Critical Care
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New Persistent Opioid Use Among ICU Survivors After Discharge: Incidence, Predictors, and Nationwide Cohort Insights
New persistent opioid use develops in 4.2% of opioid-naïve ICU survivors by six months post-discharge, with early opioid prescription as the strongest predictor. Risk varies by opioid potency and patient factors, highlighting tailored taper
Rescue Noninvasive Ventilation After Extubation: High Failure but No Clear Increase in Hospital Mortality — A Post‑hoc RINO Trial Analysis
A post‑hoc analysis of the RINO trial found rescue NIV for post‑extubation respiratory failure had a 58% failure rate but was associated with lower ICU mortality and no clear increase in hospital mortality when applied with prespecified re‑
Hemorrhage Dominates Obstetric ICU Admissions in Japan: Insights from a Nationwide Inpatient Database
A nationwide Japanese study of 8,184 peripartum ICU admissions (2010–2022) found hemorrhage accounted for 52.6% of cases; interventions commonly included transfusion (71.5%), mechanical ventilation (28.0%), and transcatheter arterial emboli
Preventing Post‑Induction Hypotension With Low‑Dose Norepinephrine Reduces Postoperative Complications After Major Abdominal Surgery
A single‑center RCT found that starting a titrated norepinephrine infusion at anesthesia induction reduced intraoperative hypotension and lowered 30‑day medico‑surgical complications compared with reactive ephedrine boluses in high‑risk abd
Higher Standardized ICU Admission Ratio After Rapid Response Calls Is Linked to Better Neurologic and Survival Outcomes: Insights from a Multicenter Japanese Registry
A multicenter retrospective Japanese study found that hospitals admitting more patients to ICU than predicted after rapid response activations had fewer poor neurologic outcomes or deaths within 30 days, suggesting ICU utilization after RRS
Continuous Intravenous Sedation Produces Novel EEG ‘Ups’ in Early Acute Hypoxemic Respiratory Failure — Implications for Monitoring and Outcomes
In mechanically ventilated patients with early acute hypoxemic respiratory failure, continuous IV sedation produces EEG patterns (EEG Ups) not seen in natural sleep; these patterns correlate with sedation dose, drug combinations, clinical s
Physiologic PK-PD Modeling Reveals Greater Fentanyl Potency for Ventilatory Depression Than Simpler Approaches
A population PK–PD study in healthy volunteers found that a physiologic model incorporating CO2 kinetics and a ventilatory controller estimates fentanyl potency for ventilatory depression at ~2.3 ng/mL—substantially lower than estimates fro
Restrictive Red Blood Cell Transfusion Is Safe for Most Patients — Except in Neurocritical Care (and Some Bleeding Syndromes)
A Cochrane update (2025) of 69 randomized trials found restrictive RBC transfusion thresholds (typically Hb 7–8 g/dL) cut transfusion exposure ~42% without increasing 30‑day mortality overall, but liberal strategies improved long‑term neuro
Lower-Intensity Anticoagulation During Venovenous ECMO: A Pilot RCT Shows Feasibility and a Signal Toward Less Bleeding
A 3-center randomized pilot trial found that randomized allocation to low- versus moderate-intensity anticoagulation during venovenous ECMO is feasible, with lower major bleeding rates in the low-intensity arm and no clear excess of thrombo
Higher Early IV Fluid Rates Tied to More SIRS but Lower BUN Rise in Acute Pancreatitis: Findings From an International Cohort Presented at ACG 2025
An international prospective cohort found that higher early IV fluid rates were associated with lower odds of BUN rise but higher odds of new or persistent SIRS at 6 and 24 hours after presentation, highlighting confounding issues and the n
Selective Decontamination of the Digestive Tract in ICU Ventilated Patients: Impact on Mortality and Microbial Ecology
A large international trial found that selective decontamination of the digestive tract (SDD) during mechanical ventilation did not reduce hospital mortality but decreased bloodstream infections and antibiotic-resistant organisms, with no c
Noninferiority of Deferring Early Arterial Catheterization in Shock Management: Insights from a Multicenter RCT
A large multicenter trial demonstrated that deferring early arterial catheter insertion in ICU patients with shock is noninferior to early invasive monitoring for 28-day mortality, with fewer catheter-related complications and comparable sa
RIPK3 as a Prognostic Biomarker in Acute Decompensation of Cirrhosis: Advancing Risk Stratification and Therapeutic Targeting
RIPK3-associated necroptosis critically drives organ failure and mortality in acute decompensation and ACLF, with its plasma levels robustly predicting outcomes and improving prognostic models to guide personalized therapies.
Innovative Extracorporeal Therapy Combining HLA-Depleted Liver Organoids and Granulocyte-Monocyte Apheresis for Reversal of Acute Liver Failure
The UTOpiA system, integrating HLA-depleted iPSC-derived liver organoids with granulocyte-monocyte apheresis, significantly improves survival and liver regeneration in acute-on-chronic and acute liver failure rat models, representing a prom
Evaluating the Cost-Effectiveness of Early In-Bed Cycling Plus Routine Physiotherapy in Mechanically Ventilated ICU Patients: Insights from the CYCLE Trial
This economic evaluation from the CYCLE randomized trial found no significant cost or quality-adjusted life-year benefit by adding early in-bed cycling to usual physiotherapy for ICU patients on mechanical ventilation, underscoring a need f
Surge in Invasive Streptococcus pyogenes Infections Among Children Post-COVID-19: Insights from a Spanish Nationwide Study
A Spanish multicenter study reveals a sharp rise in pediatric invasive group A streptococcal infections and severity after 2022, highlighting emm1 strain predominance and risk factors for critical illness and mortality.
Risk Factors and Epidemiological Trends in Severe Pediatric Invasive Group A Streptococcal Disease: Insights from the Netherlands 2015–2024
A comprehensive study identifies key clinical and temporal risk factors associated with severe invasive group A streptococcal disease in children, highlighting increased severity and incidence post-COVID-19 pandemic in the Netherlands.
Epstein-Barr Virus and Pediatric Sepsis: Unraveling Links to Immune Dysregulation and Mortality
This study links EBV seropositivity to immune dysregulation and increased mortality in pediatric sepsis, highlighting potential pathways for targeted therapies.
Reassessing the Safety of Peripheral Vasopressor Use in Early Sepsis: Evidence from a Large Prospective Cohort Study
This study evaluates factors influencing vasopressor route choice in sepsis and demonstrates low complication rates associated with peripheral administration, supporting its safety in early resuscitation.
Postoperative Vasopressor Use After Noncardiac Surgery: Patterns, Outcomes, and Clinical Implications from a Global Observational Study
An international study reveals that postoperative vasopressor infusions after noncardiac surgery vary widely across hospitals and are linked to higher mortality and complications, highlighting the need for optimized management strategies.
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