Updates
What changed
Changed recommendations, new safety warnings and practice-changing evidence, newest first. Every entry names what actually changed rather than restating the topic.
- Guideline2026-09-01
Heart failure: four pillars started together rather than sequentially
Society guidance now favours starting low doses of all four disease-modifying classes early and uptitrating, instead of maximising one class before adding the next.
What changed: Sequencing changed from stepwise uptitration to early low-dose combination.
Source: ESC heart failure guideline 2023 · demo summary
- Drug safety2026-08-30
SGLT2 inhibitors: hold during acute illness and before surgery
Euglycaemic ketoacidosis can occur at normal or near-normal glucose. Withhold during vomiting, fasting or very low carbohydrate intake, and typically for three days before elective surgery.
What changed: Perioperative hold period made explicit; diagnosis based on ketones and pH, not glucose.
Source: Regulatory drug safety communication · demo summary
- Evidence2026-08-28
Balanced crystalloids preferred to 0.9% saline for resuscitation
Pooled trial evidence shows a modest benefit in composite renal outcomes with balanced solutions, without an increase in harm.
What changed: Default resuscitation fluid changed from 0.9% saline to a balanced crystalloid.
Source: Critical care trial synthesis · demo summary
- Guideline2026-08-22
COPD: exacerbation history drives the ABE group, not symptom score alone
Group assignment now separates exacerbation risk from symptom burden, which changes who starts an inhaled corticosteroid-containing regimen.
What changed: C and D groups replaced by a single E group defined by exacerbations.
Source: GOLD report · demo summary
- Evidence2026-08-15
Dengue: haematocrit trend outweighs a single platelet count
Rising haematocrit with a falling platelet count and narrowing pulse pressure indicates plasma leakage; prophylactic platelet transfusion does not prevent bleeding.
What changed: Emphasis moved from platelet thresholds to perfusion and haematocrit trends.
Source: WHO dengue guidance · demo summary
- Regulatory2026-08-08
Metformin: eGFR-based rather than creatinine-based thresholds
Continue with review between eGFR 45 and 30 mL/min/1.73m², stop below 30, and withhold around iodinated contrast where renal function is impaired.
What changed: Creatinine cut-offs replaced by eGFR bands.
Source: Regulatory label update · demo summary
- Guideline2026-07-30
Stroke: extended thrombectomy window with perfusion selection
Selected large vessel occlusions benefit from thrombectomy beyond six hours when imaging shows salvageable tissue.
What changed: Time-based selection supplemented by imaging-based selection.
Source: Stroke society guideline · demo summary
Demo content. Educational decision support only. Verify every dose, citation and recommendation against your national formulary and the primary source before clinical use.