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The ANDROMEDA-SHOCK-2 trial tested a personalised haemodynamic resuscitation strategy in adults with septic shock during the first hours of treatment. The protocol used capillary refill time together with pulse pressure, diastolic arterial pressure, fluid responsiveness and bedside echocardiography to tailor fluids, vasopressors and inotropes. Across 86 centres in 19 countries, 1,467 patients were randomised to the personalised strategy or usual care. The trial was designed around a central problem in septic shock: giving the same amount of fluid and vasoactive support to every patient may expose some patients to unnecessary treatment while undertreating others. The intervention therefore moved resuscitation toward physiology-guided decision-making rather than a fixed algorithm. For HCPs, the important message is not that capillary refill time replaces all other monitoring. Instead, the study demonstrates how a bedside perfusion marker can be integrated into a broader, individualised framework. This fits the conference emphasis on personalised haemodynamic resuscitation and evolving sepsis care. The practical implication is to reassess perfusion repeatedly and adjust the balance among fluids, vasopressors and inotropes according to the patient's physiological response rather than relying on a single target or a fixed fluid dose.
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The ANDROMEDA-SHOCK-2 trial tested a personalised haemodynamic resuscitation strategy in adults with septic shock during the first hours of treatment. The protocol used capillary refill time together with pulse pressure, diastolic arterial pressure, fluid responsiveness and bedside echocardiography to tailor fluids, vasopressors and inotropes. Across 86 centres in 19 countries, 1,467 patients were randomised to the personalised strategy or usual care. The trial was designed around a central problem in septic shock: giving the same amount of fluid and vasoactive support to every patient may expose some patients to unnecessary treatment while undertreating others. The intervention therefore moved resuscitation toward physiology-guided decision-making rather than a fixed algorithm. For HCPs, the important message is not that capillary refill time replaces all other monitoring. Instead, the study demonstrates how a bedside perfusion marker can be integrated into a broader, individualised framework. This fits the conference emphasis on personalised haemodynamic resuscitation and evolving sepsis care. The practical implication is to reassess perfusion repeatedly and adjust the balance among fluids, vasopressors and inotropes according to the patient's physiological response rather than relying on a single target or a fixed fluid dose.
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