Episode 4 – March 2026 (2)

Top Hot Critical Care Trials, Papers & Guidelines!

Event poster for Critical Care Northampton, featuring illustrations of a stethoscope, heart rate, medical papers, and an IV bag, with the date March 2026 and the title 'Best Critical Care Papers & Trials'.

Here is edition 4 of the hottest critical care trials and papers. These papers are generating buzz across sites like Critical Care Reviews, EMCrit/PulmCrit, and REBEL EM. You can also find discussions on LITFL, The Bottom Line, and many others.

There are many fantastic sites. They are run by some very dedicated people who are constantly curating information. This effort makes all of this noise listenable! You know who you are…….thank you!

Jump Links!

Click the buttons, then the pics for the trial / paper / guideline to read more!

DREAM
ALERT
AKI DELIRIUM
SHOCK-FLOW
THINNERS
TRACHE WEAN
CYTOKINE
LESS-INVASIVE
AIRWAY COLLAPSE
SEPSIS AND INFECTION LAUNCH
RECOVER AKI
REMOTE HEART
CRRT KIDS
CVP MORTALITY
VIT-C
VEXuS-ED
SEPSIS-UPDATE

Society of Critical Care Medicine Guidelines for the Allocation of Critical Care Resources to Adults During Crisis-Level Shortages

A waiting room scene with two healthcare workers at a reception desk, a group of anxious patients waiting in line, and a large sign stating 'PLEASE WAIT TO BE ADMITTED TO ITU'.
CRIT CARE MED

Guidelines developed one an evidence-based, rather than expert-based, set of recommendations for triaging critically ill patients eligible for ICU admission during times of crisis-level shortages in ICU capacity.

A Pilot, Parallel-Group, Blinded, Placebo-Controlled, Randomised Pragmatic Trial Investigating the Effect of Temazepam on Objective and Subjective Measures of Sleep in Critically Ill Patients (DREAM Trial)

A cartoon-style illustration of a worried male patient in a hospital bed, wearing a hospital gown, with a concerned doctor holding a clipboard beside him. The setting includes medical equipment and a sign that says 'DREAM'.
CRITICAL CARE & RESUSCITATION

Patients in the intensive care unit (ICU) suffer from disturbed sleep and pharmacological sleep aids are frequently prescribed despite limited data on their efficacy. The objective of this study was to assess the effect of a single nocturnal dose of the benzodiazepine temazepam on sleep duration and quality in ICU patients.

Effects of Real-Time Automated Clinical Deterioration Alert and Trigger Systems on Clinical Outcomes in Adult General Ward Patients: A Systematic Review and Meta-Analysis

Animated scene in a hospital sepsis ward with two concerned healthcare workers. One is holding a clipboard while the other gestures with alarm. A patient in bed looks frightened, with medical equipment and warning alerts visible in the background.
CRIT CARE MED

Real-time automated alert and trigger systems that notify clinical staff beyond the patient’s assigned bedside nurse are increasingly used to improve the recognition and response to clinical deterioration in hospital wards. This review evaluated their effects on clinical outcomes in adult general ward patients.

Association Between Acute Kidney Injury, Delirium, and Outcomes in Patients With Critical Illness: A Systematic Review and Meta-Analysis

A cartoon scene in a hospital showing a man in a hospital bed looking confused and worried, while two medical professionals stand nearby, one holding a clipboard, displaying concern. The room is equipped with medical devices, and cheerful birds are flying around, adding a whimsical contrast to the serious setting.
CRIT CARE MED

Acute kidney injury (AKI) and delirium are common complications of critical illness. There is limited evidence on their link. This systematic synthesis and meta-analysis of existing evidence clarifies the association in critically ill patients.

Prognostic Factors Among Patients Receiving Microaxial Flow Pump for Acute Myocardial Infarction-Related Cardiogenic Shock: A Systematic Review and Meta-Analysis

A cartoon heart lying on a hospital bed with steam rising, looking anxious. A smiling doctor in a white coat is comforting the heart, with a sign in the background that says 'SHOCKED... PUMP IT.'
CRIT CARE MED

This in depth review identifies factors associated with short-term mortality among patients receiving microaxial flow pump (mAFP) therapy for acute myocardial infarction-related cardiogenic shock (AMI-CS).

Management of Direct Oral Anticoagulants in Adult Patients Undergoing Cardiac Surgery: A Joint Consensus Statement

A cartoonish heart character looking frightened and sweating on an operating table, while a doctor in scrubs and a mask stands beside it, in a well-equipped cardiac operating room.
ANAESTH & ANALGESIA

Nice consensus statement on a tricky area; DOACS and cardiac surgery.

Expert Consensus–Based Clinical Practice Guidelines for Care and Weaning Procedures in Tracheostomized ICU Patients After Invasive Mechanical Ventilation 

A realistic model of human lungs with a breathing tube on a hospital bed, with a sign that reads 'WEANING?' in the background.
ANNALS OF INTENSIVE CARE

Multi-disciplinary, evidence-aligned guidelines for adult ICU tracheostomy care. From ventilator weaning through restoration of phonation and swallowing, to decannulation. 

