Personalized Hemodynamic Resuscitation Targeting Capillary Refill Time in Early Septic Shock: The ANDROMEDA-SHOCK-2 Randomized Clinical Trial
Primary result · Wins for hierarchical compositeResult — go to the resultWin ratio 1.16 95% CI 1.02–1.33Authors' conclusion
Among patients with early septic shock, a personalized hemodynamic resuscitation protocol targeting capillary refill time was superior to usual care for the primary composite outcome, primarily due to a lower duration of vital support.
Study context
- Population
- Patients within the first 4 hours of septic shock1,467 in primary analysis
- Participants
- 1,501 patients
- Comparison
- CRT-PHR vs Usual care
- CRT-PHRn = 720
- Usual caren = 747reference
- Primary endpoint
- Hierarchical composite of:
- Mortality
- Duration of vital support (vasoactives, mechanical ventilation, kidney replacement therapy)
- Hospital LOS
- Follow-up
- 28 days
Methodological detailsmulticentre, 86 centers in 19 countries, Enrolment March 2022 to April 2025; last follow-up July 2025
- Multicentre
- 86 centers in 19 countries
- Enrolment March 2022 to April 2025; last follow-up July 2025
Primary result
Wins for hierarchical composite
Win ratio
1.16
95% CI 1.02–1.33
P = 0.04
Events by treatment group
CRT-PHR vs Usual care
win ratio 1.16 (95% CI 1.02–1.33); P = 0.04
As reported in the abstract
Secondary outcomes
Individual wins by component (death; duration of vital support; hospital LOS)
- Wins for death, CRT-PHR vs usual care
- 19.1% vs 17.8%
- Wins for duration of vital support, CRT-PHR vs usual care
- 26.4% vs 21.1%
- Wins for hospital LOS, CRT-PHR vs usual care
- 3.4% vs 3.2%
Original publication
Personalized Hemodynamic Resuscitation Targeting Capillary Refill Time in Early Septic Shock: The ANDROMEDA-SHOCK-2 Randomized Clinical Trial. JAMA. Published 9 December 2025. doi:10.
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