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Personalized medicine in the ICU

Thematic Series

New Content Item

After so many negative randomized, controlled trials, that have evaluated a number of simplified therapeutic interventions that could be applied to large patient populations, people are turning their interest back to personalized medicine.
This new Thematic Series will share thoughts based on scientific data and help the clinician to individualize the different aspects of the patient management.


  1. Recent high-quality trials have shown that the anti-inflammatory effects of colchicine reduce the risk of cardiovascular events in patients suffering post-myocardial infarction and chronic coronary disease. Th...

    Authors: Tuo Pan, Chen-Yu Jiang, He Zhang, Xi-Kun Han, Hai-Tao Zhang, Xin-Yi Jiang, Wei Chen, Kuo Wang, Fu-Dong Fan, Jun Pan, Qing Zhou, Chuang-Shi Wang, Li Zhang and Dong-Jin Wang
    Citation: Critical Care 2023 27:49
  2. Cumulative evidence has demonstrated that the ventilatory ratio closely correlates with mortality in acute respiratory distress syndrome (ARDS), and a primary feature in coronavirus disease 2019 (COVID-19)-ARD...

    Authors: Mingjia Zheng
    Citation: Critical Care 2023 27:46
  3. Pulse pressure variation (PPV) has been widely used in hemodynamic assessment. Nevertheless, PPV is limited in low tidal volume ventilation. We conducted this systematic review and meta-analysis to evaluate wh...

    Authors: Xiaoying Wang, Shuai Liu, Ju Gao, Yang Zhang and Tianfeng Huang
    Citation: Critical Care 2023 27:45
  4. The global mortality rate of patients with MV is very high, despite a significant variation worldwide. Previous studies conducted in Sub-Saharan Africa among ICU patients focused on the pattern of admission an...

    Authors: Semagn Mekonnen Abate, Bivash Basu, Bedru Jemal, Siraj Ahmed, Bahru Mantefardo and Tagesse Taye
    Citation: Critical Care 2023 27:37
  5. Post-cardiac arrest, outcomes for most patients are poor, regardless of setting. Many patients who do achieve spontaneous return of circulation require vasopressor therapy to maintain organ perfusion. There is...

    Authors: Jeremy Penn, Will Douglas, Jeffrey Curran, Dipayan Chaudhuri, Joanna C. Dionne, Shannon M. Fernando, David Granton, Rebecca Mathew and Bram Rochwerg
    Citation: Critical Care 2023 27:12
  6. Acute kidney injury (AKI) is a common complication in sepsis. However, the trajectories of sepsis-induced AKI and their transcriptional profiles are not well characterized.

    Authors: Zhongheng Zhang, Lin Chen, Huiheng Liu, Yujing Sun, Pengfei Shui, Jian Gao, Decong Wang, Huilin Jiang, Yanling Li, Kun Chen and Yucai Hong
    Citation: Critical Care 2022 26:398
  7. Although guidelines provide excellent expert guidance for managing patients with septic shock, they leave room for personalization according to patients’ condition. Hemodynamic monitoring depends on the evolut...

    Authors: Daniel De Backer, Maurizio Cecconi, Michelle S. Chew, Ludhmila Hajjar, Xavier Monnet, Gustavo A. Ospina-Tascón, Marlies Ostermann, Michael R. Pinsky and Jean-Louis Vincent
    Citation: Critical Care 2022 26:372
  8. Defining the optimal moment to start renal replacement therapy (RRT) in acute kidney injury (AKI) remains challenging. Multiple randomized controlled trials (RCTs) addressed this question whilst using absolute...

    Authors: Paweł Morzywołek, Johan Steen, Stijn Vansteelandt, Johan Decruyenaere, Sigrid Sterckx and Wim Van Biesen
    Citation: Critical Care 2022 26:365
  9. The intensive care unit (ICU) is an emotionally taxing environment. Patients and family members are at an increased risk of long-term physical and psychological consequences of critical illness, known collecti...

    Authors: Sarah Petrecca, Adrian Goin, David Hornstein, Milanka Stevanovic and Adamo Anthony Donovan
    Citation: Critical Care 2022 26:346
  10. Steroid profiles in combination with a corticotropin stimulation test provide information about steroidogenesis and its functional reserves in critically ill patients.

