Landiolol and Organ Failure in Patients With Septic Shock: The STRESS-L Randomized Clinical Trial

When deciding whether to admit a patient to the ICU, the question is not only what we can do, but what we ought to do. In this podcast, we explore the ethical complexities of ICU admission, balancing the potential benefits and burdens of intensive care, patient preferences, prognostic uncertainty, and the fair allocation of limited resources. Drawing on the concept of proportionality, we discuss how clinicians can navigate difficult decisions, manage disagreements, and ensure that the care provided is aligned with what matters most to each patient. These themes are explored in depth in a paper co-authored by our guests: Proportionality and the process of decision-making around ICU admission: A narrative review of the ethical complexities of navigating from “can” to “ought”.

What has changed in the 2025 ESICM guidelines on circulatory shock and haemodynamic monitoring, and what does it mean for clinical practice? In this podcast, our guest, Dr Antonio Messina, Chair of the CD Section, discusses the key updates in the new guidelines and explores practical approaches to assessing tissue perfusion and haemodynamic status, including the role of capillary refill time, peripheral perfusion, and combined biological and macrocirculatory parameters. The discussion also explores fluid responsiveness assessment and its role in guiding fluid therapy in patients with circulatory shock. These are just some of the topics discussed, with many more practical insights and recommendations from the 2025 guidelines explored throughout the podcast. Listen to the latest ESICM Podcast and discover what is new in the 2025 guidelines.

How do you optimise drug dosing in a critically ill patient undergoing continuous renal replacement therapy (CRRT)? Drug dosing during CRRT can be challenging, with multiple factors influencing drug clearance and exposure. In the latest ESICM Podcast, experienced clinical pharmacists explore the key determinants of drug clearance during CRRT, focusing on the interplay between the patient, the drug and the CRRT circuit. The discussion highlights how drug characteristics, such as volume of distribution, and CRRT-related factors can influence drug removal and dosing, and why a personalised approach is essential to optimise treatment in critically ill patients. Listen to the latest ESICM Podcast and discover what determines drug clearance during RRT.

This year, ESICM is proud to mark World Sepsis Day with a special podcast, "From Awareness to Action," featuring ESICM President Jan De Waele in conversation with Krista Bracke, sepsis survivor and advocate behind the initiative Sepsis Stronger Together. Together, they discuss what survival really costs, where the gaps between evidence and practice remain, what the new 2026 SSC Guidelines mean for the bedside, and how the clinical and patient communities can work together to drive meaningful change — from education and workforce investment to European policy and national sepsis plans.

Why should every ICU clinician be prepared to recognise heat stroke? In this podcast, we explore the importance of early recognition and treatment of heat stroke, from the emergency department to the ICU. Discover how rapid intervention can dramatically improve outcomes, with survival rates of up to 80% when treatment is initiated early. We also discuss the key clinical signs to look out for—including neurological symptoms such as ataxia—and the challenges of recognising multi-organ dysfunction and the overlap between heat stroke and sepsis. Listen to the podcast and discover the key messages every ICU clinician should know when managing this time-critical emergency.