Critical Care Evidence Updates – November 2025

Randomised Controlled Trials

A Conservative Dialysis Strategy and Kidney Function Recovery in Dialysis-Requiring Acute Kidney Injury – The Liberation From Acute Dialysis (LIBERATE-D) Randomized Clinical Trial  JAMA

A preventive care strategy to reduce moderate or severe acute kidney injury after major surgery (BigpAK-2); a multinational, randomised clinical trial  The Lancet

Anaemia management with red blood cell transfusion to improve post-intensive care disability: Protocol for the ABC post-ICU randomised controlled trial  Journal of the Intensive Care Society

Application of active subglottic airway humidification in intermittent subglottic secretion drainage in patients with tracheostomy: a randomized controlled trial  Journal of Anesthesia, Analgesia and Critical Care

Comparison of two different bicarbonate replacement fluids during CVVH with RCA: a prospective, randomized, controlled trial  Intensive Care Medicine

Effect of Neuromuscular Electrical Stimulation for Older Critically Ill Patients in the ICU: A Randomized Controlled Trial  Critical Care Explorations

Effect of Paracetamol on Cerebral Temperature in Febrile Brain-Injured Patients. The NEUROTHERM Study: A Randomized Controlled Pharmacodynamic Trial  Critical Care Medicine

Effects of a multicomponent sleep enhancement protocol on delirium incidence in elderly critically ill surgical patients: a randomized controlled trial  Journal of Intensive Care

Effects of intraoperative higher versus lower positive end-expiratory pressure during one-lung ventilation for thoracic surgery on postoperative pulmonary complications (PROTHOR): a multicentre, international, randomised, controlled, phase 3 trial  The Lancet Respiratory Medicine

Efficacy and safety of REGN9933^A2 and REGN7508^Cat for preventing postoperative venous thromboembolism (ROXI-VTE-I and ROXI-VTE-II): two randomised, open-label, phase 2 trials  The Lancet

Efficacy and safety of regional citrate anticoagulation using calcium-containing replacement solution in different modalities of continuous renal replacement therapy: a randomized controlled trial  BMC Nephrology

Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19: an investigator-initiated international meta-trial of randomised clinical studies  eClinicalMedicine

Liberal or Restrictive Postoperative Transfusion in Patients at High Cardiac Risk – The TOP Randomized Clinical Trial  JAMA

Low dose of landiolol does not prevent postoperative atrial fibrillation after cardiac surgery in non-Asian patients: a multicentre randomised study  British Journal of Anaesthesia

Nitric Oxide to Reduce Acute Kidney Injury in Patients with Pre-existing Endothelial Dysfunction Requiring Prolonged Cardiopulmonary Bypass: A Randomized Clinical Trial  Anesthesiology

Randomized Controlled Trial of Mechanical Thrombectomy With Anticoagulation Versus Anticoagulation Alone for Acute Intermediate-High Risk Pulmonary Embolism: Primary Outcomes from the STORM-PE Trial  Circulation

The impact of extracorporeal diaphragm pacing therapy on diaphragm function in critically III patients dependent on mechanical ventilation: a double-blind randomized controlled trial  Medicine

The impact of PEEP-guided electrical impedance tomography on oxygenation and respiratory mechanics in moderate-to-severe ARDS: a randomized controlled trial  Scientific Reports

Triple Versus Dual Lipid-Lowering Therapy in Acute Coronary Syndrome: The ES-BempeDACS Randomized Clinical Trial  Circulation

 

NICE

Suspected sepsis in over 16s QS213

Suspected sepsis in people aged 16 or over: recognition, assessment and early management NG253

Suspected sepsis in pregnant or recently pregnant people: recognition, diagnosis and early management NG255

 

Other Guidance/Reports

American Burn Association Clinical Practice Guideline on Blood Product Transfusion in Burn Care  Journal of Burn Care & Research

Coronary Artery Revascularization in the Older Adult Population: A Scientific Statement From the American Heart Association  Circulation

Difficult Airway Society 2025 guidelines for management of unanticipated difficult tracheal intubation in adults  British Journal of Anaesthesia

ESICM guidelines on circulatory shock and hemodynamic monitoring 2025  Intensive Care Medicine

Haemodynamic monitoring and management of the hypotensive out-of-hospital cardiac arrest patient in the adult intensive care unit: a clinical consensus statement of the Association for Acute CardioVascular Care of the ESC  European Heart Journal – Acute Cardiovascular Care

