Towards the personalization of septic shock resuscitation: the fundamentals of ANDROMEDA-SHOCK-2 trial

Rev Esp Anestesiol Reanim (Engl Ed). 2024 Feb;71(2):112-124. doi: 10.1016/j.redare.2024.01.003. Epub 2024 Jan 18.

Abstract

Septic shock is a highly lethal and prevalent disease. Progressive circulatory dysfunction leads to tissue hypoperfusion and hypoxia, eventually evolving to multiorgan dysfunction and death. Prompt resuscitation may revert these pathogenic mechanisms, restoring oxygen delivery and organ function. High heterogeneity exists among the determinants of circulatory dysfunction in septic shock, and current algorithms provide a stepwise and standardized approach to conduct resuscitation. This review provides the pathophysiological and clinical rationale behind ANDROMEDA-SHOCK-2, an ongoing multicenter randomized controlled trial that aims to compare a personalized resuscitation strategy based on clinical phenotyping and peripheral perfusion assessment, versus standard of care, in early septic shock resuscitation.

Keywords: ANDROMEDA-SHOCK trial; Capillary refill time; Diastolic blood pressure; Ensayo ANDROMEDA-SHOCK; Fluid responsiveness; Presión arterial diastólica; Presión de pulso; Pulse pressure; Respuesta a líquidos; Sepsis; Septic shock; Shock séptico; Tiempo de llenado capilar.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Fluid Therapy
  • Humans
  • Multicenter Studies as Topic
  • Resuscitation
  • Shock, Septic* / therapy