Durable mechanical circulatory support, represented by the left ventricular assist device (LVAD), plays an important role in the treatment of patients with end-stage heart failure. The introduction of levitation technologies (magnetic or hydraulic) has substantially improved the hemocompatibility and survival of LVAD, further transforming the therapeutic philosophy for LVAD (evidenced by increased proportion of destination therapy). In the future, fully implantable LVADs will further improve patients' quality of life, while physiologically adaptive pulsatile pumps are expected to achieve even greater improvements in hemocompatibility. This article provides a review of the application of durable mechanical circulatory support (dMCS) in patients with end-stage heart failure, focusing on the current status of LVAD, its indications and timing of surgery, as well as future development directions.

Postoperative pulmonary complications (PPC) are one of the most challenging complications faced by patients after cardiac surgery, and are the major cause of postoperative mortality. Electrical impedance tomography (EIT) is a kind of noninvasive bedside lung ventilation monitoring technology which is used increasingly in intensive respiratory management. Recently, it has been found that EIT lung ventilation imaging features can be used to predict the occurrence of PPC after abdominal surgery. Based on the practical experience of EIT application in our center, this paper summarizes the PPC diagnosis and treatment strategy based on EIT lung ventilation image feature, in order to provide reference for the application of EIT technology in cardiac surgery.

Fluid therapy runs throughout the hemodynamic treatment process for ICU patients. A precise fluid therapy strategy is key to implement individualized fluid management and organ protection. A fluid therapy approach guided by fluid responsiveness can help assess the effectiveness, limits, and optimal timing of fluid therapy by evaluating the body's volume responsiveness, fluid tolerance, blood pressure responsiveness, and perfusion responsiveness. This approach enables precise hemodynamic fluid management, identifies patients who truly benefit from fluid therapy, avoids organ dysfunction, and promotes the rapid recovery of critically ill patients.

The recognition and management of valvular heart disease (VHD) pose a significant challenge for intensivists. The priorities include rapid diagnosis, timely differentiation of potential etiologies, implementation of effective therapies, and creating opportunities for definitive surgical intervention. Key aspects that require optimization cncompass efficient hemodynamic monitoring, tailored pharmacotherapy, judicious application of extracorporeal life support and determining the optimal timing for surgical or transcatheter procedures. This article reviews the current evidence regarding the diagnosis and managementof VHD in critically ill patients, aiming to provide a reference for clinicians to optimize clinical practice in ICU.

To evaluate the effects of inhaled nitric oxide (iNO) on oxygenation and ventilation-perfusion (V/Q) matching in patients with moderate to severe acute respiratory distress syndrome (ARDS).

Adult patients with acute respiratory distress syndrome (ARDS) who met the Berlin criteria, had an oxygenation index (PaO₂/FiO₂) ≤ 200 mmHg, and received invasive mechanical ventilation in the Department of Intensive Care Medicine at Zhongda Hospital, Affiliated to Southeast University from January 2023 to March 2024, were prospectively enrolled. Vital signs, respiratory mechanics, arterial blood gas analysis and electrical impedance tomography (EIT) data were collected at baseline and 30 minutes after iNO. V/Q matching, shunt and dead space fraction were analyzed using EIT offline analysis. The changes in gas exchange and V/Q in patients before and after iNO treatment were evaluated.

Twenty-four patients were enrolled, with the median age of 75 (65, 83) years. In the overall population, PaO₂/FiO₂ increased [206.2(159.6, 231.5) mmHg vs 168.7 (150.1, 181.4) mmHg, P＜0.001] after iNO, accompanied by decreased shunt fraction [18.2 (11.5, 24.2)% vs 22.7 (11.6, 27.4)%, P=0.001], and improved V/Q matching [75.3 (65.6, 79.9)% vs 71.1 (61.9, 79.3)%, P=0.002], while the dead space fraction was unchanged. A significant correlation was found between changes in PaO₂/FiO₂ and shunt fraction following iNO (r=-0.461, P=0.023). Among the 11 Oxygenation responders, iNO significantly reduced the shunt fraction and improved V/Q matching among responders, whereas these effects were not significant in the non-responders.

