CONCLUSION: Microcirculatory monitoring should currently be viewed as a complementary framework for identifying persistent or heterogeneous tissue hypoperfusion beyond conventional macrocirculatory targets. Its integration into individualized resuscitation remains promising but requires standardized methodology, external validation, and prospective interventional evidence before any single modality or multimodal strategy can be adopted as a validated resuscitation endpoint.

The Tigris trial recently reported that polymyxin B hemoadsorption (PMX) achieved a high posterior probability of benefit for mortality in adults with endotoxic septic shock (endotoxemia with multiple organ failure). The trial used a Bayesian framework with a prior derived from a subgroup of an earlier trial (EUPHRATES) and this subgroup was used to design eligibility criteria for Tigris. Ten questions that expose the trial's strengths and limitations are answered in this review. Writing as the...

Pediatric sepsis involves dynamic, developmentally conditioned immune dysfunction that a single cytokine concentration or one-time severity label cannot represent. This structured narrative Review examines how nano-enabled microfluidic systems could support blood-sparing, serial assessment of functional immune states in the pediatric intensive care unit (PICU). We separate soluble-protein concentration, cell phenotype, ex vivo stimulation response, cellular effector function, immunometabolic...

CONCLUSION: This study developed and externally validated an interpretable XGBoost-based model for predicting sepsis risk during ICU stay among patients after intracranial hematoma evacuation. The model showed generally consistent AUC-based discrimination across multiple validation cohorts and may support individualized risk stratification. Further prospective validation and clinical impact assessment are required before routine clinical implementation.