This article reviews noteworthy literature published in 2025 pertinent to the care of critically ill cardiothoracic surgical patients. We reviewed over 9000 articles to identify 12 publications that provided new or supportive evidence on a diverse range of topics including the management of cardiogenic shock, pulmonary and renal failure, precision immunotherapy in sepsis care, and resuscitation. Additional topics included outcomes following mechanical thrombectomy and methods of hemodynamic monitoring.
GillilandSKimKKLiXTanabeKHenniganAAlberS. Year in review 2024: noteworthy literature in cardiothoracic critical care. Semin Cardiothorac Vasc Anesth. 2025;29(2):116-125.
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AlberSTanabeKTregearHHenniganAGillilandS. Year in review 2022: noteworthy literature in cardiothoracic critical care. Semin Cardiothorac Vasc Anesth. 2023;27(2):87-96.
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AlberSTanabeKHenniganATregearHGillilandS. Year in review 2023: noteworthy literature in cardiothoracic critical care. Semin Cardiothorac Vasc Anesth. 2024;28(2):66-79.
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JaderlingGCalzavaccaPBellM, et al.The deteriorating ward patient: a Swedish-Australian comparison. Intensive Care Med. 2011;37(6):1000-1005.
5.
GrasselliGCalfeeCSCamporotaL, et al.ESICM guidelines on acute respiratory distress syndrome: definition, phenotyping and respiratory support strategies. Intensive Care Med. 2023;49(7):727-759.
6.
BrochardLHarfALorinoHLemaireF. Inspiratory pressure support prevents diaphragmatic fatigue during weaning from mechanical ventilation. Am Rev Respir Dis. 1989;139(2):513-521.
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BrochardLIsabeyDPiquetJ, et al.Reversal of acute exacerbations of chronic obstructive lung disease by inspiratory assistance with a face mask. N Engl J Med. 1990;323(22):1523-1530.
8.
BrochardLManceboJWysockiM, et al.Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med. 1995;333(13):817-822.
9.
MacIntyreNR. Physiologic effects of noninvasive ventilation. Respir Care. 2019;64(6):617-628.
10.
SquadroneVMassaiaMBrunoB, et al.Early CPAP prevents evolution of acute lung injury in patients with hematologic malignancy. Intensive Care Med. 2010;36(10):1666-1674.
11.
WermkeMSchiemanckSHöffkenGEhningerGBornhäuserMIllmerT. Respiratory failure in patients undergoing allogeneic hematopoietic SCT--a randomized trial on early non-invasive ventilation based on standard care hematology wards. Bone Marrow Transplant. 2012;47(4):574-580.
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MontiGCabriniLKotaniY, et al.Early noninvasive ventilation in general wards for acute respiratory failure: an international, multicentre, open-label, randomised trial. Br J Anaesth. 2025;134(2):382-391.
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CabriniLIdoneCColomboS, et al.Medical emergency team and non-invasive ventilation outside ICU for acute respiratory failure. Intensive Care Med. 2009;35(2):339-343.
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CabriniLMoizoENicelliE, et al.Noninvasive ventilation outside the intensive care unit from the patient point of view: a pilot study. Respir Care. 2012;57(5):704-709.
15.
PerkinsGDJiCConnollyBA, et al.Effect of noninvasive respiratory strategies on intubation or mortality among patients with acute hypoxemic respiratory failure and COVID-19: the RECOVERY-RS randomized clinical trial. JAMA. 2022;327(6):546-558.
16.
PirracchioRVenkateshBLegrandM. Low-dose corticosteroids for critically ill adults with severe pulmonary infections: a review. JAMA. 2024;332(4):318-328.
17.
TaenakaHWickKDSarmaA, et al.Biological effects of corticosteroids on pneumococcal pneumonia in mice-translational significance. Crit Care. 2024;28(1):185.
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TorresASibilaOFerrerM, et al.Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial. JAMA. 2015;313(7):677-686.
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GroupWHOREAf.C-TWSterneJACMurthyS, et al.Association between administration of systemic corticosteroids and mortality among critically ill patients with COVID-19: a meta-analysis. JAMA. 2020;324(13):1330-1341.
20.
