Meropenem and piperacillin/tazobactam optimised dosing regimens for critically ill patients receiving renal replacement therapy.

Purpose: Optimal dosing of meropenem and piperacillin/tazobactam in critically ill patients receiving renal replacement therapy (RRT) is uncertain due to variable pharmacokinetics. We aimed to develop generalisable optimised dosing recommendations for these antibiotics.

Methods: Prospective, multinational pharmacokinetic study including patients requiring various forms of RRT.

The impact of intensive care strain on patients' outcomes-a multinational observational cohort (UNITE-COVID) study.

Purpose: Intensive care unit (ICU) strain is associated with increased mortality. Most strain metrics focus on 'simple' measures such as bed occupancy or admission rates. There is limited data on mitigation strategies, such as procedure teams or staff well-being services on strain, or the impact of increased patient-to-nurse ratios and non-ICU trained nurses working in ICU.

Be-SNAP: the Belgian Sepsis National Action Plan.

Sepsis represents a significant healthcare challenge in Belgium with an estimated 40,952 cases annually (95% CI 31,938-54,451). This life-threatening condition leads to approximately 7,675 premature deaths per year (95% CI 6,421-9,089) and a loss of 38,106 quality-adjusted life years. The economic impact is substantial with annual costs ranging from €277 million to €4.

Source control in bloodstream infections in patients with sepsis, septic shock, or requiring ICU admission: a scoping review with recommendations for standardizing research.

Background: Bloodstream infections (BSI) account for 15% of intensive care unit (ICU) infections, often causing sepsis with mortality rates up to 50%. Source control (SC), encompassing interventions to reduce bacterial or fungal load and prevent infection spread, is a critical yet under-investigated component of management.

Objectives: This scoping review examines SC definitions, interventions, timing, adequacy, and outcomes in BSI literature in patients with sepsis, septic shock, or ICU admission, and offers a proposal for standardized reporting.

The weekend effect in critically ill patients with severe infections in Japanese intensive care units: a multicenter retrospective cohort study.

Background: Reduced or delayed access to medical resources on weekends could lead to worsening outcomes, in critically ill infected patients requiring intensive care unit (ICU) admission.

Objective: To investigate the "weekend effect," on critically ill infected patients in Japanese ICUs for the first time.

Design: Multicenter retrospective cohort study.

Evaluating early mobilisation in critically ill COVID-19 patients: Secondary analysis from the ESICM UNITE-COVID-II multicentre observational study.

Background: Early mobilisation (EM) within the first 72 h of ICU admission is essential for preventing ICU-acquired weakness; however, mobilisation rates remained low among mechanically ventilated (MV) COVID-19 patients during the pandemic waves. This study aimed to characterise the association between EM and 60-day outcomes.

Methods: A multicentre observational study conducted by the European Society of Intensive Care Medicine (ESICM) examined mobilisation strategies during the second COVID-19 wave (UNITE-COVIDed2021).

Environmental sustainability in intensive care: An international survey of intensive care professionals'views, practices and proposals to the European Society of Intensive Care Medicine.

Background: The intensive care unit (ICU) is a high-resource area, generating more waste and greenhouse gas (GHG) emissions than standard hospital wards. Environmental sustainability is important for healthcare professionals worldwide, prompting scientific societies to call for urgent action. To respond to this global need, the European Society of Intensive Care Medicine (ESICM) conducted an international survey assessing intensive care professionals' attitudes and practices towards environmental sustainability.

Shortening antibiotic therapy duration for hospital-acquired bloodstream infections in critically ill patients: a causal inference model from the international EUROBACT-2 database.

Introduction: Hospital-acquired bloodstream infections (HA-BSIs) are severe and require antibiotic therapy. In non-complicated BSIs, shortened therapy reduces side effects without compromising efficacy. The impact of shortened antibiotic therapy in HA-BSI critically ill patients without indication of prolonged therapy requires further evaluation.

A consensus of European experts on the definition of ventilator-associated pneumonia recurrences obtained by the Delphi method: the RECUVAP study.

Background: There are recognized diagnostic criteria for a first ventilator-associated pneumonia (VAP) episode, but not for recurrences. Many randomized clinical trials (RCTs) have used the recurrence of VAP as a criterion for efficacy evaluation. Still, the different definitions used in RCTs make it difficult to compare studies.

