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Life
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Innovations in Critical Care and Anesthesiology
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Innovations in Critical Care and Anesthesiology

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 2 October 2026 | Viewed by 2580

Special Issue Editor

Dr. Luigi La Via

E-Mail Website
Guest Editor
Department of Anesthesia and Intensive Care, Azienda Ospedaliero Universitaria Policlinico “G.Rodolico-San Marco”, 95123 Catania, Italy
Interests: loco-regional anesthesia; pain medicine; ERAS
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Critical care and anesthesiology have undergone remarkable transformations in recent years, driven by technological advances, evolving clinical protocols, and lessons learned from global health challenges. This Special Issue aims to showcase cutting-edge innovations that are reshaping perioperative medicine and intensive care practice.

We invite contributions exploring novel monitoring technologies, artificial intelligence applications in critical care decision-making, advanced ventilation strategies, and personalized approaches to sedation and analgesia. Papers addressing point-of-care diagnostics, enhanced recovery protocols, organ support innovations, and telemedicine applications in ICU settings are particularly welcome. We also encourage submissions on emerging pharmacological agents, non-invasive monitoring techniques, and quality improvement initiatives that enhance patient safety and outcomes.

This collection seeks to bridge the gap between technological innovation and clinical implementation, highlighting translational research that directly impacts patient care. We welcome original research articles, comprehensive reviews, case studies demonstrating novel techniques, and perspective pieces on future directions in the field. By bringing together diverse perspectives from clinicians, researchers, and biomedical engineers, this Special Issue aims to provide a comprehensive overview of the current landscape and future horizons in critical care and anesthesiology.

Dr. Luigi La Via
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • artificial intelligence in ICU
  • point-of-care monitoring
  • enhanced recovery protocols
  • precision anesthesia
  • mechanical ventilation
  • organ support systems
  • perioperative medicine
  • critical care innovations

