ARDS and acute brain injury require individualised ventilation that balances lung protection with cerebral physiology and neuromonitoring. Link in the first comment.

Machine learning models predicted disease severity and mortality in secondary hemophagocytic lymphohistiocytosis, but external validation remains essential. Link in the first comment.

Intensive care innovation can include architectural redesign that supports family engagement, natural light and a better care experience while generating measurable value. zurl.co/sjxt9

#VisualAbstract Prehospital airway and ventilatory management requires timely intubation, physiology optimization, structured rescue pathways and cautious use of non-invasive respiratory support. zurl.co/343ek

Antibiotic use near the end of life may offer limited survival or symptom benefit while adding treatment burden and contributing to antimicrobial resistance. zurl.co/o9TTG

In ARDS, changes in airway and pleural pressure during mechanical ventilation can alter venous return, ventricular loading and pulmonary vascular resistance, making the right ventricle central to heart–lung interactions. zurl.co/0isaZ

When noninvasive ventilation is unavailable, a bag-valve mask is a reasonable alternative, but the additional benefit of positive end-expiratory pressure remains uncertain and unsupported by clinical outcomes. zurl.co/lPJ9h

#ICM-Quizz #MedEd Pacemaker-induced atrioventricular dissociation caused marked pulse pressure variation and relative hypotension after anaesthesia in a woman with a single-chamber leadless ventricular pacemaker. zurl.co/JpkhO

#ICM-Quizz #MedEd A 59-year-old woman with a leadless ventricular pacemaker developed relative hypotension and apparent pulse pressure variation of 30–45% after anaesthesia induction. What is the most likely cause?

Digital twin simulations found that a proposed transition protocol for airway pressure release ventilation reduced tidal de-recruitment and carbon dioxide levels compared with pressure control ventilation. zurl.co/q5H3K

#VisualAbstract Neurological complications are common in critical illness and are linked to morbidity, mortality and long-term disability in ICU patients. zurl.co/mWEWt

Further analyses of acute kidney injury criteria and cumulative hypotension exposure could clarify whether the apparent benefit of the ≥80 mmHg target reflects ascertainment, avoidance of harmful hypotension, or both. zurl.co/aodGO

Selective decontamination of the digestive tract may support antimicrobial stewardship when routine microbiological surveillance is paired with active feedback to clinicians. zurl.co/yYpiM

#VisualAbstract In patients with sepsis or septic shock, mNGS added to routine microbiological diagnostics did not improve the DOOR/RADAR score but favored several secondary outcomes. zurl.co/hT76F

When noninvasive ventilation is unavailable, bag-valve-mask preoxygenation with positive end-expiratory pressure may offer physiological and practical advantages over flush-rate oxygen through a non-rebreather mask. zurl.co/eYQ0W

Intracranial hypertension after acute brain injury requires interpretation beyond fixed pressure thresholds, using physiological context and multimodal neuromonitoring to support individualized management. zurl.co/uUnua

#VisualAbstract The HLH-Risk-Calculator predicted initial disease severity and time-point specific mortality in adult secondary hemophagocytic lymphohistiocytosis patients. zurl.co/ZgyHk

Out-of-bed armchair positioning improved oxygenation over 3 hours in spontaneously breathing ICU patients receiving respiratory support, without serious adverse events. zurl.co/prS8I

A new acute kidney injury reporting framework sets specific standards to improve the quality, comparability, and clinical use of biomarker diagnostic accuracy studies. zurl.co/Wv1bv

#VisualAbstract Obesity alone should not preclude ECMO access, particularly VV-ECMO, but care requires anticipation of physiological, technical and organisational challenges. zurl.co/Y0MAu

#ICM-Quizz #MedEd A pulmonary artery intramural hematoma caused sudden chest and back pain with hypoxemia in a woman with severe pulmonary hypertension and a giant patent ductus arteriosus. zurl.co/4dDWG

#ICM-Quizz #MedEd A 36-year-old woman presented with sudden chest and back pain, severe hypoxaemia and marked pulmonary artery dilatation. Imaging showed extreme pulmonary hypertension and right heart enlargement. What is your diagnosis?

#VisualAbstract In high-risk hypertensive patients undergoing major elective abdominal surgery, targeting an intraoperative MAP of at least 80 mmHg reduced major organ dysfunction compared with at least 65 mmHg. zurl.co/ugUTc

Prone positioning improves oxygenation, reduces lung stress and strain, and lowers mortality when applied early for prolonged sessions in selected intubated patients with moderate-to-severe acute respiratory distress syndrome. zurl.co/ZjW6e

#VisualAbstract In acute respiratory distress syndrome, PEEP effects reflect recruitability, overdistension risk, airway closure and hemodynamic tolerance. zurl.co/JiJ1W

Drug-induced acute kidney injury has distinct recovery patterns, and normalization of serum creatinine may conceal persistent structural damage. zurl.co/g6xGO

Rehabilitation after critical illness in patients with obesity requires early, tailored respiratory care, nutrition, mobilisation, appropriate equipment and structured post-ICU follow-up. zurl.co/44g5V

#ICM-Quizz #MedEd Disulfiram-induced neurotoxicity can present with acute severe encephalopathy, rapid coma and bilateral symmetrical abnormalities of the basal ganglia, substantia nigra and pontine tegmentum. zurl.co/bxYcD

#ICM-Quizz #MedEd A 36-year-old woman receiving long-term disulfiram for alcohol use disorder developed rapid encephalopathy, deep coma and symmetrical basal ganglia and brainstem abnormalities on MRI. What's your diagnosis?

Critical illness changes antiseizure medication exposure, requiring tailored selection, dosing, and monitoring in intensive care. zurl.co/69LiK