ANDROMEDA-SHOCK: Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels in Septic Shock
Multicenter, randomized trial conducted at 28 intensive care units in 5 countries
424 patients with septic shock were randomized to to a step-by-step resuscitation protocol aimed at:
000
normalizing capillary
refill time
(n=212)
normalizing or decreasing lactate levels (n=212)
Primary Outcome
median overall survival
34.9% HR 0.75 [95% CI, 0.55 to 1.02]; 43.4%
5.6
P = 0.06
Secondary Outcome
organ dysfunction at 72 hours based on mean SOFA scores
difference, -1.00, 95% CI, -1.97 to -0.02;
P = .045
ICU and hospital length of stay
No difference
renal replacement therapy
and vasopressor-free days No difference
6.6
Among patients with septic shock, a resuscitation strategy targeting normalization of capillary refill time, compared with a strategy targeting serum lactate levels, did not
reduce all-cause 28-day mortality.
Hernández G et al. JAMA. 2019 Feb 19;321(7):654-664.
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