    Authors: Josef Briegel, Patrick Möhnle, Didier Keh, Johanna M. Lindner, Anna C. Vetter, Holger Bogatsch, Dorothea Lange, Sandra Frank, Ludwig C. Hinske, Djillali Annane and Michael Vogeser
    Citation: Critical Care 2022 26:343
  11. Sepsis is a severe systemic inflammatory response to infections that is accompanied by organ dysfunction and has a high mortality rate in adult intensive care units. Most genetic studies have identified gene v...

    Authors: Tamara Hernandez-Beeftink, Beatriz Guillen-Guio, Jose M. Lorenzo-Salazar, Almudena Corrales, Eva Suarez-Pajes, Rui Feng, Luis A. Rubio-Rodríguez, Megan L. Paynton, Raquel Cruz, M. Isabel García-Laorden, Miryam Prieto-González, Aurelio Rodríguez-Pérez, Demetrio Carriedo, Jesús Blanco, Alfonso Ambrós, Elena González-Higueras…
    Citation: Critical Care 2022 26:341
  12. Renal replacement therapy (RRT) remains the key rescue therapy for critically ill patients with severe acute kidney injury (AKI). However, there are currently no tools available to predict successful liberatio...

    Authors: Thilo von Groote, Felix Albert, Melanie Meersch, Raphael Koch, Christian Porschen, Oliver Hartmann, Deborah Bergmann, Peter Pickkers and Alexander Zarbock
    Citation: Critical Care 2022 26:333
  13. Evidence supports therapeutic drug monitoring of polymyxin B, but clinical data for establishing an area under the concentration–time curve across 24 h at steady state (AUCss,24 h) threshold are still limited. Th...

    Authors: Jing Yang, Shaohua Liu, Jingli Lu, Tongwen Sun, Peile Wang and Xiaojian Zhang
    Citation: Critical Care 2022 26:320

    The Correspondence to this article has been published in Critical Care 2023 27:41

  14. Mechanical ventilation increases the risk of lung injury (VILI). Some authors propose that the way to reduce VILI is to find the threshold of driving pressure below which VILI is minimized. In this study, we p...

    Authors: Álvaro Mingote, Ramsés Marrero García, Martín Santos González, Raquel Castejón, Clara Salas Antón, Juan Antonio Vargas Nuñez and Javier García-Fernández
    Citation: Critical Care 2022 26:316
  15. The 40-year-old experience with glucocorticosteroids (GCs) in the context of severe infections is complex and troublesome. Recently, however, a clear indication for GCs in severe COVID-19 has been established....

    Authors: Martin S. Winkler, Marcin F. Osuchowski, Didier Payen, Antoni Torres, Steffen Dickel and Tomasz Skirecki
    Citation: Critical Care 2022 26:308
  16. Fluid overload and venous congestion are associated with morbi-mortality in the ICU (intensive care unit). Administration of diuretics to correct the fluid balance is common, although there is no strong relati...

    Authors: Pierre-Grégoire Guinot, Pierre-Alain Bahr, Stefan Andrei, Bogdan A. Popescu, Vincenza Caruso, Paul-Michel Mertes, Vivien Berthoud, Maxime Nguyen and Belaid Bouhemad
    Citation: Critical Care 2022 26:305
  17. Right ventricular (RV) and pulmonary vascular dysfunction appear to be common in sepsis. RV performance is frequently assessed in isolation, yet its close relationship to afterload means combined analysis with...

    Authors: Emma Maria Bowcock, Benjamin Gerhardy, Stephen Huang and Sam Orde
    Citation: Critical Care 2022 26:303
  18. It is unknown how to titrate positive end-expiratory pressure (PEEP) in patients with COVID-19-related acute respiratory distress syndrome (ARDS). Guidelines recommend the one-size-fits-all PEEP-FiO2 table. In th...

    Authors: Peter Somhorst, Philip van der Zee, Henrik Endeman and Diederik Gommers
    Citation: Critical Care 2022 26:272

    The Correspondence to this article has been published in Critical Care 2022 26:388

    The Comment to this article has been published in Critical Care 2022 26:327

  19. Adequate antibiotic dosing may improve outcomes in critically ill patients but is challenging due to altered and variable pharmacokinetics. To address this challenge, AutoKinetics was developed, a decision sup...

