You can gain up to 5 items during a loadout now, but more importantly, there are a few new items now. And there's a leaderboard!
Adrenaline - steal an enemy item (of your choice, except their adrenaline) and use it immediately
Expired meds - 40% chance to gain 2 health, otherwise lose 1 health
Burner phone - chooses a random shell in the gun (seems to be any shell except the next one) and tells you whether it's live or a blank (and where it is)
Inverter - transforms the next shell into the opposite of what is currently is
The adrenaline is almost certainly the best item in the game, and playing around enemy adrenaline is very difficult, since you don't want to constantly waste all your items.
Inverter is also great, it's very likely that you'll have a guaranteed blank at some point, so it's frequently free damage. Combos well with things like magnifying glass and hand saw.
Burner phone is hard to evaluate. To me it looks like a generally worse magnifying glass. It is a lot of fun to play around, though.
Expired meds are so bad, on average it's a 0.2 heal (.4x2 - .6x1), and that's if you're actually missing 2 health, in which case you might just lose by using them. They're so bad that you can't always waste them to free up inventory space in carryover rounds.
00:00 70k mode
13:53 endless
18:48 endless 2
43:18 endless 3
store.steampowered.com/app/28...