Four current ICU nutrition guidelines give four different first-week targets, and no guideline puts a norepinephrine number on when to start enteral feeding. The trials behind them agree on one thing — feeding less in the first week does not kill anyone, and the fashionable case for more protein has not survived the randomised trials. What I found when I checked my own habits against ESPEN 2023, ASPEN 2022, the Japanese 2024 and French 2025 guidelines.

Culture confirms, Xpert goes out with the first sputum, the 2-month visit is the fork in the road, and isolation comes off after 2 weeks of effective treatment plus three consecutive negative smears — not two. What I found when I went back to the 2024 Korean guideline (5th edition) and the 2026 national programme guideline.

There is no guideline for it. The consensus — lower peak pressure, lower PEEP, shorter inspiratory time, less suction — comes from case reports and two animal models, and the only numbers with a source are PEEP under 6 and a tidal volume of 7 rather than 4. What I found when I went looking for where my note's figures came from.

Most ICU pneumothoraces are iatrogenic, most pneumothoraces after draining an effusion are a lung that will not re-expand rather than a punctured one, and a ventilated patient with a pneumothorax gets a drain. What I found when I went back to the 2023 BTS documents.

The IDSA 2026 guidance makes sulbactam-durlobactam plus a carbapenem the preferred regimen for invasive CRAB, and demotes everything else to bridging therapy. Which is a problem if the drug is not available where you work.

Klebsiella pneumoniae dominates pyogenic liver abscess in Korea, not E. coli — and that changes the empiric regimen, the eye exam, and the length of therapy.