DequinPFMezianiFQuenotJP, et al.Hydrocortisone in severe community-acquired pneumonia. N Engl J Med. 2023;388(21):1931-1941.
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HemingNRenaultAKupermincE, et al.Hydrocortisone plus fludrocortisone for community acquired pneumonia-related septic shock: a subgroup analysis of the APROCCHSS phase 3 randomised trial. Lancet Respir Med. 2024;12(5):366-374.
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ChaudhuriDNeiAMRochwergB, et al.Focused update: guidelines on use of corticosteroids in sepsis, acute respiratory distress syndrome, and community-acquired pneumonia. Crit Care Med. 2024;52(5):e219-e233.
23.
BergmannFPracherLSawodnyR, et al.Efficacy and safety of corticosteroid therapy for community-acquired pneumonia: a meta-analysis and meta-regression of randomized, controlled trials. Clin Infect Dis. 2023;77(12):1704-1713.
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CheemaHAMusheerAEjazA, et al.Efficacy and safety of corticosteroids for the treatment of community-acquired pneumonia: a systematic review and meta-analysis of randomized controlled trials. J Crit Care. 2024;80:154507.
25.
LiuJDongYChenJJinYQiuYHuangL. Corticosteroid in non-COVID-19 induced community-acquired pneumonia, a meta-analysis. Heart Lung. 2024;65:59-71.
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MeduriGUShihMCBridgesL, et al.Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia. Intensive Care Med. 2022;48(8):1009-1023.
27.
PitreTAbdaliDChaudhuriD, et al.Corticosteroids in community-acquired bacterial pneumonia: a systematic review, pairwise and dose-response meta-analysis. J Gen Intern Med. 2023;38(11):2593-2606.
28.
SeeXYWangTHChangYC, et al.Impact of different corticosteroids on severe community-acquired pneumonia: a systematic review and meta-analysis. BMJ Open Respir Res. 2024;11(1):e002141.
29.
InvestigatorsR-CAngusDC. Effect of hydrocortisone on mortality in patients with severe community-acquired pneumonia: the REMAP-CAP corticosteroid domain randomized clinical trial. Intensive Care Med. 2025;51(4):665-680.
30.
GroupRC. Dexamethasone in hospitalized patients with Covid-19. N Engl J Med. 2021;384(8):693-704.
31.
de JongeEPeelenLKeijzersPJ, et al.Association between administered oxygen, arterial partial oxygen pressure and mortality in mechanically ventilated intensive care unit patients. Crit Care. 2008;12(6):R156.
32.
PalmerEPostBKlapaukhR, et al.The association between supraphysiologic arterial oxygen levels and mortality in critically ill patients. A multicenter observational cohort study. Am J Respir Crit Care Med. 2019;200(11):1373-1380.
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InvestigatorsI-R. Conservative oxygen therapy during mechanical ventilation in the ICU. N Engl J Med. 2020;382(11):989-998.
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van der WalLIGrimCCADel PradoMR, et al.Conservative versus liberal oxygenation targets in intensive care unit patients (ICONIC): a randomized clinical trial. Am J Respir Crit Care Med. 2023;208(7):770-779.
35.
SchjorringOLKlitgaardTLPernerA, et al.Lower or higher oxygenation targets for acute hypoxemic respiratory failure. N Engl J Med. 2021;384(14):1301-1311.
36.
SemlerMWCaseyJDLloydBD, et al.Oxygen-saturation targets for critically ill adults receiving mechanical ventilation. N Engl J Med. 2022;387(19):1759-1769.
37.
NielsenFMKlitgaardTLSiegemundM, et al.Lower vs higher oxygenation target and days alive without life support in COVID-19: the HOT-COVID randomized clinical trial. JAMA. 2024;331(14):1185-1194.
38.
PetersMJGouldDWRayS, et al.Conservative versus liberal oxygenation targets in critically ill children (Oxy-PICU): a UK multicentre, open, parallel-group, randomised clinical trial. Lancet. 2024;403(10424):355-364.
39.
LiXYDaiBHouHJ, et al.Conservative versus liberal oxygen therapy for intensive care unit patients: meta-analysis of randomized controlled trials. Ann Intensive Care. 2024;14(1):68.
40.