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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13 pages, 725 KB  
Article
Indications, Dwell Time, and Removal Reasons of Standardized Mid-Thigh Lower-Extremity PICCs in Adult ICU Patients: A Retrospective Cohort Study
by Wei-Hung Chang, Ting-Yu Hu, Hui-Fang Hsieh, Kuang-Hua Cheng and Kuan-Pen Yu
Life 2026, 16(2), 262; https://doi.org/10.3390/life16020262 - 3 Feb 2026
Viewed by 681
Abstract
Lower-extremity peripherally inserted central catheters (PICCs) are used in critically ill adults when upper-extremity access is limited, yet real-world data on indications, dwell time, and device-related outcomes remain scarce. We retrospectively reviewed consecutive ultrasound-guided mid-thigh lower-extremity PICC placements performed under a standardized protocol [...] Read more.
Lower-extremity peripherally inserted central catheters (PICCs) are used in critically ill adults when upper-extremity access is limited, yet real-world data on indications, dwell time, and device-related outcomes remain scarce. We retrospectively reviewed consecutive ultrasound-guided mid-thigh lower-extremity PICC placements performed under a standardized protocol (15 cm below the inguinal ligament; fixed 55-cm insertion depth) in an adult ICU and extracted indication patterns, catheter dwell time, removal reasons, and microbiological findings. Among 38 placements in 37 patients, difficult peripheral access was present in all cases; prolonged intravenous antibiotics were the predominant indication (34/38, 89.5%), followed by total parenteral nutrition (13/38, 34.2%) and vasopressor therapy (2/38, 5.3%). Median dwell time was 19.5 days (IQR 12–25; range 3–48). Catheters were most commonly removed due to death (15/38, 39.5%), discharge (13/38, 34.2%), or no longer being clinically indicated (8/38, 21.1%), while removal for suspected catheter infection/fever occurred in 2/38 (5.3%). A catheter-drawn culture was positive in 1/38 (2.6%; Candida albicans), whereas peripheral blood cultures were positive in 4/38 (10.5%). In this single-center retrospective descriptive cohort, standardized mid-thigh lower-extremity PICCs were used for prolonged venous access. Removals for suspected infection/fever evaluation were uncommon; however, CRBSI was not adjudicated and thrombosis surveillance was not performed. These findings describe local utilization patterns and support future comparative studies and stewardship-focused quality improvement. Full article
(This article belongs to the Special Issue Innovations in Critical Care and Anesthesiology)
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16 pages, 1462 KB  
Article
Fluid Creep as an Independent Predictor of Fluid Overload and Mortality in Critically Ill Patients: A Cohort Study
by George Briassoulis, Theodora Antonopoulou, Joanna Velegraki, Stavroula Ilia and Eumorfia Kondili
Life 2025, 15(12), 1900; https://doi.org/10.3390/life15121900 - 12 Dec 2025
Viewed by 1245
Abstract
Background: Fluid overload (FO) is a frequent ICU complication and an important predictor of adverse outcomes. While classically attributed to resuscitative fluids, recent data emphasize the contribution of non-therapeutic “fluid creep” from medication diluents and carrier infusions. This study examined associations between fluid [...] Read more.
Background: Fluid overload (FO) is a frequent ICU complication and an important predictor of adverse outcomes. While classically attributed to resuscitative fluids, recent data emphasize the contribution of non-therapeutic “fluid creep” from medication diluents and carrier infusions. This study examined associations between fluid creep, FO, acute kidney injury (AKI), and mortality, and explored the predictive value of the modified Renal Angina Index (mRAI) for AKI risk stratification and FO; Methods: A retrospective cohort of 250 critically ill adults (ICU stay ≥72 h) admitted to a mixed medical–surgical ICU between May 2021 and November 2024 was analyzed. All fluids administered during the first 72 h were categorized and indexed to ideal body weight. Fluid creep included drug diluents, carriers, and flushes. FO% was calculated as [(Cumulative Fluid Balance)/IBW] × 100; Results: Fluid creep was higher in non-survivors (5183 ± 2541 vs. 4354 ± 2171 mL; p = 0.008) and correlated with FO, cumulative balance, and total input (r = 0.41 to 0.43; p < 0.001). Creep and FO independently predicted ICU mortality. Abnormal mRAI scores were associated with FO and early AKI; Conclusions: Fluid creep and FO were independent mortality predictors. Routine monitoring and minimization of creep, along with structured de-resuscitation protocols, may improve outcomes in critically ill adults. Full article
(This article belongs to the Special Issue Innovations in Critical Care and Anesthesiology)
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13 pages, 999 KB  
Systematic Review
The Effects of CytoSorb in Critically Ill Adult Patients on Vasopressor Support: A Systematic Review and Meta-Analysis
by Martina Giacco, Benedetta Savasta, Andrea Montisci, Federico Pappalardo and Luigi La Via
Life 2026, 16(4), 576; https://doi.org/10.3390/life16040576 - 1 Apr 2026
Viewed by 247
Abstract
Background: The impact of CytoSorb hemoadsorption on hemodynamic stability, mortality, and intensive care unit length of stay in critically ill adult patients requiring vasopressor support is unclear. Methods: Systematic review and meta-analysis of randomized controlled trials and observational studies, enrolling adult intensive care [...] Read more.
Background: The impact of CytoSorb hemoadsorption on hemodynamic stability, mortality, and intensive care unit length of stay in critically ill adult patients requiring vasopressor support is unclear. Methods: Systematic review and meta-analysis of randomized controlled trials and observational studies, enrolling adult intensive care unit patients requiring vasopressor support. We compared CytoSorb hemoadsorption versus standard care or control interventions. Results: Twelve studies enrolling 568 patients met the inclusion criteria. Primary outcomes included noradrenaline dosage, mortality at longest follow-up, and intensive care unit length of stay. CytoSorb treatment significantly reduced noradrenaline requirements (mean difference −0.08 μg/kg/min [95% CI: −0.15 to −0.02], p = 0.02, I2 = 8%). Mortality at the longest follow-up was lower with CytoSorb (risk ratio 0.66 [95% CI: 0.55–0.80], p < 0.001, I2 = 0%), though this finding was driven primarily by observational studies; randomized controlled trials alone showed non-significant mortality reduction (risk ratio 0.23 [95% CI: 0.05–1.06], p = 0.06). No difference in intensive care unit length of stay was observed (mean difference 0.24 days [95% CI: −1.23 to 1.70], p = 0.75). Trial sequential analysis indicated insufficient information size for definitive conclusions. Overall evidence quality was low to very low. Conclusions: CytoSorb hemoadsorption may reduce vasopressor requirements in critically ill patients. Observed mortality benefits were driven primarily by observational studies, with RCTs showing non-significant trends. Overall evidence quality is low, and findings should be considered hypothesis-generating; adequately powered RCTs are needed before clinical recommendations can be made. Full article
(This article belongs to the Special Issue Innovations in Critical Care and Anesthesiology)
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