CLOVERS
Crystalloid Liberal or Vasopressors Early Resuscitation in Sepsis
Paziente / Popolazione Intervento / Esposizione Confronto Esito
In 1,563 patients with sepsis-induced hypotension after 1–3 L fluid, a restrictive-fluid strategy with early vasopressors did not change 90-day mortality compared with a liberal-fluid strategy.
N
1563
Disegno
Multicentre RCT, NHLBI PETAL Network
Esito
Death from any cause before discharge home by day 90
Rilevanza
2
Risultato14.0% vs 14.9% (Δ −0.9 pp; 95% CI −4.4 to 2.6; p=0.61). DSMB stopped trial for futility.
Shapiro NI, et al. N Engl J Med. 2023;388(6):499-510. 10.1056/NEJMoa2212663
Discussione e critica
Either strategy is acceptable after the initial 1–3 L; choose by phenotype.