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

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), driven mainly by shorter duration of organ support rather than lower mortality.
A 250‑ml Ultrafiltration Challenge Identifies Patients at Risk of Becoming Preload‑Dependent During CRRT
Posted inCritical Care Nephrology news

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 cardiac index change during a postural maneuver predicted this risk.
Resistance Training in the ICU Improves Muscle, Function, and Survival — HMB Adds Only Modest Benefit
Posted inCritical Care news Rehabilitation Medicine

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 produced only small gains in phase angle and fatigue with no additive effect.
Baseline SGLT2 Inhibitor Use Associated with Lower Risk of Sepsis-Induced Cardiomyopathy and Improved Outcomes in Type 2 Diabetes: Insights from a Large Propensity-Matched Cohort
Posted inCardiology Critical Care news

Baseline SGLT2 Inhibitor Use Associated with Lower Risk of Sepsis-Induced Cardiomyopathy and Improved Outcomes in Type 2 Diabetes: Insights from a Large Propensity-Matched Cohort

A large propensity-matched cohort study found that baseline SGLT2 inhibitor use versus DPP4 inhibitor therapy in adults with type 2 diabetes and infection was associated with lower 30-day sepsis-induced cardiomyopathy and improved 1-year mortality and cardiovascular outcomes; residual confounding and safety considerations warrant prospective trials.
Lactate Predicts Citrate Accumulation During Continuous Kidney Replacement Therapy: incidence, severity, and clinical implications
Posted inCritical Care Nephrology news

Lactate Predicts Citrate Accumulation During Continuous Kidney Replacement Therapy: incidence, severity, and clinical implications

In 911 critically ill patients on RCA-CKRT, citrate accumulation occurred in 17%. Pre-CKRT lactate strongly predicted accumulation (OR 2.34 per 1-unit increase on log scale); VIS was less discriminatory. Accumulation linked to liver dysfunction but not to shock and—after adjustment—did not increase mortality.
Higher Standardized ICU Admission Ratio After Rapid Response Calls Is Linked to Better Neurologic and Survival Outcomes: Insights from a Multicenter Japanese Registry
Posted inCritical Care news

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 events may influence recovery.