Roles of Cytokine Storm in Sepsis Progression: Biomarkers, and Emerging Therapeutic Strategies

A dramatic illustration depicting an explosive mushroom cloud with the word 'SEPSIS' in fiery letters at the center, surrounded by red virus-like spheres amidst dark smoke.
FRONT IMMUNOL

Mini-review outlining current and emerging therapeutic strategies targeting both immune overactivation and late-stage immunosuppression, including cytokine antagonists, immune checkpoint inhibitors, and nanomedicine-based approaches, providing a comprehensive framework to guide precision immunotherapy in sepsis management.

Less-Invasive Hemodynamic and Tissue Perfusion Monitoring in Sepsis and Septic Shock 

A cartoonish bacterium with eyes and various medical devices attached is lying on a hospital bed surrounded by medical equipment.
J CLIN MED

This narrative review summarises current evidence on less-invasive hemodynamic and tissue perfusion monitoring in sepsis and septic shock, discussing their physiological rationale and potential role within contemporary, multimodal resuscitation strategies.

Peri-intubation Cardiovascular Collapse During Emergency Airway Management

A cartoonish heart with a surprised expression is being chased by a frantic medical professional in scrubs, holding a container labeled 'Acute Airway'.
PULM THER

This review synthesises current knowledge on the epidemiology, risk factors, and pathophysiology of peri-intubation hemodynamic deterioration. They review targeted strategies for hemodynamic optimization of physiologic parameters before intubation.

The New Pulse of Sepsis and Severe Infection – Journal Launch

Cover of a book titled 'Critical Care: Sepsis and Severe Infection' featuring cartoonish germs, medical equipment, and colorful graphic elements.
CRIT CARE: SEPSIS AND SEVERE INFECTION

A new branch of Crit Care Journal!

State of the art: Renal recovery after AKI – from basic science to clinical practice

A cartoonish red bean character with glasses and a bandage is relaxing on a deck chair beside a swimming pool, waving cheerfully. Palm trees and a pastel-colored building are in the background.
INTENSIVE CARE MED

Lovely review from Marlies Ostermann et al. summarising the current understanding of the mechanisms of renal recovery, as well as some key risk factors for non-recovery and knowledge gaps.

Remote Patient Monitoring in Heart Failure: Firm Evidence for Mortality Reduction

A cartoon heart character reading a newspaper titled 'HEADLINES' while sitting comfortably in a chair, connected to medical equipment in a cozy room with a fireplace and bookshelves.
MEDRXIV

This pre-print systematic review, meta-analysis, and trial sequential analysis of 59 poolable RCTs encompassing approximately 23,000 patients, may demonstrate that remote patient monitoring significantly reduces all-cause mortality. It perhaps suggests that this could be the gold-standard in this cohort of patients.

Small Patients, Big Gaps: Why Adult CRRT Timing Evidence Does Not Translate to Children 

A cartoon illustration of two kidneys, one large and aggressive with a frown, and a smaller, worried kidney. The background features a stylized depiction of human kidneys.
CRITICAL CARE

This editorial highlights the differences inherent, and possibly the need for more focussed research.

Impact of Central Venous Pressure Trajectories on Prognosis in ICU Patients with Sepsis Retrospective MIMIC-IV analysis:

Graph illustrating the relationship between Central Venous Pressure (in mmHg) and ICU mortality percentage, showing a peak mortality rate at elevated pressure levels.
SCIENTIFIC REPORTS

Distinct CVP trajectories during the early ICU period are associated with varying mortality risks in septic patients. Persistently elevated CVP trajectories may was associated with poor outcomes and warrants cautious fluid management.

Trends in Use of IV Vitamin C Among Patients With Sepsis

A cartoonish orange character lying in a hospital bed with a thermometer in its mouth and steam rising, while medical equipment displays vital signs in the background.
CRITICAL CARE MEDICINE

Looks at the trends in use of IV vitamin C for hospitalised patients with sepsis in the context of evolving evidence, including a single-center before-after study in late 2016 and several trials in 2019–2021.

VExUS-ED: Early venous congestion is associated with clinical fluid overload in patients with sepsis

An illustrated depiction of human lungs connected to an IV drip, with swirling vapors and blood vessels visible.
JOURNAL OF CRITICAL CARE

In patients with suspected sepsis, mild venous congestion was independently associated with clinical fluid overload within 72 h. Abnormal hepatic and intrarenal flow patterns may provide additional information on venous congestion. Early, serial VExUS assessments may detect fluid intolerance and support individualized fluid management.


Refractory septic shock: our updated pragmatic approach

A colorful illustration featuring various cartoonish germs with expressive faces, some looking scared or surprised, surrounding a prominent sign that reads 'SEPSIS'.
J ANAESTHESIA ANALGESIA & CRIT CARE

This paper describes a comprehensive set of treatment options for clinicians to restore organ perfusion and haemodynamic coherence and to minimise the detrimental effects of high-dose vasopressors and acid–base derangement.

Quick Hits from the Trenches:

  • X chatter on cytokine storm therapies, less-invasive sepsis monitoring, and pre-ox combos for intubation.
  • March buzz around SCCM triage guidelines and new sepsis journal launch.
  • Ongoing ARDS/glucocorticoid metas and pharmacotherapy roundups in #FOAMcc.

Stay tuned for Episode 5!

JW and Team x

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