Digital twins suggest APRV can lower mechanical power and tidal recruitment versus PCV in ARDS — modeling evidence and clinical implications
Posted inCritical Care news Respiratory

Digital twins suggest APRV can lower mechanical power and tidal recruitment versus PCV in ARDS — modeling evidence and clinical implications

High-fidelity digital twins of 98 ARDS patients indicate APRV (Phigh 25/Plow 0, long Tinsp, short Tlow to 75% peak expiratory flow) reduced mechanical power by ~32% and tidal recruitment by ~34% versus recorded PCV, at the cost of controlled hypercapnia; clinical trials are needed.
Pregnancy DMT Management in Multiple Sclerosis Increases Relapse Risk — Anti‑CD20 Before Conception Is Most Protective
Posted inNeurology news Rheumatology

Pregnancy DMT Management in Multiple Sclerosis Increases Relapse Risk — Anti‑CD20 Before Conception Is Most Protective

A large French registry study shows that how disease-modifying therapies (DMTs) are managed during pregnancy meaningfully affects relapse rates in relapsing‑onset MS; prolonged natalizumab interruption and fingolimod use carry the highest risks, while preconception anti‑CD20 strategies are most protective.
RBC Transfusions in Early Sepsis Resuscitation: Common, Complex, and Potentially Harmful Above a 10 g/dL Threshold
Posted inAnesthesiology Critical Care Hematology-Oncology news

RBC Transfusions in Early Sepsis Resuscitation: Common, Complex, and Potentially Harmful Above a 10 g/dL Threshold

In a multicenter Korean sepsis cohort, early RBC transfusions were frequent and driven by illness severity. No overall 60‑day mortality difference was seen after propensity matching, but transfusion was associated with harm at hemoglobin ≥10 g/dL and a possible benefit below that threshold.
急性虚血性脳卒中における補助的静注アルガトロバンまたはエプチフィバチド投与：MOST無作為化臨床試験によるエビデンス
Posted inClinical Updates Neurology news

急性虚血性脳卒中における補助的静注アルガトロバンまたはエプチフィバチド投与：MOST無作為化臨床試験によるエビデンス

Recent multi-site randomized evidence demonstrates that adding intravenous argatroban or eptifibatide to standard thrombolysis within 3 hours of stroke onset does not improve functional recovery and is associated with increased mortality, including in patients undergoing mechanical thrombectomy.
Higher Mortality When Children on Mechanical Ventilation Are Cared for Outside ICUs: National Japanese Cohort Signals Need for Pediatric ICU Centralization
Posted inCritical Care news Pediatrics

Higher Mortality When Children on Mechanical Ventilation Are Cared for Outside ICUs: National Japanese Cohort Signals Need for Pediatric ICU Centralization

A national retrospective cohort of 129,375 mechanically ventilated children in Japan found most received care on general wards and that ward care was associated with higher in-hospital mortality than ICU care after propensity matching (6.4% vs 4.1%; OR 1.49). Findings raise systems-level questions about pediatric critical care capacity and centralization.
White Matter Microstructure and Cognitive Decline in Aging and Alzheimer Disease: A Comprehensive Review of Recent Advances
Posted inClinical Updates Neurology news Radiology

White Matter Microstructure and Cognitive Decline in Aging and Alzheimer Disease: A Comprehensive Review of Recent Advances

This review synthesizes recent large-scale multi-cohort studies revealing white matter microstructural abnormalities—especially free water increases—in limbic tracts as critical markers of cognitive decline in aging and Alzheimer's disease, emphasizing integrated biomarker approaches.
Phenylephrine Versus Norepinephrine in Acute Abdomen Surgery: Similar Clinical Outcomes but Different Early Renin Responses — Implications for Perioperative Hemodynamic Care
Posted inAnesthesiology Critical Care news

Phenylephrine Versus Norepinephrine in Acute Abdomen Surgery: Similar Clinical Outcomes but Different Early Renin Responses — Implications for Perioperative Hemodynamic Care

A randomized trial in 156 emergency acute-abdomen patients found phenylephrine and norepinephrine produced similar postoperative RAAS changes and complication rates; norepinephrine produced an early renin rise, while high preoperative renin predicted greater vasopressor needs and higher AKI incidence.
Frailty Amplifies Mortality Risk Across the PaO2/FiO2 Spectrum: Insights from a 497,185‑Patient ANZICS Cohort
Posted inCritical Care news Respiratory

Frailty Amplifies Mortality Risk Across the PaO2/FiO2 Spectrum: Insights from a 497,185‑Patient ANZICS Cohort

In a 497,185‑patient registry study, frailty (CFS ≥5) was common and associated with substantially higher in‑hospital mortality across all severities of acute hypoxemic respiratory failure (AHRF). The relationship between PaO2/FiO2 and death was nonlinear and distinctly separated by frailty category.
Why Emergency Medicine Residents Rarely Choose Surgical Critical Care — A Nationwide Survey and a Roadmap to Increase EM-SCC Matriculation
Posted inCritical Care Emergency Medicine news

Why Emergency Medicine Residents Rarely Choose Surgical Critical Care — A Nationwide Survey and a Roadmap to Increase EM-SCC Matriculation

A national survey of 111 emergency medicine trainees identifies limited exposure to surgical critical care, institutional and geographic factors, and program characteristics (ECMO, multidisciplinary teams) as key modifiable drivers of low EM matriculation into surgical critical care fellowships.
Dose-Dependent Radiation and Chemotherapy Risks for Colorectal Subsequent Malignancies in Childhood Cancer Survivors: Clinical Implications from a CCSS Analysis
Posted innews Oncology Pediatrics

Dose-Dependent Radiation and Chemotherapy Risks for Colorectal Subsequent Malignancies in Childhood Cancer Survivors: Clinical Implications from a CCSS Analysis

A CCSS analysis of 25,723 five-year childhood cancer survivors shows clear dose-response relationships between colorectum-specific radiation dose, irradiated colorectal volume, several chemotherapy exposures (notably procarbazine, high alkylator and platinum doses), and subsequent colorectal cancers, with actionable implications for RT planning and survivorship surveillance.