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A randomized clinical trial demonstrates that adding intraoperative dobutamine to norepinephrine during surgical source control for septic shock significantly decreases postoperative acute kidney injury incidence and severity.
A large randomized trial finds no difference in 90-day days alive and out of hospital between early vasopressors with restricted fluids versus higher fluids with delayed vasopressors in septic shock, though pulmonary edema was less frequent
Septic shock following allogeneic hematopoietic stem-cell transplantation has a high 90-day mortality rate of 63%, strongly influenced by illness severity, fungal infection, and neutropenia. Early aminoglycoside use shows complex associatio
The TRANSPORT trial showed no superiority of liberal versus restrictive RBC transfusion in septic shock patients with cancer, highlighting no mortality benefit and increased thrombotic events with liberal strategy, underscoring the need for
This study identifies baseline frailty, organ dysfunction severity, and corticosteroid use as independent predictors of severe post-intensive care frailty in older septic shock survivors, highlighting critical factors for targeted post-ICU
This study emulated a target trial to compare ultra-early (0-3h) versus early (>3-6h) vasopressin initiation after norepinephrine escalation in septic shock, revealing significant mortality and renal therapy benefits with ultra-early use
A multicenter randomized trial found that initiating a 1-hour resuscitation bundle including early antibiotics, fluids, vasopressors, and hydrocortisone in the prehospital setting did not significantly reduce 28-day mortality in adults with
A multicenter study investigated whether initiating a 1-hour resuscitation bundle—including antibiotics, fluids, vasopressors, and hydrocortisone—in the prehospital setting influences 28-day mortality in septic shock, finding no significant
This study explores whether renal resistive index (RRI) changes during a transient elevation of mean arterial pressure (MAP) can guide individualized MAP targets to optimize renal function in early septic shock, finding that RRI decrease do
Persistent tissue hypoperfusion alongside vasopressor dosing improves early risk stratification in refractory septic shock, identifying patients with markedly increased 28-day mortality beyond vasopressor dose alone, as shown in a secondary
A new SCCM–ESICM Delphi consensus standardizes clinical criteria for refractory septic shock, focusing on persistent hypoperfusion, fluid unresponsiveness, high vasopressor needs, and bedside ultrasound when mixed shock is suspected.
The ARISS randomized clinical trial found that 20% albumin supplementation to maintain serum levels ≥3.0 g/dL is safe in septic shock but does not significantly improve 90-day survival compared to standard crystalloids, though the studyR
A post-hoc analysis of the SEPSIS-PAM trial reveals that while high MAP targets do not provide a universal survival benefit, they significantly increase mortality risk when requiring high norepinephrine doses or failing to resolve microcirc
A large-scale study of over 300,000 ANZ ICU patients reveals that sepsis mortality plummeted from 28% to 11% between 2000 and 2020, followed by a concerning 0.9% annual increase through 2023, highlighting both clinical triumphs and emerging
In the TARTARE-2S trial, a tissue-perfusion–guided resuscitation strategy that permitted lower MAP (50–65 mm Hg) did not increase days alive with normalized lactate and without vasopressors at 30 days versus standard-of-care MAP-guided trea
ANDROMEDA‑SHOCK‑2 randomized 1,501 patients with early septic shock to a personalized CRT‑guided hemodynamic protocol versus usual care. A hierarchical composite outcome favored the CRT strategy (win ratio 1.16; 95% CI 1.02–1.33; P = .04),
A systematic review of 17 randomized trials (n=4,259) found no consistent renoprotective effect from any vasopressor in septic shock. Heterogeneous definitions, underpowered studies, and reliance on RRT limit conclusions; standardized renal
In a double-blind RCT of 130 patients with refractory septic shock, terlipressin increased the proportion achieving MAP ≥65 mmHg with low catecholamine exposure at 6 hours versus placebo but did not change 28-day mortality; digital ischemia
A recent double-blind RCT shows iloprost did not reduce organ failure severity in septic shock patients with persistent hypoperfusion, highlighting challenges in improving outcomes despite theoretical benefits in microcirculation.
This trial evaluated low-dose hydrocortisone in cirrhotic patients with septic shock, finding no improvement in 28-day mortality or shock resolution compared to placebo.