MartinDSGouldDWShahidT, et al.Conservative oxygen therapy in mechanically ventilated critically ill adult patients: the UK-ROX randomized clinical trial. JAMA. 2025;334(5):398-408.
41.
den UilCAVan MieghemNMB BastosM, et al.Primary intra-aortic balloon support versus inotropes for decompensated heart failure and low output: a randomised trial. EuroIntervention. 2019;15(7):586-593.
42.
FriedJANairATakedaK, et al.Clinical and hemodynamic effects of intra-aortic balloon pump therapy in chronic heart failure patients with cardiogenic shock. J Heart Lung Transplant. 2018;37(11):1313-1321.
43.
MoriciNSaccoAFreaS, et al.Early intra-aortic balloon support for heart failure-related cardiogenic shock: a randomized clinical trial. J Am Coll Cardiol. 2025;85(16):1587-1597.
44.
ThieleHZeymerUNeumannFJ, et al.Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med. 2012;367(14):1287-1296.
45.
Machanahalli BalakrishnaAReddiVBelfordPM, et al.Intermediate-risk pulmonary embolism: a review of contemporary diagnosis, risk stratification and management. Medicina (Kaunas). 2022;58(9):1186.
46.
KonstantinidesSVMeyerGBecattiniC, et al.ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the european respiratory society (ERS). Eur Heart J. 2019;41(4):543-603. 2020.
47.
MoriartyJMDohadSYSchiroBJ, et al.Clinical, functional, and quality-of-life outcomes after computer assisted vacuum thrombectomy for pulmonary embolism: interim analysis of the STRIKE-PE study. J Vasc Interv Radiol. 2024;35(8):1154-1165 e6.
48.
SistaAKHorowitzJMTapsonVF, et al.Indigo aspiration system for treatment of pulmonary embolism: results of the EXTRACT-PE trial. JACC Cardiovasc Interv. 2021;14(3):319-329.
49.
LooksteinRAKonstantinidesSVWeinbergI, et al.Randomized controlled trial of mechanical thrombectomy with anticoagulation versus anticoagulation alone for acute intermediate-high risk pulmonary embolism: primary outcomes from the STORM-PE trial. Circulation. 2026;153(1):21-34.
50.
EvansLRhodesAAlhazzaniW, et al.Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Crit Care Med. 2021;49(11):e1063-e1143.
51.
LevyBBastienOKarimB, et al.Experts' recommendations for the management of adult patients with cardiogenic shock. Ann Intensive Care. 2015;5(1):52.
52.
MullerGContouDEhrmannS, et al.Deferring arterial catheterization in critically ill patients with shock. N Engl J Med. 2025;393(19):1875-1888.
53.
SelfWHSemlerMWWandererJP, et al.Balanced crystalloids versus saline in noncritically ill adults. N Engl J Med. 2018;378(9):819-828.
54.
ZampieriFGCavalcantiABDi TannaGL, et al.Balanced crystalloids versus saline for critically ill patients (BEST-Living): a systematic review and individual patient data meta-analysis. Lancet Respir Med. 2024;12(3):237-246.
55.
McIntyreLFergussonDMcArdleT, et al.A crossover trial of hospital-wide lactated ringer's solution versus normal saline. N Engl J Med. 2025;393(7):660-670.
56.
AsfarPMezianiFHamelJF, et al.High versus low blood-pressure target in patients with septic shock. N Engl J Med. 2014;370(17):1583-1593.
57.
LamontagneFMeadeMOHébertPC, et al.Higher versus lower blood pressure targets for vasopressor therapy in shock: a multicentre pilot randomized controlled trial. Intensive Care Med. 2016;42(4):542-550.
58.
CarayannopoulosKLPiduttiAUpadhyayaY, et al.Mean arterial pressure targets and patient-important outcomes in critically ill adults: a systematic review and meta-analysis of randomized trials. Crit Care Med. 2023;51(2):241-253.
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StolkRFvan der PollTAngusDCvan der HoevenJGPickkersPKoxM. Potentially inadvertent immunomodulation: norepinephrine use in sepsis. Am J Respir Crit Care Med. 2016;194(5):550-558.
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LamontagneFDayAGMeadeMO, et al.Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock. Intensive Care Med. 2018;44(1):12-21.
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