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.
Continuous Intravenous Sedation Produces Novel EEG ‘Ups’ in Early Acute Hypoxemic Respiratory Failure — Implications for Monitoring and Outcomes
Posted inAnesthesiology Critical Care news

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 sedation depth, and ICU mortality.
Physiologic PK-PD Modeling Reveals Greater Fentanyl Potency for Ventilatory Depression Than Simpler Approaches
Posted inAnesthesiology Critical Care news

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 from simpler models, with implications for perioperative opioid safety and modeling methodology.
Urine‑guided Intraoperative Hydration Halves AKI Risk After CRS‑HIPEC with Cisplatin: Randomized Trial Shows Promise
Posted inAnesthesiology Nephrology news

Urine‑guided Intraoperative Hydration Halves AKI Risk After CRS‑HIPEC with Cisplatin: Randomized Trial Shows Promise

A randomized trial found that maintaining high intraoperative urine output (≥3 ml·kg−1·h−1 or ≥200 ml·h−1) during cytoreductive surgery and cisplatin‑based HIPEC reduced 7‑day postoperative AKI from 39.3% to 21.4% and lowered major 30‑day complications without increasing adverse events.
Pregabalin Restores Sleep and Circadian Rhythms in Neuropathic Pain—Unlike Morphine: Translational Insights from a Mouse SNI Model
Posted inAnesthesiology Neurology news

Pregabalin Restores Sleep and Circadian Rhythms in Neuropathic Pain—Unlike Morphine: Translational Insights from a Mouse SNI Model

In a mouse spared nerve injury model, pregabalin—but not morphine—restored REM sleep, normalized locomotor and temperature circadian rhythms, and reversed spinal circadian gene changes. Findings suggest analgesic choice can differentially affect sleep and circadian biology in neuropathic pain.
Restrictive Red Blood Cell Transfusion Is Safe for Most Patients — Except in Neurocritical Care (and Some Bleeding Syndromes)
Posted inAnesthesiology Critical Care Hematology-Oncology news

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 neurological outcomes after brain injury and restrictive thresholds reduced mortality in GI bleeding.
Pathogen-Reduced Red Blood Cells Are Safe in Cardiac Surgery: ReCePI Phase 3 Shows Noninferior AKI Rates
Posted inAnesthesiology Cardiology General Surgery news

Pathogen-Reduced Red Blood Cells Are Safe in Cardiac Surgery: ReCePI Phase 3 Shows Noninferior AKI Rates

The ReCePI randomized phase 3 trial found that amustaline/glutathione pathogen-reduced red blood cells produced similar rates of acute kidney injury compared with conventional transfusion after cardiac or thoracic-aorta surgery, with few treatment-emergent antibodies and no clinically significant hemolysis.
Lower-Intensity Anticoagulation During Venovenous ECMO: A Pilot RCT Shows Feasibility and a Signal Toward Less Bleeding
Posted inCardiology Critical Care news

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 thromboembolic events—but the study was underpowered for definitive safety or efficacy conclusions.