stem-cell transplantation: outcomes and prognostic factors in a multicenter ICU cohort. — Chest 2026
5. Cerebral Tissue Oxygen Saturation at Defibrillation and Return of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest With a Shockable Rhythm. — Resuscitation 2026
6. Multicenter invasive validation of the Venous Excess Ultrasound Score (VExUS) in patients referred for pulmonary hypertension. — Chest 2026
7. Vasopressor weaning in septic shock: Why the field has been asking the wrong question. — Journal of Critical Care 2026
8. The effect of augmented protein intake on nitrogen balance: A nested cohort study of the TARGET protein trial. — Journal of Critical Care 2026
9. Clinical outcomes of dengue patients requiring intensive care in Brazil: A 10-year nationwide observational study. — Journal of Critical Care 2026
10. Glycocalyx degradation is associated with increased circulating unmeasured ions after cardiopulmonary bypass. — Journal of Critical Care 2026

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Welcome to This Week in Critical Care. This week we're covering 10 notable papers spanning ICU recovery and rehabilitation, the physiology of managing two failing organs at once, and the practical business of diagnosis and monitoring at the bedside. Let's dive in.

This week's papers:

1. Early mobilization for mechanical ventilation for sepsis or acute respiratory failure (EVER): a multicenter randomized controlled trial with 12-month outcomes. — Intensive Care Medicine 2026
2. State-of-the-art review: ß-blockade in critical illness. — Intensive Care Medicine 2026
3. Balancing lung and brain: physiological strategies for ARDS management in acute brain injury. — Intensive Care Medicine 2026
4. ARDS management in trauma patients. — Intensive Care Medicine 2026
5. AKI as a systemic syndrome and its impact on other organ systems. — Critical Care 2026
6. Assessment of the effectiveness of protein in critical illness: the role of statistical shortcomings in explaining discrepancies between observational studies and randomized controlled trials. — Critical Care 2026
7. Immune clinical profiles as determinants of acute respiratory failure etiologies in critically ill patients with hematological malignancies: A multicenter analysis. — Journal of Critical Care 2026
8. When trauma turns septic: Associated factors and focus-specific mortality in 61,399 patients from the TraumaRegister DGU®. — Journal of Critical Care 2026
9. Psychosocial coping with intensive care delirium: a mixed-methods systematic review of patient and family perspectives. — Critical Care 2026
10. Esophageal thermometry outperforms bladder and tympanic monitoring during targeted temperature management and shock in the ICU. — Journal of Critical Care 2026

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Welcome to This Week in Critical Care. This week we're covering 10 notable papers spanning resuscitation decisions in septic shock, the mechanics and pharmacology of the airway, and a set of studies on diagnostics, glucose timing and system-level safety. Let's dive in.

This week's papers:

1. Early red blood cell transfusion strategy in septic shock among patients with cancer: the TRANSPORT randomized controlled trial — Intensive Care Medicine 2026
2. Impact of a strategy using multiplex PCR on targeted antibiotic therapy for patients with suspected ventilator-associated pneumonia or hospital-acquired pneumonia requiring mechanical ventilation: a randomized, single-blind trial — Intensive Care Medicine 2026
3. Induction Agents for Tracheal Intubation of Critically Ill Patients: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials — Chest 2026
4. ARDS management beyond the guidelines: a practical physiology-based approach to individualized care — Intensive Care Medicine 2026
5. Respiratory mechanics modifies the impact of ventilator settings on clinical outcome in patients with acute brain injury — Intensive Care Medicine 2026
6. Effect of early versus delayed or no insulin therapy for moderate hyperglycemia in ICU patients: A target trial emulation — Chest 2026
7. Physiological comparison of high-flow oxygen via endotracheal tube and T-piece strategies during spontaneous breathing trials: a randomized crossover study — Critical Care 2026
8. Association of timing of vasopressin initiation with renal replacement therapy in septic shock patients — Journal of Critical Care 2026
9. Incidence, Outcomes, and Risk Factors for Mortality in Patients With Sepsis in South Korea: A Nationwide Cohort Study — Critical Care Medicine 2026
10. Lessons from preventable ICU-related coronial deaths: A large-language-model-assisted national analysis of adult cases in Australia (1997 to 2025) — Journal of Critical Care 2026

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Welcome to This Week in Critical Care. This week we're covering 10 notable papers spanning septic shock resuscitation and the timing of vasoactive support, kidney replacement therapy and fluid management, and the evolving evidence base in hypoxemic respiratory failure and ARDS — plus two smaller studies that will change how you interpret blood cultures and prescribe stress ulcer prophylaxis. Let's…

This week's papers:

