Precision Immunotherapy for Sepsis: ImmunoSep Trial Shows Early Organ‑Function Benefit with Targeted Anakinra or IFN‑γ
Posted inCritical Care Infectious Diseases news

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 mortality was unchanged. Safety signals require follow‑up.
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
Posted inCardiology Critical Care news

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‑elevation; no patient subgroup showed a clear differential benefit.
Real-time Sepsis Risk Prediction in Acute Gastrointestinal Bleeding: A Validated Dynamic Monitoring Tool That Improves Early Stratification
Posted inCritical Care Gastroenterology news

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 calibration, and an online monitoring platform for dynamic alerts.
Both Too Little and Too Much Respiratory Drive and Effort Predict Worse Outcomes on Mechanical Ventilation: Insights from a Prospective Toronto Cohort
Posted inCritical Care news Respiratory

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 mmHg; ventilator driving pressure effects were amplified by patient effort.
Post‑COVID Resurgence of Mycoplasma pneumoniae in French Children: Hospital Burden, Risk Factors for ICU Admission, and Clinical Implications
Posted inCritical Care Infectious Diseases news Pediatrics Public Health Respiratory

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 highlights stewardship and surveillance priorities.
Persistent Inspiratory Muscle Weakness After Prolonged Intubation: MIP at Day 12 Predicts Failure to Recover in the Acute-Care Stay
Posted inCritical Care news Nursing & care Respiratory

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 and may guide early rehabilitation and resource allocation.
Cefiderocol Non‑Inferior to Standard Therapy for Hospital‑Acquired Gram‑Negative Bacteraemia: Insights from the GAME CHANGER Trial
Posted inCritical Care Infectious Diseases news

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 carbapenem‑resistant infections.
Conservative Dialysis Strategy Accelerates Kidney Recovery in Dialysis-Requiring AKI — Early Randomized Evidence from LIBERATE-D
Posted inCritical Care Nephrology news

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-weekly dialysis in patients with dialysis-requiring AKI.
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.