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Intensive care unit (ICU) treatment can be associated with substantial suffering of patients, and those over eighty years old carry a much worse prognosis than younger ICU patients. Nevertheless, in the Netherlands we admit many people over the age of eighty to the ICU. Is this good practice? Whilst some elderly people may benefit, others don't. ICU treatment without mechanical ventilation is associated with less suffering, can still lead to a good outcome, and thus can often be justified in patients over eighty years. Full ICU treatment including prolonged mechanical ventilation, however, should only be used in selected cases.
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Crit Care Explor
September 2025
Division of Tropical Medicine and Infectious Diseases, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Importance: Sepsis remains a leading cause of death in infectious cases. The heterogeneity of immune responses is a major challenge in the management and prognostication of patients with sepsis. Identifying distinct immune response subphenotypes using parsimonious classifiers may improve outcome prediction, particularly in resource-limited settings.
View Article and Find Full Text PDFJ Spinal Cord Med
September 2025
Department of Surgery, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.
Study Design: A retrospective study with a crossover design.
Objectives: Maintaining mean arterial pressure (MAP) is crucial in the early management of SCI, yet the role of oral midodrine in this setting remains unclear. This study evaluates whether midodrine facilitates IV vasopressor weaning within 24 hours of initiation.
Background: Patients who have been treated in intensive care units (ICUs) display a multitude of physical, cognitive, and/or mental impairments that are collectively called post-intensive care syndrome (PICS). People with PICS have difficulty returning to everyday life.
Methods: In this narrative review, we present epidemiologic data, risk factors, and approaches to the prevention and treatment of PICS, along with the evidence supporting them.
Introduction: Continuous renal replacement therapy (CRRT) is often performed for critically ill patients in intensive care units (ICUs), but its optimal indication and settings have yet to be determined. Thus, we aimed to describe the current status of CRRT in Japan through a multicenter retrospective observational study.
Methods: Adult ICU patients receiving CRRT at 18 tertiary hospitals in Japan (up to 100 patients from each hospital over the past year) were retrospectively enrolled.
Int Arch Allergy Immunol
September 2025
Background: Anaphylaxis is a life-threatening, systemic allergic reaction. This study aims to compare anaphylactic triggers, clinical presentation and management between elderly (≥65 years old) and non-elderly adults.
Methods: Data from the Cross-Canada Anaphylaxis Registry (C-CARE) from April 2011 to May 2024 was collected, spanning five emergency departments (EDs) and one emergency medical service (EMS) across three Canadian provinces.