Critical Care
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ARISE FLUIDS Trial: Early Vasopressors vs More Fluids in Septic Shock
For decades, intravenous fluids have been a cornerstone of early septic shock management. However, growing concern about fluid overload has led clinicians to question whether vasopressors should be started earlier, allowing patients to receive less intravenous fluid. The ARISE FLUIDS trial, published in the New England Journal of Medicine in 2026, directly tested these two…
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WATERFALL Trial: Aggressive vs Moderate Fluid Resuscitation in Acute Pancreatitis
Clinical question: In adults with acute pancreatitis, does early aggressive fluid resuscitation improve outcomes compared with a more moderate fluid strategy? Acute pancreatitis is one of those conditions where “give fluids early” has been drilled into clinical practice for years. The logic makes sense: patients may be volume depleted, pancreatic microcirculation may be impaired, and…