ArticleAnnals of intensive care2020
Effects of capillary refill time-vs. lactate-targeted fluid resuscitation on regional, microcirculatory and hypoxia-related perfusion parameters in septic shock: a randomized controlled trial.
Article in Annals of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03762005 (Peripheral Perfusion Versus Lactate Targeted Fluid Resuscitation in Septic Shock), which is not on this map. Cited by 37 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Peripheral Perfusion Versus Lactate Targeted Fluid Resuscitation in Septic Shock: ANDROMEDA-SHOCK PHYSIOLOGY STUDY
Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Comparison of non-invasive strategies to drive fluid resuscitation in sepsis or septic shock: a meta-analysis of RCTs.Internal and emergency medicine · 2026Pooled it
- Early management of adult sepsis and septic shock: Korean clinical practice guidelines.Acute and critical care · 2024Guideline
- Physiological limits of capillary refill time: a human endotoxemia study.Critical care (London, England) · 2026Trial
- Anisodamine hydrobromide reduces 28-day mortality in septic shock: a randomized controlled.Frontiers in pharmacology · 2026Trial
- Restrictive fluids versus standard care in adults with sepsis in the emergency department (REFACED): A multicenter, randomized feasibility trial.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2022Trial
- Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026.Intensive care medicine · 2026Article
- Article
- Less-Invasive Hemodynamic and Tissue Perfusion Monitoring in Sepsis and Septic Shock: A Narrative Review.Journal of clinical medicine · 2026Review
- Comparison of four noninvasive tools for predicting sepsis and septic shock mortality: a prospective cohort study.Clinical and experimental emergency medicine · 2026Article
- Microcirculation Monitoring in Septic Shock: Focused Review.Medicina (Kaunas, Lithuania) · 2026Review
- Development and Validation of a Prediction Model for Early ARDS in Children with Sepsis in the PICU: A Multicenter Retrospective Cohort Study.Journal of multidisciplinary healthcare · 2026Article
- The effectiveness of tissue-perfusion-guided resuscitation in shock: A systematic review and meta-analysis.Annals of intensive care · 2026Review
- Septic shock in the era of precision medicine: rethinking fluids, vasopressors, and immunomodulation.Frontiers in medicine · 2026Review
- The intricate relationship between capillary refill time and systemic hemodynamics in septic shock.Annals of intensive care · 2025Review
- Postoperative sepsis-associated neurocognitive disorder: mechanisms, predictive strategies, and treatment approaches.Frontiers in medicine · 2025Review
- Peripheral and Organ Perfusion's Role in Prognosis of Disease Severity and Mortality in Severe COVID-19 Patients: Prospective Cohort Study.Journal of clinical medicine · 2024Article
- ERAS-Based Anesthetic Management of Patients Undergoing Abdominal-Based Free Flap Breast Reconstruction: A Narrative Review.JPRAS open · 2024Review
- Early peripheral perfusion monitoring in septic shock.European journal of medical research · 2024Review
- The association between prolonged capillary refill time and microcirculation changes in children with sepsis.BMC pediatrics · 2024Article
- Effect on capillary refill time of volume expansion and increase of the norepinephrine dose in patients with septic shock.Critical care (London, England) · 2023Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundPersistent hyperlactatemia has been considered as a signal of tissue hypoperfusion in septic shock patients, but multiple non-hypoperfusion-related pathogenic mechanisms could be involved. Therefore, pursuing lactate normalization may lead to the risk of fluid overload. Peripheral perfusion, assessed by the capillary refill time (CRT), could be an effective alternative resuscitation target as recently demonstrated by the ANDROMEDA-SHOCK trial. We designed the present randomized controlled trial to address the impact of a CRT-targeted (CRT-T) vs. a lactate-targeted (LAC-T) fluid resuscitation strategy on fluid balances within 24 h of septic shock diagnosis. In addition, we compared the effects of both strategies on organ dysfunction, regional and microcirculatory flow, and tissue hypoxia surrogates.
resultsForty-two fluid-responsive septic shock patients were randomized into CRT-T or LAC-T groups. Fluids were administered until target achievement during the 6 h intervention period, or until safety criteria were met. CRT-T was aimed at CRT normalization (≤ 3 s), whereas in LAC-T the goal was lactate normalization (≤ 2 mmol/L) or a 20% decrease every 2 h. Multimodal perfusion monitoring included sublingual microcirculatory assessment; plasma-disappearance rate of indocyanine green; muscle oxygen saturation; central venous-arterial pCO
conclusionsCRT-targeted fluid resuscitation was not superior to a lactate-targeted one on fluid administration or balances. However, it was associated with comparable effects on regional and microcirculatory flow parameters and hypoxia surrogates, and a faster achievement of the predefined resuscitation target. Our data suggest that stopping fluids in patients with CRT ≤ 3 s appears as safe in terms of tissue perfusion. Clinical Trials: ClinicalTrials.gov Identifier: NCT03762005 (Retrospectively registered on December 3rd 2018).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.