1. Ultra-early versus early adjunctive vasopressin initiation after norepinephrine escalation in septic shock: a target trial emulation — Intensive Care Medicine 2026
2. A 1-Hour Resuscitation Bundle for Prehospital Management of Septic Shock — Critical Care Medicine 2026
3. Heterogeneous Treatment Effects of Renal Replacement Therapy in Critically Ill Patients: A Multicenter Observational Study Using a Japanese ICU Registry — Critical Care Medicine 2026
4. Efficacy and safety of pantoprazole for stress-ulcer prophylaxis in critically ill patients: A systematic review and meta-analysis of randomized controlled trials — Journal of Critical Care 2026
5. Net Ultrafiltration Rate and Mortality in Critically Ill Patients: A Multicenter Cohort Study With Analysis of Fluid Balance Changes — Critical Care Medicine 2026
6. Risk of blood culture contamination during central venous catheter insertion in critically ill adults: a self-controlled study — Journal of Critical Care 2026
7. Epidemiology, Ventilatory Patterns, and Outcomes in Acute Hypoxemic Respiratory Failure Among ICU Patients Requiring Respiratory Support: A Registry-Based Cohort Study — Critical Care Medicine 2026
8. Predictive value of diaphragmatic ultrasound for weaning outcomes in mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis — Critical Care 2026
9. Corticosteroids in ARDS: old controversies, new insights, and future directions — Intensive Care Medicine 2026
10. Interventions with a significant mortality difference in acute respiratory distress syndrome: A systematic review and comparison with Guidelines — Journal of Critical Care 2026

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Welcome to This Week in Critical Care. This week we're covering eight notable papers spanning the kidney in critical illness, the search for treatable sepsis phenotypes, and how we dose and interpret our anti-inflammatory therapies. Let's dive in.

This week's papers:

1. Renal Resistive Index Responsiveness to a Mean Arterial Pressure Test As a Guide for Mean Arterial Pressure Target in the Early Phase of Septic Shock: A Physiological Study — Critical Care Medicine 2026
2. Safety and outcomes of dapagliflozin initiation in critically ill patients with acute kidney injury: A post-hoc analysis of the DEFENDER trial — Journal of Critical Care 2026
3. High-dose corticosteroids are associated with higher mortality in patients with COVID-19 ARDS: Results from a nationwide observational study — Journal of Critical Care 2026
4. Inflammatory Phenotypes In Severe Pneumonia: Clinical Evidence To Mouse Models For Precision Therapeutics — American Journal of Respiratory and Critical Care Medicine 2026
5. STARDaki: a consensus-based STARD extension for standardized reporting of diagnostic accuracy in acute kidney injury — Intensive Care Medicine 2026
6. Phenotyping Sepsis at Emergency Department Presentation Using Early Clinical Data: A Multicenter Cohort Study — Shock 2026
7. H3.1 Nucleosomes to Predict Renal Replacement Therapy and Mortality in Sepsis: A Secondary Analysis of the SISPCT Randomized Control Trial — Critical Care Medicine 2026
8. Renal impairment after burn-associated shock — Shock 2026

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Welcome to This Week in Critical Care. This week we're covering 10 notable papers spanning individualized physiological monitoring, optimization of shock resuscitation, and the clinical and human complexities of advanced life support. Let's dive in.

This week's papers:

1. A decade of SEP-1 compliance and sepsis mortality in the United States. — Critical care (London, England) 2026
2. Intracranial pressure physiology, monitoring and individualized management in the acute brain injured patient. — Intensive care medicine 2026
3. Assessing tissue perfusion during septic shock resuscitation through the vascular waterfall lens. — American journal of respiratory and critical care medicine 2026
4. Re-evaluation of oxygenation and oxygen exposure in patients with ARDS and veno-venous extracorporeal membrane oxygenation. — Critical care (London, England) 2026
5. Examining the intersection of biologic sex and predicted body weight in patients with acute respiratory distress syndrome. — Critical care (London, England) 2026
6. Terminal complement inhibition is associated with renal, hematologic, and thrombotic complications during septic shock: A global propensity score-matched cohort study. — Journal of critical care 2026
7. The Human Impact of ECMO: Best Practices to Improve Experiences of Patients, Families, and Clinicians. — Chest 2026
8. SDD as a stewardship intervention: the missing feedback loop. — Intensive care medicine 2026
9. Bradycardia associated with dexmedetomidine in critically ill patients: A retrospective study of risk factors and clinical outcomes. — Journal of critical care 2026
10. Anabolic androgen therapy in critically ill adults: A systematic review and meta-analysis. — Journal of critical care 2026

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Welcome to This Week in Critical Care. This week we're covering 4 notable papers spanning acute kidney injury biomarker reporting and cardiac arrest resuscitation and prognostication. Let's dive in.

This week's papers:

1. STARDaki: a consensus-based STARD extension for standardized reporting of diagnostic accuracy in acute kidney injury — Intensive Care Medicine 2026
2. Neuroprognostication after cardiac arrest in patients without withdrawal of life-sustaining therapy: a prospective observational multicenter study — Critical Care 2026
3. Incidence, outcomes, and temporal trends of pediatric in-hospital cardiac arrest in Japan: a nationwide study — Resuscitation 2026
4. Association between Preexisting Electrocardiographic Abnormalities and Shockable Initial Rhythm in Out-of-Hospital Cardiac Arrest — Resuscitation 2026

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