septic shock – Medxy AI

Evaluating Renal Resistive Index Responsiveness to MAP Targets in Early Septic Shock: Clinical Implications and Physiologic Insights

By MedXY 08/05/2026

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 does not predict improved outcomes with higher MAP, while lack of RRI decrease may identify patients benefiting from MAP elevation.

$Combining Tissue Hypoperfusion Markers with Vasopressor Dose Enhances Mortality Risk Stratification in Refractory Septic Shock$

Critical Care Infectious Diseases news

Combining Tissue Hypoperfusion Markers with Vasopressor Dose Enhances Mortality Risk Stratification in Refractory Septic Shock

By MedXY 07/21/2026

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 analysis of the ANDROMEDA-SHOCK-2 trial.

$New SCCM–ESICM Consensus Defines Refractory Septic Shock$

Critical Care Infectious Diseases news

New SCCM–ESICM Consensus Defines Refractory Septic Shock

By MedXY 05/15/2026

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.

Critical Care Internal Medicine news

Albumin Replacement in Septic Shock: Safety Confirmed but Survival Benefit Remains Elusive

By MedXY 02/23/2026

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 study's early termination limits its definitive power.

Critical Care Internal Medicine news

Higher Blood Pressure Targets in Septic Shock: When More Vasopressors Do More Harm than Good

By MedXY 12/27/2025

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 microcirculatory dysfunction like skin mottling.

Critical Care Infectious Diseases news

Sepsis Survival in Australia and New Zealand: Analyzing Two Decades of Progress and the Recent Mortality Rebound

By MedXY 12/27/2025

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 challenges in critical care.

Critical Care news

Targeting Tissue Perfusion and Lower MAP in Septic Shock Did Not Improve 30‑Day Perfusion-Free Survival: Results from the TARTARE-2S Randomized Trial

By MedXY 12/10/2025

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 treatment in septic shock.

Critical Care news

Targeting Capillary Refill Time in Early Septic Shock Reduced Duration of Organ Support: Key Findings from ANDROMEDA‑SHOCK‑2

By MedXY 11/07/2025

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), driven mainly by shorter duration of organ support rather than lower mortality.

Critical Care Nephrology news

Choice of Vasopressor in Septic Shock: Does It Change Kidney Outcomes? A Critical Appraisal of the Evidence

By MedXY 11/07/2025

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 endpoints and focused trials are needed.

$Adjunctive Terlipressin in Refractory Septic Shock: Lowers High-Dose Catecholamine Need at 6 Hours but No Mortality Benefit$

Critical Care Nephrology news

Adjunctive Terlipressin in Refractory Septic Shock: Lowers High-Dose Catecholamine Need at 6 Hours but No Mortality Benefit

By MedXY 11/07/2025

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 rates were high in both groups.

Critical Care news Specialties

Iloprost in Severe Septic Shock with Persistent Hypoperfusion: Insights from a Rigorous Randomized Trial

By MedXY 08/13/2025

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.

Clinical Updates Gastroenterology news Specialties

Low-Dose Hydrocortisone in Cirrhotic Patients With Septic Shock: A Double-Blind Randomised Placebo-Controlled Trial

By MedXY 08/06/2025

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.