--- name: brycewang-stanford/critical-care-medicine source: https://app.decimal.ai/s/brycewang-stanford-critical-care-medicine@1/SKILL.md source_sha256: b43499528f65 --- # Critical Care Medicine (critical-care-medicine) ## Journal positioning Critical Care Medicine is the flagship journal of the Society of Critical Care Medicine (SCCM), publishing clinical and translational research centered on the **care of the critically ill across the whole ICU** — sepsis, ARDS, resuscitation, shock, multiorgan failure and organ support, and the systems and processes of critical-care delivery. Its defining expectation is a **clinically important advance in intensive-care management or critical-illness mechanism that informs how clinicians care for ICU patients**, not a narrow single-center series with no outcome relevance or a basic experiment without critical-illness anchoring. Unlike the broader pulmonary/critical-care flagship, Critical Care Medicine is ICU-discipline-focused and spans the whole critically ill patient, not just the lung. This skill is a **fit / venue-selection / re-framing** aid; it is not clinical or regulatory advice and does not replace the journal's current instructions for authors. Before submitting, re-check the live Critical Care Medicine author instructions. ## When to trigger - The author names Critical Care Medicine for an ICU, sepsis, resuscitation, or organ-support study and wants a fit/framing check. - A critical-care study must be re-framed around an intensive-care management question or a critical-illness mechanism with outcome relevance. - The author is choosing between Critical Care Medicine, AJRCCM (broader respiratory + critical care), and The Lancet Respiratory Medicine. - The author needs the journal's reporting-guideline, registration, and ICU-trial/quality expectations. ## Scope & topic fit - Sepsis and septic shock: resuscitation, antimicrobial timing, hemodynamics, and outcome studies. - ARDS and acute respiratory failure: ventilation strategy, oxygenation, and rescue therapies in the ICU context. - Resuscitation and shock: fluids, vasopressors, cardiac arrest, and post-resuscitation care. - Organ support and multiorgan failure: renal replacement, ECMO, nutrition, and sedation/ delirium management. - ICU systems, quality, staffing, and process-of-care and outcomes research, including long-term/post-ICU outcomes. - Translational critical-illness science (immunology, endothelial/coagulation biology) anchored to critically ill patients or relevant models. ## Method & evidence bar - Studies must be adequately powered with prespecified, patient-centered ICU endpoints (mortality, organ-failure-free or ventilator-free days, functional outcome); surrogate physiologic endpoints need justification. - The applicable reporting guideline and checklist are expected: CONSORT for trials, STROBE for observational work, PRISMA for systematic reviews, ARRIVE for animal studies. - Trials require prospective registration and the registration number; protocol/SAP are expected, and pragmatic/cluster designs need appropriate analysis. - Observational ICU analyses must address confounding by indication, immortal-time and selection bias, and missing data; causal language must match the design. - Translational claims need controls and replication and must anchor to critically ill patients or validated models. - Effect estimates need confidence intervals and absolute as well as relative measures. ## Structure & house style - SCCM format with a structured abstract and a key-points/clinical-relevance statement; re-check current article types (Clinical Investigation, etc.) and limits on the live guide. - The introduction frames the ICU clinical gap; the discussion states the management implication and bounds generalizability to ICU practice. - A CONSORT/STROBE/PRISMA flow diagram is expected for the relevant design; animal work reports ARRIVE-aligned detail. - Tables/figures follow the journal's statistical-reporting standards; a supplement carries the protocol, full statistical methods, and additional analyses. ## Official-submission checklist - Before giving submission-ready advice, read `../../resources/source-basis.md` and `../../resources/official-source-map.md`; start from the ICMJE/EQUATOR and SCCM anchors, then cite the current Critical Care Medicine page you checked. - Search the live site for "Critical Care Medicine SCCM instructions for authors" and follow the current version. - Re-check article types, abstract and key-points format, and word/figure/reference limits. - Confirm trial registration, the reporting checklist (CONSORT/STROBE/PRISMA/ARRIVE), data/code-availability, and protocol/SAP submission. - Re-check IRB/ethics and consent (including waived/deferred consent for emergency research), animal-care/IACUC approval, ICMJE authorship and conflict-of-interest disclosure, funding, and AI-use disclosure. - If the live official instructions conflict with this skill, the official instructions win. ## Pre-submission self-check - [ ] The study delivers a clinically important ICU-management advance or a critical-illness mechanism with outcome relevance. - [ ] ICU endpoints are prespecified and powered; trials are registered with the number in the manuscript. - [ ] The correct reporting checklist (CONSORT/STROBE/PRISMA/ARRIVE) is completed and attached. - [ ] Observational analyses address confounding by indication, immortal-time/selection bias, and missing data. - [ ] Translational claims are anchored to critically ill patients or validated models with controls. - [ ] IRB/consent (incl. deferred consent), IACUC (if animal), ICMJE disclosures, and a data-availability statement are prepared. ## Common desk-reject triggers - Single-center descriptive ICU series with no outcome relevance and limited generalizability. - Observational analyses with confounding by indication or immortal-time bias and overstated causal claims. - Surrogate physiologic endpoints presented as clinically definitive without patient outcomes. - Missing trial registration, protocol, or the required reporting checklist. - Lung-biology-dominant or purely respiratory-mechanism work better placed in a broader respiratory venue. ## Re-routing decision - Pulmonary biology / respiratory-mechanism dominant over ICU management → `american-journal-of-respiratory-and-critical-care-medicine`. - High-impact respiratory/critical-care trial with broad reach → `the-lancet-respiratory-medicine`. - Perioperative critical care, sedation, or anesthesia-led ICU work → `anesthesiology`. - ICU AKI / renal-replacement centered on nephrology → `journal-of-the-american-society-of-nephrology` / `kidney-international`. - Broad practice-changing critical-care trial → general medicine (`jama` / NEJM / The Lancet in the natural-science bundle). ## Output format ```text [Fit] High / Medium / Low (one-line reason) [Target] Critical Care Medicine (SCCM) [Specialty tags] [Study design / reporting guideline] [Method/evidence] [Top risk] [Official items to re-check]
[Re-route suggestion] ```