In patients with moderate to severe ARDS, iNO improves oxygenation possibly by reducing the shunt fraction.

To investigate the current practice in the diagnosis and treatment of hemorrhagic shock and trauma-induced coagulopathy (TIC) in ICUs across China.

A nationwide questionnaire-based survey was conducted among 1733 critical care physicians from 814 secondary and tertiary hospitals across all 31 provincial-level regions in China. The collected data were statistically analyzed to comprehensively evaluate key aspects and influencing factors in the management of these conditions.

The majority of respondents were from comprehensive ICUs in tertiary Grade A teaching hospitals. Heart rate (87.88%), blood pressure (93.83%), prothrombin time (98.27%), and fibrinogen level (94.40%) were the most commonly used indicators for diagnosing hemorrhagic shock and TIC and for guiding transfusion decisions. Physicians' perceptions regarding the choice of resuscitation fluids and blood products, goals of coagulation management, target ionized calcium level, core temperature control, and deep vein thrombosis prophylaxis were largely consistent with the European Guideline on Management of Major Bleeding and Coagulopathy Following Trauma: Sixth Edition. Several key discrepancies with the guideline were identified: viscoelastic testing was not widely used in clinical practice; fresh frozen plasma was still commonly used to correct hypoalbuminemia; calcium gluconate was preferred over calcium chloride for supplementing ionized calcium; and graduated compression stockings were considered effective for preventing lower extremity deep vein thrombosis.

Chinese intensivists demonstrate a relatively high level of knowledge in managing hemorrhagic shock and TIC.However, significant opportunities for standardization and improvement remain. Targeted training programs and quality control initiatives based on these survey findings are warranted to bridge the gap between current practices and evidence-based guidelines.

Based on the Web of Science database, a bibliometric analysis was conducted on global literature in the field of acute respiratory distress syndrome (ARDS) from 2020 to 2025 to explore the research landscape and hotspots in this domain.

Literature on ARDS from 2020 to 2025 indexed in the Web of Science database was retrieved. CiteSpace and VOSviewer were employed to analyze the publication countries, authors, institutions, and journals. Keyword cluster analysis was performed to identify research hotspots and themes.

A total of 9271 articles were included. The United States contributed the highest number of publications (2792 articles), followed by China (2078 articles), Italy (1048 articles). The top three authors were Pelosi Paolo (78 articles), Marcus J. Schultz (65 articles), and Matthay Michael A (64 articles). The University of Toronto was the most prolific institution. Current research hotspots primarily included precise respiratory function assessment, ventilator-induced lung injury (VILI), subphenotypes, and risk prediction models.

Global research activity in the ARDS field has increased. Compared with European and American countries, China still lags in terms of publication volume, influential institutions, and highly cited authors. Future research will focus more on precise respiratory support strategies and subphenotype-based risk prediction models for ARDS patients.

Blood glucose monitoring and management in critically ill patients constitutes an important part of intensive care. Continuous glucose monitoring (CGM) can improve the time in the target blood glucose range and reduce hypoglycemic events, and it has been widely used in patients with diabetes. Its advantages, including continuous glucose data collection, multiple glucose dynamic indicators, minimal invasiveness and reduced workload for medical staff, have drawn increasing attention from ICU clinicians. However, the clinical applicability of CGM in ICU patients remains controversial due to the critical conditions and rapid pathophysiological changes. This article elaborates on the recent progress regarding the accuracy of CGM in critically ill patients, as well as whether it can improve the quality of blood glucose control and clinical prognosis.

With the continuous advancement of critical care medicine, early mortality among critically ill patients has significantly declined. However, a subset of survivors continue to experience persistent multi-organ dysfunction, requiring prolonged stays in the intensive care unit (ICU). These patients are clinically defined as having chronic critical illness (CCI). Notably, CCI is characterized by marked hypercatabolism, which severely impacts prognosis and quality of life. This article systematically reviews the definition, epidemiology, and pathophysiological mechanisms of hypercatabolism in CCI, including the roles of sustained inflammatory responses, neuroendocrine dysregulation, and their effects on tissue metabolism—particularly skeletal muscle catabolism. Furthermore, we summarize biomarkers associated with hypercatabolism in CCI patients and evaluate the critical role of nutritional support strategies, such as enteral nutrition, nutritional adjuvants, and anabolic agents, in mitigating metabolic dysregulation. By synthesizing current evidence, this review aims to provide reference for optimizing nutrition-focused interventions in CCI patients, ultimately improving clinical outcomes and guiding future research directions in this evolving field.

