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A Bayesian meta-analysis of the SNAP and CloCeBa trials (1,579 patients) gave a 95.5% probability that cefazolin is non-inferior for 90-day mortality (OR 0.84), with fewer treatment stops for adverse events (OR 0.25) and less AKI (OR 0.54). The authors conclude cefazolin should be preferred for adults with MSSA bacteraemia.
In a cluster-randomised trial across North Carolina counties (22,459 patients), dispatcher training, community CPR training and wider AED use did not improve survival to discharge with good neurological outcome (9.0% vs 9.4%). Bystander CPR and early defibrillation remain standard; the lesson is that rolling these out widely needs better implementation strategies.
Dutch helicopter teams able to start VA-ECMO at the scene had 40% survival to discharge vs 20% with conventional care in adults aged 50 or under with refractory out-of-hospital arrest (good neurological outcome at 6 months: 36% vs 13%). The study was non-randomised and the patients were highly selected, so it supports fast ECPR referral pathways, not routine ECPR for every arrest.
The Union health ministry has notified a proposal to immediately suspend a manufacturer's licence for a drug found 'not of standard quality' on assay, dissolution, impurities or sterility, removing the current show-cause delay. CDSCO's September 2026 alert listed 330 such samples, including a ciprofloxacin product that failed its assay test. This is still a proposal, so keep checking CDSCO's monthly alerts against your ICU pharmacy stock.
Pooling 4 RCTs (1,544 patients, including SODa-BIC and BICARICU-2), bicarbonate did not clearly reduce mortality (RR 0.94) but had a 97% probability of reducing RRT initiation (RR 0.74). This supports selective use in severe acidaemia with AKI, in line with SSC 2026, while watching for high sodium, low calcium and alkalosis.
Across 13 hospitals (3,959 patients), a strategy of starting vasopressin at noradrenaline-equivalent 0.1 µg/kg/min did not lower 28-day mortality compared with 0.4 µg/kg/min (31.8% vs 33.0%), and kidney replacement-free days were the same. This adds data to the vasopressin trigger dose that SSC 2026 leaves open.
In 535 critically ill patients with AKI needing RRT, starting with intermittent haemodialysis was not non-inferior to CRRT for major adverse kidney events. It was also associated with higher 90-day mortality (63.1% vs 53.5%; HR 1.30). The trial was stopped early, so treat the size of the effect with caution, but it supports CRRT as the first modality in unstable patients.
