Hacia la personalización de la reanimación del paciente con shock séptico: fundamentos del ensayo ANDROMEDA-SHOCK-2

IF 0.9 Q3 ANESTHESIOLOGY Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-02-01 DOI:10.1016/j.redar.2023.07.006

F. Ramasco , G. Aguilar , C. Aldecoa , J. Bakker , P. Carmona , D. Dominguez , M. Galiana , G. Hernández , E. Kattan , C. Olea , G. Ospina-Tascón , A. Pérez , K. Ramos , S. Ramos , G. Tamayo , G. Tuero , for the ANDROMEDA-SHOCK-2 Spanish Investigators, Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR)

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Abstract

Septic shock is a highly lethal and prevalent disease. Progressive circulatory dysfunction leads to tissue hypoperfusion and hypoxia, eventually evolving to multiorgan dysfunction and death. Prompt resuscitation may revert these pathogenic mechanisms, restoring oxygen delivery and organ function. High heterogeneity exists among the determinants of circulatory dysfunction in septic shock, and current algorithms provide a stepwise and standardized approach to conduct resuscitation.

This review provides the pathophysiological and clinical rationale behind ANDROMEDA-SHOCK-2, an ongoing multicenter randomized controlled trial that aims to compare a personalized resuscitation strategy based on clinical phenotyping and peripheral perfusion assessment, versus standard of care, in early septic shock resuscitation.

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实现脓毒性休克患者复苏的个性化：ANDROMEDA-SHOCK-2 试验的基本原理

脓毒性休克是一种致死率极高的常见疾病。进行性循环功能障碍会导致组织灌注不足和缺氧，最终演变为多器官功能障碍和死亡。及时复苏可逆转这些致病机制，恢复氧输送和器官功能。本综述介绍了 ANDROMEDA-SHOCK-2 背后的病理生理学和临床原理。ANDROMEDA-SHOCK-2 是一项正在进行的多中心随机对照试验，旨在比较在早期脓毒性休克复苏中基于临床表型和外周灌注评估的个性化复苏策略与标准护理。

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