Intensive Care Medicine

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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.

Volatile anesthetics were proposed for ARDS due to potential anti-inflammatory, epithelial-protective, and respiratory e...
10/10/2026

Volatile anesthetics were proposed for ARDS due to potential anti-inflammatory, epithelial-protective, and respiratory effects. Promising preliminary data demonstrated reductions in inflammatory mediators and improvements in oxygenation. However, a recent multicenter randomized controlled trial found that sevoflurane sedation for patients with moderate-to-severe ARDS reduced ventilator-free days and increased mortality compared to propofol sedation.

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The impact of tidal volume on clinical outcomes varied with respiratory system elastance in mechanically ventilated pa...
09/10/2026

The impact of tidal volume on clinical outcomes varied with respiratory system elastance in mechanically ventilated patients with acute brain injury. Higher tidal volume was associated with lower ICU mortality at low elastance but not at high elastance, while higher respiratory rate was associated with worse outcomes. The findings were observational and require prospective validation.

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Obesity may primarily result in mass loading of the respiratory system rather than elastic stiffening of the chest wall,...
08/10/2026

Obesity may primarily result in mass loading of the respiratory system rather than elastic stiffening of the chest wall, which is important for understanding respiratory mechanics. Elevated end-expiratory esophageal pressure can signal a high pleural pressure environment, promoting expiratory airway closure and intrinsic positive end expiratory pressure. Whether Pes-guided ventilation improves clinical outcomes in ARDS remains unresolved.

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Landmark intensive care trials showed that strong physiological rationale does not reliably produce better patient-cen...
07/10/2026

Landmark intensive care trials showed that strong physiological rationale does not reliably produce better patient-centred outcomes. Structured supportive care improved timeliness and consistency, while later pragmatic trials questioned rigid targets and excessive intervention. More recent evidence supports selective treatment based on timing, disease phase, baseline risk, patient selection and treatment-related harm.

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The EURECA study investigated factors associated with specific causes of death in severe meningitis and encephalitis. It...
06/10/2026

The EURECA study investigated factors associated with specific causes of death in severe meningitis and encephalitis. It found that neurologic causes, accounting for two-thirds of deaths, were linked to initial brain injury severity and intracranial complications. Systemic causes were associated with host vulnerability and multiorgan failure, suggesting different management priorities.

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Patients who fail to wean from invasive mechanical ventilation experience prolonged mechanical ventilation and ICU sta...
05/10/2026

Patients who fail to wean from invasive mechanical ventilation experience prolonged mechanical ventilation and ICU stays, with 78% ICU mortality. Three distinct phenotypes were identified based on separation attempt intensity and the timing of life-sustaining therapy withdrawal. A failed first separation attempt strongly correlates with subsequent withdrawal decisions and higher ICU mortality.

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In cancer patients with septic shock, a liberal red blood cell transfusion strategy targeting a higher hemoglobin thre...
04/10/2026

In cancer patients with septic shock, a liberal red blood cell transfusion strategy targeting a higher hemoglobin threshold did not improve 12-hour lactate reduction compared with a restrictive strategy. Mortality did not differ significantly, while arterial and venous thrombotic events were more frequent with the liberal strategy. Premature termination for safety concerns means lactate and mortality results should be interpreted with uncertainty.

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Among 146 analyzed immunocompetent adults with suspected ventilator-associated or ventilated hospital-acquired pneumon...
03/10/2026

Among 146 analyzed immunocompetent adults with suspected ventilator-associated or ventilated hospital-acquired pneumonia, targeted antimicrobial therapy at 24 hours occurred in 35.1% with multiplex PCR and 23.6% with conventional microbiology alone, without a significant difference. In culture-documented pneumonia, targeted therapy was significantly more frequent with multiplex PCR. No difference in 28-day patient outcomes was observed.

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ICU admission for acute leukemia patients has seen improved outcomes over time, with recent studies reporting lower mort...
02/10/2026

ICU admission for acute leukemia patients has seen improved outcomes over time, with recent studies reporting lower mortality rates. An individual participant data meta-analysis provides valuable insights into prognostic factors and changes in ICU mortality. Evolving therapeutic approaches for older patients and advances in allogeneic stem-cell transplantation are influencing intensive care.

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Trauma-related ARDS follows a multi-hit process in which mechanical injury is compounded by dysregulated inflammation ...
01/10/2026

Trauma-related ARDS follows a multi-hit process in which mechanical injury is compounded by dysregulated inflammation and secondary insults such as transfusion, infection or fat embolism. Chest X-ray, lung ultrasound and computed tomography support diagnosis, monitoring and risk stratification. Management is largely supportive, with lung-protective ventilation, careful fluid management, effective analgesia and timely surgery.

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