Persistent tissue hypoperfusion improves risk stratification beyond vasopressor dose in refractory septic shock: a secondary analysis of the ANDROMEDA-SHOCK-2 trial
Authors' conclusion
In early septic shock, combining persistent tissue hypoperfusion with vasopressor dose improves risk stratification beyond vasopressor dose alone and identifies a subgroup with markedly increased mortality.
Study context
- Population
- Patients with septic shock after 6 h of protocolized hemodynamic resuscitation in the ANDROMEDA-SHOCK-2 trialcomplete data
- Participants
- 1,363 patients
- Comparison
- Refractory vs non-refractory septic shock
- Refractory, two-hypoperfusion criterian = 53
- Non-refractory, two-hypoperfusion criterian = 1,310reference
- Refractory, ≥ 1-hypoperfusion criterionn = 124
- Non-refractory, ≥ 1-hypoperfusion criterionn = 1,239reference
- Primary endpoint
- 28-day mortality
- Follow-up
- 28 days
Methodological detailsexploratory
- Exploratory
Primary result
As reported in the abstract
Further findings
| Outcome | LR + (95% CI) | P value |
|---|---|---|
| Prognostic enrichment for 28-day mortality: two-hypoperfusion construct vs NEE > 0.5 µg/kg/min alonevs. 2.71; 95% CI 2.10-3.50 | 8.12 (4.70–14.03) | P < 0.001 |
NEE > 0.5 µg/kg/min at 6 h
- Patients with NEE > 0.5 µg/kg/min at 6 h
- 188 (13.8%)
- Mortality among them
- 47.9%
Life-support free days
- Fewer in refractory patients under either approach
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Persistent tissue hypoperfusion improves risk stratification beyond vasopressor dose in refractory septic shock: a secondary analysis of the ANDROMEDA-SHOCK-2 trial. Intensive Care Med. Published 15 July 2026. doi:10.
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