Septic shock is one of the most important threats to human life and health. Despite ongoing researches, the morbidity and mortality remain high. As a non-catecholamine-based vasoconstrictor, methylene blue has been shown in many studies to increase mean arterial pressure, reduce the need of catecholamine vasopressors and reduce the mortality of septic shock. However, these findings have not been consistently conclusive. This article reviewed the therapeutic effect of methylene blue in septic shock in this manuscript.

Sepsis can trigger the onset of atrial fibrillation (AF). When AF occurs in septic patients, hospital length of stay is often prolonged, and the risk of in-hospital mortality increases. Compared to septic patients without AF, those with sepsis-induced AF face nearly a threefold increase in the risk of in-hospital stroke. Clinically, there is an ongoing debate over whether anticoagulant therapy should be administered to septic patients with concurrent AF. Some advocate for anticoagulation to reduce the incidence of ischemic stroke, while other caution that it may increase the risk of bleeding. In light of these differing perspectives, this article reviews both domestic and international literature to explore whether anticoagulant therapy should be initiated in septic patients with AF, particularly in cases of new-onset AF. The goal is to enhance clinicians' understanding of anticoagulation strategies in this context and to provide guidance on better balancing the potential benefits of anticoagulation with the associated risks of bleeding.

Camel whey protein (CWP), a by-product derived from camel milk during processing, is a nutritionally rich component characterized by its high protein content, excellent digestibility and efficient absorption. Recognized for its high purity,superior absorption rate, and well-balanced amino acid profile, CWP is often regarded as a"king of protein"and is acknowledged as a high-quality dietary protein supplements. Furthermore, emerging research has revealed that CWP possesses diverse bioactive properties, including anti-inflammatory, antimicrobial, antiviral, antioxidant, and immunomodulatory effects, alongside lowallergenicity. These bioactivities suggest considerable potential for CWP in the treatment and prevention of various diseases. This review summarizes the current evidence biological activities of CWP and its potential clinical applications in promoting health and facilitating recovery from disease, with a specific focus on proposing a novel adjuvant therapeutic strategy forsepsis. Our aim is to provide a theoretical foundation for the future clinical development and utilization of CWP.

Artificial intelligence (AI) is a new quality productive forces of modern information technology. It provides innovative approaches to optimize critical care workflows and improve patient safety and quality of care. In addition, AI promotes the development of scientific and precise critical care. This article reviews AI applications in critical care, analyzes current challenges and proposes corresponding strategies to support future advances of AI technology in critical care.

Carbapenem-resistant Acinetobacter baumannii (CRAB) infection is associated with reduced early postoperative survival among liver transplant recipients with acute-on-chronic liver failure (ACLF). We report the first case at our center in which Sulbactam-Durlobactam (SUL-DUR) was successfully used to treat a CRAB pulmonary infection patient with ACLF following liver transplantation. After initiating SUL-DUR therapy, next-generation sequencing (NGS) demonstrated a progressive decline in CRAB sequence counts. By day 4, CRAB-specific PCR of bronchoalveolar lavage fluid (BALF) returned negative, and CRAB was undetectable in subsequent BALF cultures. The treatment demonstrated favorable clinical efficacy, with notable radiological improvement and rapid microbial eradication. SUL-DUR not only rapidly controlled the progression of CRAB-induced pulmonary infection, but also facilitated the early initiation of immunosuppressive therapy. Subsequent in vitro antimicrobial susceptibility testing revealed synergy between SUL-DUR and cefepime, though no such synergy was observed with imipenem. This case underscores the promising role of SUL-DUR in managing post-transplant CRAB pneumonia, especially in high-risk patients with acute-on-chronic liver failure. Our findings may provide a valuable reference for optimizing therapeutic strategies in similar clinical cases.