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Critical Care

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Critical Care

Precision Immunotherapy for Sepsis: ImmunoSep Trial Shows Early Organ‑Function Benefit with Targeted Anakinra or IFN‑γ

The ImmunoSep randomized trial found that biomarker-guided immunotherapy (anakinra for macrophage activation‑like syndrome; interferon‑γ for sepsis‑induced immunoparalysis) improved organ dysfunction by day 9 versus placebo, though 28‑day m

Dec 8, 2025
Cardiology

Immediate Coronary Angiography After Out‑of‑Hospital Cardiac Arrest Without ST Elevation Shows No 1‑Year Survival Benefit — IPD Meta‑Analysis of COACT and TOMAHAWK

An individual patient data meta‑analysis of COACT and TOMAHAWK (n=1,031) found no 1‑year survival benefit to immediate coronary angiography versus delayed/selective angiography after out‑of‑hospital cardiac arrest (OHCA) without ST‑elevatio

Dec 3, 2025
Critical Care

Real-time Sepsis Risk Prediction in Acute Gastrointestinal Bleeding: A Validated Dynamic Monitoring Tool That Improves Early Stratification

A multicenter Chinese study developed and validated a real-time nomogram that predicts sepsis in acute gastrointestinal bleeding (AGIB) using clinical and laboratory variables; the tool showed strong discrimination (AUCs 0.827–0.884), good

Dec 2, 2025
Critical Care

Both Too Little and Too Much Respiratory Drive and Effort Predict Worse Outcomes on Mechanical Ventilation: Insights from a Prospective Toronto Cohort

A prospective registry study found a U-shaped relationship between respiratory drive/effort and ICU outcomes: both low and high drive/effort linked with higher mortality and slower discharge, especially when oxygenation (PaO2:FiO2) ≤150 mmH

Dec 1, 2025
Critical Care

Biomarker-Guided Preventive Care Halves Risk of Moderate–Severe AKI After Major Surgery: Results from BigpAK-2

In BigpAK-2, a multinational randomized trial, a KDIGO-based preventive bundle triggered by tubular stress biomarkers reduced moderate or severe acute kidney injury within 72 hours after major surgery (OR 0.57; NNT 12) without increasing ad

Nov 26, 2025
Critical Care

Post‑COVID Resurgence of Mycoplasma pneumoniae in French Children: Hospital Burden, Risk Factors for ICU Admission, and Clinical Implications

A nationwide French multicentre cohort (ORIGAMI) documents a substantial 2023–24 paediatric hospitalisation surge from Mycoplasma pneumoniae, identifies older age, asthma, comorbidity and erythema multiforme as ICU risk factors, and highlig

Nov 23, 2025Sign in to read
Critical Care

Persistent Inspiratory Muscle Weakness After Prolonged Intubation: MIP at Day 12 Predicts Failure to Recover in the Acute-Care Stay

In patients extubated after ≥7 days of mechanical ventilation, 43% had persistent inspiratory muscle weakness at hospital discharge. Maximal inspiratory pressure (MIP) measured 12 days after diagnosis strongly predicted persistent weakness

Nov 11, 2025
Critical Care

Prolonged Prone Positioning in ARDS: Current Evidence Is Inconclusive — No Clear Mortality or Safety Benefit

A systematic review and meta-analysis found no clear mortality, oxygenation, or safety benefit for prolonged prone positioning (≥24 h) in ARDS; evidence is low to very low certainty and does not support routine use outside clinical trials.

Nov 11, 2025
Critical Care

Cefiderocol Non‑Inferior to Standard Therapy for Hospital‑Acquired Gram‑Negative Bacteraemia: Insights from the GAME CHANGER Trial

The GAME CHANGER randomized trial found cefiderocol non‑inferior to standard‑of‑care antibiotics for 14‑day mortality in hospital‑acquired and healthcare‑associated Gram‑negative bloodstream infection; no superiority was seen, including in

Nov 11, 2025
Critical Care

Conservative Dialysis Strategy Accelerates Kidney Recovery in Dialysis-Requiring AKI — Early Randomized Evidence from LIBERATE-D

The LIBERATE-D randomized trial found that a conservative, indication-triggered dialysis strategy increased unadjusted kidney-recovery rates at hospital discharge and shortened time to dialysis independence compared with routine thrice-week