Ketogenic diet for status epilepticus in adult intensive care unit patients: a standard operating procedure  Neurological Research and Practice

Management of Invasive Pulmonary Aspergillosis in Intensive Care Units: Guidelines From the Fungal Infection Network of Switzerland (FUNGINOS)  Mycoses

State-of-the-Art Review: Antibiotic Allergy—A Multidisciplinary Approach to Delabeling  Clinical Infectious Diseases

The definition and aims of Anesthesia: a Delphi-based consensus statement  Anaestehsia Critical Care & Pain Medicine

The intensive care medicine research agenda for the management of ICU acquired weakness: a multinational, interprofessional perspective  Intensive Care Medicine

Top three priorities for artificial intelligence integration into emergency, critical, and perioperative medicine: an interdisciplinary clinical expert consensus  Journal of Anesthesia, Analgesia and Critical Care

 

Cochrane

Colchicine for the secondary prevention of cardiovascular events

Non‐invasive ventilation for cystic fibrosis

 

Primary Research

Adult extracorporeal cardiopulmonary resuscitation in the United Kingdom 2012 to 2022: A multicentre observational study  Journal of the Intensive Care Society

Approaches to Mechanical Ventilation in Patients With and Without Acute Brain Injury: A Registry-Based Cohort Study  Critical Care Medicine

Association between anemia and trauma-related severe acute kidney injury in trauma patients at risk of major bleeding: A post-hoc analysis of the RESTRIC trial  Journal of Critical Care

Association between controlled mechanical ventilation and systemic inflammation in acute hypoxemic respiratory failure: an observational cohort study  Critical Care

Association between respiratory-related cortical activation and weaning from mechanical ventilation: a physiological study  Critical Care

Association of Glycemic Variability with Mortality among Septic Patients with Coronary Artery Disease: A Multicenter Cohort Study  Journal of Intensive Care Medicine

Association of Sepsis Survivor Subtypes With Long-Term Mortality and Disability After Discharge: A Retrospective Cohort Study  Critical Care Medicine

Beds we make, futures we shape: A life cycle and cost analysis of reusable and disposable linen in the ICU  Intensive and Critical Care Nursing

Bedside ventilatory settings guided by respiratory mechanics in acute respiratory distress syndrome  Annals of Intensive Care

Body mass index and mortality: The “Obesity Paradox” in critically ill patients with intra-abdominal infection or sepsis – An international cohort study  Intensive and Critical Care Nursing

Clinical outcomes of early fast compared to slow sodium correction rate in adults with severe hypernatremia: A comparative effectiveness study  Journal of Critical Care

Comparison of intubation characteristics with the McGrath video laryngoscope in adults using a stylet, bougie or no intubating aid  Journal of Perioperative Practice

Continuous versus intermittent beta-lactam antibiotic infusions in critically ill patients: The UK cohort of the BLING III trial  Journal of the Intensive Care Society

Daptomycin is associated with higher treatment failure rates than alternatives for Enterococcus faecium bloodstream infections in critically ill patients: a multicentric retrospective cohort  Critical Care

Development and validation of the STeP score for predicting tracheostomy in patients with sepsis using a nationwide ICU database: a retrospective observational study  Journal of Intensive Care

Effects of mindfulness-based stress reduction on ICU nurses’ resilience and well-being  Intensive and Critical Care Nursing

Effects of Preoxygenation With Intratracheal Suctioning During Extubation: An Alternating Cluster-Controlled Trial (INtratracheal suctioning and oxygenation AT Extubation [INNOVATE])  Critical Care Medicine

Epidemiology of pain, delirium, psychiatric disorders, discomfort and sedation-analgesia management in the intensive care unit: a one-day nationwide study  Critical Care

Five-year mortality and functional trajectories in older survivors of intensive care compared to the general population  Intensive Care Medicine

Fluid removal improves muscle performance and weakness in critically ill patients: a pilot study  Intensive Care Medicine Experimental

“He is so much more than just his illness” using the Patient Dignity Question (PDQ) to elicit personhood and enhance dignity in the intensive care unit (ICU): A feasibility study examining family and healthcare professional feedback  Journal of Critical Care

High Flow Nasal Oxygen: Impact on Aspiration and the Care of Medically Complex Patients  Journal of Intensive Care Medicine

