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.
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.