Latest Critical Care and Intensive Care Medicine research

Top 10 this week

Week of 20 September 2026

1. 1

   Early Versus Late Tracheostomy: An Umbrella Review and Meta-Analysis

   Journal of clinical medicine · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 28 August 2026

   Umbrella review of early vs late tracheostomy in ICU patients

2. 2

   Multicomponent Pulmonary Rehabilitation for Prolonged Mechanical Ventilation in Patients Aged 80 Years or Older: A Randomized Controlled Trial

   Chest · Q1 journal · RCT · Evidence level 1 (High) · 19 September 2026

   In a randomized trial of 150 octogenarians on prolonged ventilation, a structured pulmonary rehab program enabled 45% of participants to be successfully weaned, compared with only 12% receiving standard care. The intervention also improved oxygenation, diaphragm movement, cough and muscle strength, and lowered pneumonia rates, suggesting a viable strategy to enhance liberation from the ventilator in the very elderly.

3. 3

   Efficacy and safety of sedation induced with cipepofol alone versus a dexmedetomidine plus propofol regimen for patients requiring mechanical ventilation: a randomized, open-label, non-inferiority trial

   Annals of intensive care · Q1 journal · RCT · Evidence level 1 (High) · 1 September 2026

   Non‑inferiority RCT of cipepofol vs dexmedetomidine/propofol for ICU sedation

4. 4

   Dose reporting and dose-stratified effects of early mobilization in mechanically ventilated adult ICU patients: a systematic review and meta-analysis

   Frontiers in medicine · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 31 August 2026

   Systematic review of early mobilization in ventilated ICU patients

5. 5

   Superior-head automated external defibrillator placement during single-rescuer cardiopulmonary resuscitation: a randomized crossover simulation study and retrospective multicenter cohort

   Frontiers in public health · Q1 journal · RCT · Evidence level 1 (High) · 3 September 2026

   High-quality evidence in a top journal

6. 6

   Neonatal Ventilation Training Using a Low-Cost, High-Fidelity Simulator in a Low-Resource Setting: A Randomized Clinical Trial

   JAMA network open · Q1 journal · RCT · Evidence level 1 (High) · 1 September 2026

   Neonatal ventilation training trial in low‑resource setting

7. 7

   Effectiveness of structured lactation support and human donor milk banking in German NICUs: a stepped-wedge cluster-randomized trial

   BMC medicine · Q1 journal · RCT · Evidence level 1 (High) · 11 September 2026

   High-quality evidence in a top journal

8. 8

   Effect of eating vegetables before carbohydrates on glucose, insulin and glycemic control - A systematic review and meta-analysis of randomized controlled trials

   Clinical nutrition (Edinburgh, Scotland) · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 2 September 2026

   Dietary timing meta‑analysis, unrelated to ICU

9. 9

   The Effect of Extracorporeal Shockwave Therapy in Tendinopathy: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

   Orthopaedic surgery · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 13 September 2026

   Systematic review of extracorporeal shockwave therapy for tendinopathy

10. 10

    Adjunctive Akkermansia muciniphila postbiotic supplementation modulates metabolic and endocrine profiles in obesity-associated polyendocrine metabolic ovarian syndrome: A randomized controlled trial

    Clinical nutrition (Edinburgh, Scotland) · Q1 journal · RCT · Evidence level 1 (High) · 7 September 2026

    Postbiotic supplementation, metabolic study

Paper of the day, last two weeks

• Deep learning-derived abdominal adiposity phenotypes and 28-day mortality in sepsis

  International journal of obesity (2005) · Q1 journal · Retrospective cohort · Evidence level 3 (Low) · 19 September 2026

  CT adiposity phenotypes linked to 28‑day sepsis mortality

• Determining Reintubation Risk Factors and Effects on Outcomes in the Surgical ICU

  Journal of intensive care medicine · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 18 September 2026

  Reintubation risk factors and outcomes in surgical ICU

• The Rate-Volume Trade-off in Mechanically Ventilated Patients: Respiratory Rate and 28-Day Mortality Across Two Independent Cohorts

  Respiratory medicine · Q1 journal · Prospective cohort · Evidence level 4 (Very Low) · 16 September 2026

  Respiratory rate vs mortality in ventilated patients

• The Rate-Volume Trade-off in Mechanically Ventilated Patients: Respiratory Rate and 28-Day Mortality Across Two Independent Cohorts

  Respiratory medicine · Q1 journal · Prospective cohort · Evidence level 4 (Very Low) · 16 September 2026

  Respiratory rate vs mortality in ventilated patients

• Mortality Effect of Peripheral Perfusion-Guided Resuscitation in Vasodilatory Shock: A Systematic Review and Dual Frequentist-Bayesian Meta-Analysis of Randomized Trials

  Critical care medicine · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 11 September 2026

  Peripheral perfusion‑guided resuscitation meta‑analysis in septic shock

• Mortality Effect of Peripheral Perfusion-Guided Resuscitation in Vasodilatory Shock: A Systematic Review and Dual Frequentist-Bayesian Meta-Analysis of Randomized Trials

  Critical care medicine · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 11 September 2026

  Peripheral perfusion‑guided resuscitation meta‑analysis in septic shock

• Hematocrit and 28-day mortality in mechanically ventilated septic patients: a prospective observational study

  Frontiers in medicine · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 26 August 2026

  Low hematocrit linked to higher 28‑day mortality in ventilated sepsis

• High-Flow Nasal Oxygen Versus Conventional Oxygen Therapy and Non-Invasive Ventilation for Acute Respiratory Failure in the Emergency Department: A Systematic Review and Meta-Analysis

  Emergency medicine Australasia : EMA · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 1 October 2026

  HFNO reduces intubation, relevant for ARDS/ventilation strategy

• Hematocrit and 28-day mortality in mechanically ventilated septic patients: a prospective observational study

  Frontiers in medicine · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 26 August 2026

  Low hematocrit linked to higher 28‑day mortality in ventilated sepsis

• Clinical outcomes of early vs. late extubation following cardiac surgery: a systematic review and meta-analysis

  Frontiers in medicine · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 26 August 2026

  A meta-analysis of 19 studies found that patients extubated within six hours had roughly one-tenth the odds of dying compared with later extubation, and also saw far lower rates of reintubation, pneumonia, renal failure requiring dialysis, tracheostomy and readmission. The data are mainly from observational cohorts, so prospective trials are needed before changing protocols.

• Ketamine for Analgosedation in Mechanically Ventilated Adults: A Double-Blind Randomized Trial

  Critical care medicine · Q1 journal · RCT · Evidence level 1 (High) · 7 September 2026

  Low-dose ketamine reduces opioid requirements in ventilated patients

• Impact of an ROX index-guided intubation strategy on mortality in patients receiving high-flow nasal cannula: a target trial emulation

  Journal of intensive care · Q1 journal · Retrospective cohort · Evidence level 3 (Low) · 14 August 2026

  In a retrospective emulation of target trials using ICU data, initiating intubation within two hours of a ROX index falling below 3.85 or 4.88 lowered 30-day death rates from about 27% to 20%, a reduction of six to seven percentage points. The association suggests a potential benefit, but the authors stress that prospective trials are needed before changing practice.

Evidence summaries in Critical Care and Intensive Care Medicine

• Septic Shock
• Sepsis