The green ICU: how to interpret green? A multiple perspective approach.

Mitigating environmental impacts is an urgent challenge supported by (scientific) intensive care societies worldwide. However, making green choices without compromising high-quality care for critically ill patients may be challenging. The current paper describes a three-step approach towards green intensive care units.

Are contemporary antifungal doses sufficient for critically ill patients? Outcomes from an international, multicenter pharmacokinetics study for Screening Antifungal Exposure in Intensive Care Units-the SAFE-ICU study.

Purpose: Appropriate antifungal therapy is a major determinant of survival in critically ill patients with invasive fungal disease. We sought to describe whether contemporary dosing of antifungals achieves therapeutic exposures in critically ill patients.

Methods: In a prospective, open-label, multicenter pharmacokinetic study, intensive care unit (ICU) patients prescribed azoles, echinocandins, or polyene antifungals for treatment or prophylaxis of invasive fungal disease were enrolled.

Mortality, functional outcome and health-related quality of life in patients with necrotizing skin- and soft tissue infections in the ICU: Protocol of a multinational prospective cohort study (SKIN-ICU).

Background: Necrotizing soft tissue infections (NSTI) are rare and life-threatening bacterial infections characterized by necrosis of subcutaneous tissue, fascia, or muscle. Few prospective studies have been conducted. The primary objective is to assess the 90-day mortality rate and to identify prognostic factors in patients with NSTI in an international setting.

Impact of reporting rapid susceptibility results in Gram negative bloodstream infections: a real world prospective study.

Purpose: Mortality and morbidity of patients with bloodstream infection (BSI) remain high despite advances in diagnostic methods and efforts to speed up reporting. This study investigated the impact of reporting rapid Minimum Inhibitory Concentration (MIC)-results in Gram negative BSIs with the ASTar system (Q-linea, Uppsala, Sweden) on the adaptation of empirically started antimicrobial therapy. We performed a real-world study during which antimicrobial susceptibility testing (AST) results were instantly reported to the treating physician in an established multidisciplinary antimicrobial stewardship setting.

A Pooled Pharmacokinetic Analysis for Piperacillin/Tazobactam Across Different Patient Populations: From Premature Infants to the Elderly.

Background And Objectives: The pharmacokinetics (PK) of piperacillin/tazobactam (PIP/TAZ) is highly variable across different patient populations and there are controversies regarding non-linear elimination as well as the fraction unbound of PIP (f). This has led to a plethora of subgroup-specific models, increasing the risk of misusing published models when optimising dosing regimens. In this study, we aimed to develop a single model to simultaneously describe the PK of PIP/TAZ in diverse patient populations and evaluate the current dosing recommendations by predicting the PK/pharmacodynamics (PD) target attainment throughout life.

Management of adult sepsis in resource-limited settings: global expert consensus statements using a Delphi method.

Purpose: To generate consensus and provide expert clinical practice statements for the management of adult sepsis in resource-limited settings.

Methods: An international multidisciplinary Steering Committee with expertise in sepsis management and including a Delphi methodologist was convened by the Asia Pacific Sepsis Alliance (APSA). The committee selected an international panel of clinicians and researchers with expertise in sepsis management.

Early detection of OXA-48 producing Klebsiella pneumoniae with the use of rapid antibiotic susceptibility testing.

Rapid antimicrobial susceptibility testing of positive blood cultures can enhance antimicrobial stewardship and patient outcomes. We present a case where OXA-48-producing Klebsiella pneumoniae with low-level carbapenem resistance was suspected 6 h after blood-culture positivity, based on ASTar system (Q-Linea, Sweden) results. OXA-48 carbapenemase presence was confirmed by the OXA-48 K-SeT lateral flow assay (Coris, Belgium) on a short-term subculture.

International cross-sectional survey on current and updated definitions of intra-abdominal hypertension and abdominal compartment syndrome.

Background: The Abdominal Compartment Society (WSACS) established consensus definitions and recommendations for the management of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in 2006, and they were last updated in 2013. The WSACS conducted an international survey between 2022 and 2023 to seek the agreement of healthcare practitioners (HCPs) worldwide on current and new candidate statements that may be used for future guidelines.

Methods: A self-administered, online cross-sectional survey was conducted under the auspices of the WSACS to assess the level of agreement among HCPs over current and new candidate statements.