Introduction Extracorporeal blood purification (EBP) devices are increasingly used in critically ill patients to manage sepsis, hyperinflammatory states, and other life-threatening conditions. However, these devices may unintentionally remove therapeutic medications, potentially compromising efficacy. Understanding these interactions is essential to optimize therapy and ensure patient safety.
View Article and Find Full Text PDFJ Crit Care
December 2025
J Crit Care
December 2025
Volatile anesthetics, while increasingly utilized in intensive care medicine, are associated with significant renal adverse effects. A critical safety concern-particularly with sevoflurane-involves its potential impact on renal function. Pathophysiologically, inorganic fluoride levels exceeding 50 µmol/L are recognized as a threshold for nephrogenic diabetes insipidus, a condition generally considered reversible.
View Article and Find Full Text PDFHyperosmolar hyperglycemic state (HHS) is a life-threatening condition characterized by extreme hyperglycemia, high plasma osmolality, and severe dehydration without significant ketoacidosis. Prompt diagnosis and appropriate management are essential to reduce morbidity and mortality, which range from 10% to 20%. We report a case of a 50-year-old man with insulin-dependent diabetes mellitus secondary to chronic alcoholic pancreatitis presenting with severe HHS and coma.
View Article and Find Full Text PDFExpert Rev Anti Infect Ther
August 2025
Introduction: Intra-abdominal candidiasis (IAC) is a serious complication in critically ill patients, particularly after abdominal surgery or trauma. Differentiating Candida colonization from invasive infection is crucial, as misdiagnosis can lead to inappropriate antifungal use, increased resistance, and worse outcomes. However, IAC remains underrecognized due to the limitations of conventional culture-based diagnostics.
View Article and Find Full Text PDFBackground: Candidemia, associated with high morbidity and mortality, remains challenging to diagnose due to the limitations of blood cultures. Serological biomarkers offer faster detection, enabling earlier treatment and improving outcomes.
Methods: This study, conducted at CHU UCL Namur (August 2023-January 2025), evaluated three diagnostic biomarkers for candidemia: CAGTA IgG VirClia Monotest, Wako β-D-glucan test, and CandId OLM RT-PCR.
Veno-venous extracorporeal membrane oxygenation (vvECMO) is a life-saving intervention for severe respiratory failure unresponsive to conventional therapies. However, managing refractory hypoxemia in morbidly obese patients poses significant challenges due to the unique physiological characteristics of this population, including hyperdynamic circulation, elevated cardiac output, and increased oxygen consumption. These factors can limit the effectiveness of vvECMO by diluting arterial oxygen content and complicating oxygen delivery.
View Article and Find Full Text PDFThe early detection, diagnosis, anticipation, and therapy of infections to prevent sepsis and septic shock remain significant challenges in cases of grave burns. This narrative review explores various tools for early infection detection, including emerging biomarkers, the American Burn Association's clinical criteria, and traditional blood parameters. A comparative study of the American Burn Association, Mann-Salinas, and Sepsis-3 criteria highlights the superior early detection capabilities of the Sepsis-3 criteria.
View Article and Find Full Text PDFBackground: Statins, acknowledged for their ability to reduce cardiovascular risk, demonstrate a variety of pleiotropic effects, including anti-inflammatory, antithrombotic, endothelial stabilizing activity and prevention of acute kidney injury (AKI) post cardiac surgery. Patients in the intensive care unit (ICU) face heightened risks of cardiovascular disease, infections, and thrombotic complications, but the effect of statin therapy on ICU mortality remains controversial. The Medical Information Mart for Intensive Care IV (MIMIC-IV) database is a publicly available intensive care medicine information database that includes data on critically ill patients admitted to the ICU at Beth Israel Deaconess Medical Center from 2008 to 2019, with a large sample size.
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