Nov 8, 2025
Critical Care

SOFA-2 Recalibrated: Global Development and Validation of an Updated Organ Dysfunction Score in >3.3 Million ICU Admissions

SOFA-2 updates the 30-year-old SOFA score using data from >3.3 million ICU admissions across diverse settings. The revised tool modestly improves ICU mortality discrimination (AUROC 0.79 vs 0.77) and incorporates contemporary organ suppo

Nov 8, 2025
Critical Care

Targeting Capillary Refill Time in Early Septic Shock Reduced Duration of Organ Support: Key Findings from ANDROMEDA‑SHOCK‑2

ANDROMEDA‑SHOCK‑2 randomized 1,501 patients with early septic shock to a personalized CRT‑guided hemodynamic protocol versus usual care. A hierarchical composite outcome favored the CRT strategy (win ratio 1.16; 95% CI 1.02–1.33; P = .04),

Nov 7, 2025Sign in to read
Critical Care

A 250‑ml Ultrafiltration Challenge Identifies Patients at Risk of Becoming Preload‑Dependent During CRRT

A randomized cross‑over trial found that a 250‑ml net ultrafiltration challenge reliably identified preload‑independent critically ill patients who became preload‑dependent during continuous renal replacement therapy; a ≥5% calibrated cardi

Nov 7, 2025
Critical Care

Circulating Endothelial Transcriptomic Signatures Predict Worse Outcomes in COVID-19, Respiratory Failure and ARDS

Transcriptomic deconvolution of blood identifies elevated circulating endothelial signatures (ECS%) that associate with higher 28‑day mortality and worse respiratory trajectories in pediatric respiratory failure and adults hospitalized with

Nov 7, 2025
Critical Care

Resistance Training in the ICU Improves Muscle, Function, and Survival — HMB Adds Only Modest Benefit

A multicenter 2×2 factorial RCT in 266 critically ill adults shows that in‑ICU resistance training improves discharge physical function, muscle mass, patient‑reported outcomes, and lowers 6‑ and 12‑month mortality; HMB supplementation produ

Nov 7, 2025
Critical Care

Sodium Bicarbonate in Severe Metabolic Acidemia with AKI: No Survival Benefit but Less Dialysis — Insights from BICARICU-2

The BICARICU-2 randomized trial found that intravenous sodium bicarbonate in patients with severe metabolic acidemia and moderate-to-severe acute kidney injury did not reduce 90‑day mortality, but was associated with a substantial reduction

Nov 7, 2025
Critical Care

Trunk Inclination Changes Worsen Compliance and Raise PaCO2 in Obese ARDS Patients: Clinical Implications from a Seven-Study Pooled Analysis

A secondary analysis of 159 mechanically ventilated ARDS patients shows that increasing trunk inclination reduces respiratory system, lung, and chest wall compliance—especially in patients with obesity—and is associated with increased PaCO2

Nov 7, 2025
Critical Care

Choice of Vasopressor in Septic Shock: Does It Change Kidney Outcomes? A Critical Appraisal of the Evidence

A systematic review of 17 randomized trials (n=4,259) found no consistent renoprotective effect from any vasopressor in septic shock. Heterogeneous definitions, underpowered studies, and reliance on RRT limit conclusions; standardized renal

Nov 7, 2025Sign in to read
Critical Care

Adjunctive Terlipressin in Refractory Septic Shock: Lowers High-Dose Catecholamine Need at 6 Hours but No Mortality Benefit

In a double-blind RCT of 130 patients with refractory septic shock, terlipressin increased the proportion achieving MAP ≥65 mmHg with low catecholamine exposure at 6 hours versus placebo but did not change 28-day mortality; digital ischemia

Nov 7, 2025
Critical Care

Inhaled PEG‑Adrenomedullin in ARDS: Safe but Ineffective — Phase 2 RCT Stopped for Futility

A multicentre randomized Phase 2a/b trial found inhaled pegylated adrenomedullin (PEG‑ADM) well tolerated in ventilated ARDS patients but without improvement in ventilator‑free survival or a composite clinical utility index; the study was s

Nov 7, 2025
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    Burn Injury Reprograms Extracellular Vesicle Communication: Linking Immune Activation and Neuroinflammation

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