Out-of-hospital cardiac arrest remains a major challenge due to its high incidence and low survival rates. In recent decades, research has focused on the performance of chest compressions and improvements in early defibrillation, while the optimal ventilation strategy remains unclear. Despite the lack of monitoring systems, manual bag-valve-device ventilation is still common. Given the potential impact of both the applied volumes and the ventilation pressures on hemodynamics and resuscitation efforts, the present study investigated the effects of various airway devices on the target parameters of ventilation therapy during manual intra-arrest ventilation.

Although driving pressure (DP) has been consistently demonstrated to be an independent predictor of mortality in mechanically ventilated patients, the clinical benefits of DP-limited ventilation strategies compared with conventional lung protective ventilation (CLPV) for patients with acute respiratory distress syndrome/acute respiratory failure (ARDS/ARF) remain controversial.

Studies have demonstrated that over 20% of patients with moderate to severe acute respiratory distress syndrome (ARDS) do not exhibit significant improvement in oxygenation following prone positioning ventilation (PPV). It is vital to investigate the modifiable characteristics associated with PPV, which would facilitate targeted interventions and minimize the adverse effects of PPV. This study aimed to investigate the physiological effects of PPV by using electrical impedance tomography (EIT), and to explore the predictors of response to PPV in patients with moderate to severe ARDS during the early phase.

Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition associated with high morbidity and mortality, with survivors often experiencing long-term neurological and functional deficits. Cerebrospinal fluid (CSF) diversion plays a pivotal role in the acute management of aSAH, both for the treatment of hydrocephalus and for the prevention of delayed cerebral ischemia (DCI) through clearance of blood breakdown products. Four principal modalities are currently employed: lumbar puncture, lumbar, cisternal, and external ventricular drain. Each technique differs in its mechanism of drainage, monitoring capacity, complication profile, and influence on shunt dependency and long-term outcome. High-quality evidence from randomized controlled trials now supports lumbar drainage as the only intervention that significantly reduces the incidence of DCI and has been shown to improve functional outcomes, making it the preferred first-line approach in suitable patients. External ventricular drains remain indispensable in cases of obstructive hydrocephalus or reduced consciousness, while lumbar puncture may be considered in carefully selected low-risk patients. Cisternal drains represent a potential adjunct in those undergoing surgical clipping of the aneurysm. In patients without hydrocephalus, lumbar drains remain the only strategy with demonstrated long-term benefit. Given the heterogeneity of aSAH presentations and the limitations of existing evidence, individualized selection of CSF diversion techniques is warranted. We propose a pragmatic decision-making algorithm to optimize patient outcomes while minimizing iatrogenic complications, which can be adapted to institutional practices and further refined through prospective evaluation.

Following postanoxic coma, continuous electroencephalography (cEEG) monitoring is widely applied for prognostication, guided by national guidelines recommending multimodal assessment. While the diagnostic accuracy of cEEG is well-established, its actual outcomes and impact on intensive care unit (ICU) length of stay (LOS) have largely remained unreported since guideline implementation. This study evaluates outcomes and the unique prognostic value of cEEG monitoring in patients with postanoxic coma after guideline implementation.

Acute kidney injury is a common complication in critically ill patients, often coinciding with the need for antibiotic therapy. The dose of beta-lactam antibiotics is frequently adjusted and often reduced based on estimated Glomerular Filtration Rate. However, early dose reductions may lead to underdosing, especially during the critical first 48 h of infection treatment, when acute kidney injury may be transient and adequate antibiotic treatment is critical. While some reviews suggest delaying dose reductions improves clinical outcomes, evidence remains limited. This scoping review evaluates the current literature on beta-lactam dosing strategies in critically ill patients with acute kidney injury, focusing on pharmacological and clinical outcomes.

Central venous catheterization is the most common invasive procedure in intensive care units but remains burdened by infectious, thrombotic, and mechanical complications. Although real-time ultrasound guidance is now widely adopted, its effect on site-specific differences in overall complication rates has not been established. The 3SITES randomized clinical trial previously demonstrated lower infection and thrombosis rates with subclavian access but higher mechanical complications. However, as only a third of its procedures were ultrasound-guided in this study, these findings may not apply to current practice. The objective of the study was to compare complication rates across these three sites under a counterfactual framework assuming universal ultrasound guidance.

Pendelluft and expiratory muscle activity during spontaneous breathing should be minimized to reduce potential harmful effects. This study aimed to describe pendelluft and expiratory muscle activity in hypoxemic patients recovering spontaneous breathing after ≥ 72 h of lung-protective, fully controlled mechanical ventilation (MV) and assess the effect of pressure support ventilation (PSV) and positive end-expiratory pressure (PEEP).

Haemorrhage remains the leading cause of preventable death in modern armed conflict, affecting both combatants and civilians. Recent conflicts-particularly the ongoing conflict in Ukraine- have highlighted the increasing complexity of battlefield injuries, characterised by hybrid warfare, disrupted evacuation chains, and delayed access to definitive surgical care. These realities challenge traditional trauma paradigms, such as the "Golden Hour" and demand adaptation of haemorrhage control and resuscitation strategies to austere environment.

Whether admission to a single-bed intensive care unit (ICU) isolation room is associated with subsequent psychiatric morbidity remains uncertain. We investigated the association between ICU isolation and new-onset psychiatric disorders after discharge.

Traumatic cardiac arrest (TCA) remains one of the most formidable challenges in acute care, with global survival rates persistently below 7.5% despite significant advances in trauma systems and resuscitative strategies. Through a comprehensive scoping review of literature from 2016 to 2025, this study delineates the shifting epidemiology, modern management, and key determinants of outcomes in TCA. Our synthesis reveals that TCA predominantly affects young males and results primarily from blunt mechanisms, with severe hemorrhage and traumatic brain injury as leading critical lesions. While pioneering interventions such as resuscitative endovascular balloon occlusion of the aorta and emergency resuscitative thoracotomy have been widely adopted, robust evidence for their survival benefit remains limited and context dependent. Early identification and correction of reversible causes, targeted hemorrhage control, and timely application of advanced life support measures-especially prehospital thoracostomy and vascular access-significantly increase the likelihood of return of spontaneous circulation and favorable neurological outcomes. Conversely, routine use of epinephrine shows at best inconsistent benefits and may be detrimental in blunt trauma. Survival is further influenced by initial rhythm, presence of signs of life, rapid patient triage to trauma centers, and tailored protocols for pediatric and older populations. Notwithstanding notable progress, major knowledge gaps persist in defining optimal intervention timing, reporting standards, and long-term neurologic recovery. The findings underscore the critical need for multicenter, prospective research, harmonized trauma registries, and global consensus to inform future guidelines and optimize outcomes for TCA patients.