?? Paper of the day
Prashant Nasa
ICU Physician - Co-editor: Rational use of IV Fluids in Critically ill (link in bio)- PROVE Network - Delphi Methodology - Fluid and Oxygen are Drugs - X: @drnasap
Clinical parameter-guided initial resuscitation in adult patients with septic shock: A systematic review and network meta-analysis
Published in Acute Medicine Surgery
Summary:
The article presents a systematic review and network meta-analysis of clinical parameter-guided initial resuscitation in adult patients with septic shock. The study compares various tissue perfusion parameters and their impact on short-term mortality and other clinical outcomes in sepsis/septic shock adults.
Key takeaways:
1. Lactate or capillary refill time-guided initial resuscitation for sepsis/septic shock patients may decrease short-term mortality.
2. Central venous oxygen saturation-guided therapy increased the risk of short-term mortality compared with lactate-guided therapy.
3. The study emphasizes the importance of personalized and optimized treatment strategies for septic shock resuscitation.
Counter arguments:
1. The validity of network meta-analysis relies on the assumption of similar study populations, but several trials in this study had diverse patient groups.
2. The study is limited by the clinical variance across different sepsis management guidelines and the sparse networks resulting from few direct intervention comparisons.