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<p>Despite the refinement in guidelines and improving outcomes, a subset of patients with septic shock fails to respond to treatment and progresses into refractory septic shock with an associated high morbidity and mortality. This population remains underrepresented in clinical trials due to their heterogeneity, in addition to time and ethical constraints. As a large specialist referral centre, we propose an updated, pragmatic, and largely inexpensive approach based on our current clinical practice, which focuses on early multimodal therapy, aiming to reduce the detrimental effects associated with high-dose vasopressors.</p>

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Refractory septic shock: our updated pragmatic approach

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年1月9日

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  • Filippo Palmesino,
  • Adam Woodman-Bailey,
  • Fraser Hanks,
  • Stephanie Khoo,
  • Marlies Ostermann,
  • Nicholas Ioannou,
  • Christopher Meadows,
  • Duncan Wyncoll

摘要

Despite the refinement in guidelines and improving outcomes, a subset of patients with septic shock fails to respond to treatment and progresses into refractory septic shock with an associated high morbidity and mortality. This population remains underrepresented in clinical trials due to their heterogeneity, in addition to time and ethical constraints. As a large specialist referral centre, we propose an updated, pragmatic, and largely inexpensive approach based on our current clinical practice, which focuses on early multimodal therapy, aiming to reduce the detrimental effects associated with high-dose vasopressors.