ANDROMEDA-SHOCK
Peripheral Perfusion versus Lactate-Targeted Resuscitation in Septic Shock
Doente / População Intervenção / Exposição Comparação Desfecho
In 424 patients with early septic shock, capillary-refill-time–guided resuscitation did not reduce 28-day mortality compared with lactate-guided resuscitation, but lowered SOFA at 72 hours.
N
424
Desenho
Multicentre RCT, Latin America
Desfecho
28-day all-cause mortality
Relevância
2
Resultado34.9% vs 43.4% (HR 0.75; 95% CI 0.55–1.02; p=0.06). SOFA at 72 h −1.00 (p=0.045); Bayesian re-analysis favoured CRT.
Hernández G, et al. JAMA. 2019;321(7):654-664. 10.1001/jama.2019.0071
Discussão e crítica
Peripheral perfusion is at least non-inferior to lactate and avoids overzealous lactate-chasing fluid resuscitation.