Major publications in the critical care pharmacotherapy literature: 2025

To summarize and provide clinical insights on the most impactful publications related to critical care pharmacotherapy in 2025.

A systematic search of PubMed/Medical Literature Analysis and Retrieval System Online (MEDLINE) was conducted between January 1, 2025 and October 5, 2025. Inclusion criteria consisted of randomized controlled trials with prospective study designs evaluating a critically ill adult patient population receiving pharmacotherapeutic interventions and reporting clinical endpoints. A multi-disciplinary and geographically diverse group of critical care clinicians was assembled and an a-priori defined three-round modified Delphi process was performed, with a focus on the publications determined to be the most impactful or novel.

The systematic search yielded a total of 1609 articles for review and 1566 were excluded, leaving 43 articles to be included in the modified Delphi process. In each round, articles were scored based on their overall contribution to the literature and novelty with articles achieving a score at or above the median progressing to the next modified Delphi round. The six included articles are summarized. Article topics include alternative sedation options in mechanically ventilated patients, thrombolytic usage in acute ischemic strokes, management of coagulopathic bleeding following cardiac surgery, and use of corticosteroids in severe community-acquired pneumonia.

This concise review identified, summarized, and offered insights on the most relevant critical care pharmacotherapy publications in the year 2025.