    Authors: Luca F. Roggeveen, Tingjie Guo, Lucas M. Fleuren, Ronald Driessen, Patrick Thoral, Reinier M. van Hest, Ron A. A. Mathot, Eleonora L. Swart, Harm-Jan de Grooth, Bas van den Bogaard, Armand R. J. Girbes, Rob J. Bosman and Paul W. G. Elbers
    Citation: Critical Care 2022 26:265
  20. To assess the impact of different electronic relaxation devices on common stressful patient symptoms experienced in intensive care unit (ICU).

    Authors: Lili Merliot-Gailhoustet, Chloé Raimbert, Océane Garnier, Julie Carr, Audrey De Jong, Nicolas Molinari, Samir Jaber and Gerald Chanques
    Citation: Critical Care 2022 26:263

    The Publisher Correction to this article has been published in Critical Care 2022 26:291

  21. Acute kidney injury (AKI) is a frequently encountered syndrome especially among the critically ill. Current diagnosis of AKI is based on acute deterioration of kidney function, indicated by an increase in crea...

    Authors: Suvi T. Vaara, Pavan K. Bhatraju, Natalja L. Stanski, Blaithin A. McMahon, Kathleen Liu, Michael Joannidis and Sean M. Bagshaw
    Citation: Critical Care 2022 26:251
  22. Trauma is a heterogeneous condition, and specific clinical phenotypes may identify target populations that could benefit from certain treatment strategies. In this retrospective study, we determined clinical p...

    Authors: Jotaro Tachino, Hisatake Matsumoto, Fuminori Sugihara, Shigeto Seno, Daisuke Okuzaki, Tetsuhisa Kitamura, Sho Komukai, Yoshiyuki Kido, Takashi Kojima, Yuki Togami, Yusuke Katayama, Yuko Nakagawa and Hiroshi Ogura
    Citation: Critical Care 2022 26:241
  23. While the Glasgow coma scale (GCS) is one of the strongest outcome predictors, the current classification of traumatic brain injury (TBI) as ‘mild’, ‘moderate’ or ‘severe’ based on this fails to capture enormo...

    Authors: Cecilia A. I. Åkerlund, Anders Holst, Nino Stocchetti, Ewout W. Steyerberg, David K. Menon, Ari Ercole and David W. Nelson
    Citation: Critical Care 2022 26:228
  24. Sepsis is a heterogeneous syndrome, and the identification of clinical subphenotypes is essential. Although organ dysfunction is a defining element of sepsis, subphenotypes of differential trajectory are not w...

    Authors: Zhenxing Xu, Chengsheng Mao, Chang Su, Hao Zhang, Ilias Siempos, Lisa K. Torres, Di Pan, Yuan Luo, Edward J. Schenck and Fei Wang
    Citation: Critical Care 2022 26:197
  25. Interleukin (IL)-18 is a marker of inflammasome activation, and high baseline plasma IL-18 is associated with increased mortality in patients with sepsis-induced ARDS. The aim of this analysis was to determine...

    Authors: Andrew James Boyle, Peter Ferris, Ian Bradbury, John Conlon, Manu Shankar-Hari, Angela J. Rogers, Cecilia M. O’Kane and Daniel F. McAuley
    Citation: Critical Care 2022 26:164
  26. Thrombotic microangiopathy-induced thrombocytopenia-associated multiple organ failure and hyperinflammatory macrophage activation syndrome are important causes of late pediatric sepsis mortality that are often mi...

    Authors: Yidi Qin, Kate F. Kernan, Zhenjiang Fan, Hyun-Jung Park, Soyeon Kim, Scott W. Canna, John A. Kellum, Robert A. Berg, David Wessel, Murray M. Pollack, Kathleen Meert, Mark Hall, Christopher Newth, John C. Lin, Allan Doctor, Tom Shanley…
    Citation: Critical Care 2022 26:128

    The Comment to this article has been published in Critical Care 2022 26:387

  27. Late mortality risk in sepsis-survivors persists for years with high readmission rates and low quality of life. The present study seeks to link the clinical sepsis-survivors heterogeneity with distinct biologi...