ICU predictive factors of fibrotic changes following COVID-19 related ARDS: a RECOVIDS substudy  Annals of Intensive Care

Impact of delirium in cardiosurgical patients on short- and long-term mortality  Intensive and Critical Care Nursing

Implementation and sustainability of an innovative ICU e-diary  Intensive and Critical Care Nursing

Incidence, severity, and predictors of citrate accumulation during continuous kidney replacement therapy in the critically ill  Critical Care

Individualised treatment effects of enhanced early mobilisation in mechanically ventilated patients: a secondary analysis of the TEAM trial  Intensive Care Medicine

Longitudinal Cognitive Recovery After Critical Illness: Trajectories in Sepsis and Non-Sepsis Survivors  Journal of Intensive Care Medicine

Management of endothelial dysfunction in septic shock: role of albumin administration  Journal of Intensive Care

Metabolomics for the Diagnosis of Secondary Infections in Critically Ill Patients With COVID-19  Critical Care Explorations

Neurological Complications During Venoarterial Extracorporeal Membrane Oxygenation and Their Implications for 6-Month Patient-Centered Outcomes  Critical Care Medicine

No flow, no cough, no clearance? The challenge of airway clearance in ECMO-supported severe acute respiratory failure  Journal of the Intensive Care Society

Oxygen Saturation Targets and Neurologic Outcomes Following Cardiac Arrest – A Secondary Analysis of the Pragmatic Investigation of Optimal Oxygen Targets Trial  Chest

Physiological comparison of noninvasive ventilation and CPAP on inspiratory efforts after extubation in critically ill patients with morbid obesity: a post-hoc analysis  Annals of Intensive Care

Practicalities of noninvasive neuromonitoring in intensive care  Neurocritical Care

Prediction Capability of Physical Assessment at Intensive Care Unit Discharge for Long-Term Functional Outcomes in Patients with Sepsis  Journal of Intensive Care Medicine

Prediction of Hospital Mortality in Sepsis-Associated Acute Kidney Injury using a Machine-Learning Approach: A Multi-Center Study Using SHAP Interpretability Analysis   Clinical Kidney Journal

Properties of testosterone transdermal gel in restoring serum testosterone levels in critically ill patients: the TestICU-1 pilot study  Journal of Critical Care

Renal Angina Indices and Urinary Biomarkers – A Combined Approach to Predict Acute Kidney Injury in Critically Ill Patients  Kidney 360

Retention and morale in the ICU: interprofessional team members’ perspectives on interprofessional staffing in adult ICUs  Intensive and Critical Care Nursing

Risk factors for nosocomial meningitis in patients with external ventricular drainages  Journal of Intensive Care

The association between endothelial activation and stress Index and the development and prognosis of acute kidney injury in elderly patients with critical illness  Renal Failure

The experiences of bedside nurses delivering an intensive care sedation study: A process evaluation within the A2B trial  Journal of the Intensive Care Society

The Weekend Effect on Evidence-Based Care Adherence Before and After Implementation of Checklist-Based Care in the Intensive Care Unit: A Multinational Study  Journal of Intensive Care Medicine

Time-weighted urine oxygen tension as a predictor of acute kidney injury in patients with sepsis: a preliminary prospective observational study  Renal Failure

Unravelling the complex inflammatory landscape of COVID-19 infection: a pathway to biomarkers identification in infection-associated delirium in the ICU  Intensive Care Medicine Experimental

Use of rescue noninvasive ventilation for post-extubation respiratory failure  Critical Care

Utilization of Intensive Care Interventions in Critically Ill Patients With Candidemia Versus Bacteremia: A Multicenter Retrospective Cohort Study  Critical Care Medicine

Voices from the ICU: Nursing students’ experiences of family involvement in patient care  Nurse Education in Practice

Which is better for glycemic control? bolus, intermittent (nocturnal pause) or continuous enteral feeding in septic critically ill patients  Science Progress

“Who are they? What does that mean for care?”: An exploratory descriptive study of clinicians’ experiences of caring for patients and family members from culturally diverse backgrounds  Intensive and Critical Care Nursing

Who is responsible for follow-up after critical illness? GP, ICU and patient perspectives  Critical Care

 

Metadata

Summary author: Rebecca Howes @ClinicalLibsPHU
Summary date:
Picture by: Ehimetalor Akhere Unuabona on Unsplash