    Authors: Sabri Soussi, Divya Sharma, Peter Jüni, Gerald Lebovic, Laurent Brochard, John C. Marshall, Patrick R. Lawler, Margaret Herridge, Niall Ferguson, Lorenzo Del Sorbo, Elodie Feliot, Alexandre Mebazaa, Erica Acton, Jason N. Kennedy, Wei Xu, Etienne Gayat…
    Citation: Critical Care 2022 26:114
  28. Trials comparing early and delayed strategies of renal replacement therapy in patients with severe acute kidney injury may have missed differences in survival as a result of mixing together patients at heterog...

    Authors: François Grolleau, Raphaël Porcher, Saber Barbar, David Hajage, Abderrahmane Bourredjem, Jean-Pierre Quenot, Didier Dreyfuss and Stéphane Gaudry
    Citation: Critical Care 2022 26:64
  29. The use of ultrasonography in the intensive care unit (ICU) is steadily increasing but is usually restricted to examinations of single organs or organ systems. In this study, we combine the ultrasound approach...

    Authors: Stefan Schmidt, Jana-Katharina Dieks, Michael Quintel and Onnen Moerer
    Citation: Critical Care 2021 25:405
  30. Identifying new effective treatments for the acute respiratory distress syndrome (ARDS), including COVID-19 ARDS, remains a challenge. The field of ARDS investigation is moving increasingly toward innovative a...

    Authors: Katherine D. Wick, Daniel F. McAuley, Joseph E. Levitt, Jeremy R. Beitler, Djillali Annane, Elisabeth D. Riviello, Carolyn S. Calfee and Michael A. Matthay
    Citation: Critical Care 2021 25:404
  31. Authors: Jean-Louis Vincent, Mervyn Singer, Sharon Einav, Rui Moreno, Julia Wendon, Jean-Louis Teboul, Jan Bakker, Glenn Hernandez, Djillali Annane, Angélique M. E. de Man, Xavier Monnet, V. Marco Ranieri, Olfa Hamzaoui, Jukka Takala, Nicole Juffermans, Jean-Daniel Chiche…
    Citation: Critical Care 2021 25:397
  32. Timely recognition of hemodynamic instability in critically ill patients enables increased vigilance and early treatment opportunities. We develop the Hemodynamic Stability Index (HSI), which highlights situat...

    Authors: Asif Rahman, Yale Chang, Junzi Dong, Bryan Conroy, Annamalai Natarajan, Takahiro Kinoshita, Francesco Vicario, Joseph Frassica and Minnan Xu-Wilson
    Citation: Critical Care 2021 25:388
  33. A high body mass index (BMI) has been associated with decreased mortality in critically ill patients. This association may, in part, relate to the impact of BMI on glycemia. We aimed to study the relationship ...

    Authors: Drago Plečko, Nicolas Bennett, Johan Mårtensson and Rinaldo Bellomo
    Citation: Critical Care 2021 25:378
  34. There is ongoing demographic ageing and increasing longevity of the population, with previously devastating and often-fatal diseases now transformed into chronic conditions. This is turning multi-morbidity int...

    Authors: Michael Beil, Hans Flaatten, Bertrand Guidet, Sigal Sviri, Christian Jung, Dylan de Lange, Susannah Leaver, Jesper Fjølner, Wojciech Szczeklik and Peter Vernon van Heerden
    Citation: Critical Care 2021 25:330
  35. A personalized mechanical ventilation approach for patients with adult respiratory distress syndrome (ARDS) based on lung physiology and morphology, ARDS etiology, lung imaging, and biological phenotypes may i...

    Authors: Paolo Pelosi, Lorenzo Ball, Carmen S. V. Barbas, Rinaldo Bellomo, Karen E. A. Burns, Sharon Einav, Luciano Gattinoni, John G. Laffey, John J. Marini, Sheila N. Myatra, Marcus J. Schultz, Jean Louis Teboul and Patricia R. M. Rocco
    Citation: Critical Care 2021 25:250
  36. Individualized positive end-expiratory pressure (PEEP) by electrical impedance tomography (EIT) has potential interest in the optimization of ventilation distribution in acute respiratory distress syndrome (AR...

    Authors: Huaiwu He, Yi Chi, Yingying Yang, Siyi Yuan, Yun Long, Pengyu Zhao, Inéz Frerichs, Feng Fu, Knut Möller and Zhanqi Zhao
    Citation: Critical Care 2021 25:230