Hey folks, I'm Scott Weingart, and this is the M-Crit podcast. Today on the podcast, we're going to discuss a brand new sepsis trial that's going to get a lot of airtime on the various social media outlets and various discussions. And I think it's very important to understand this trial. So today, I'm going to just walk you through the whole trial. And then

early next week, I will be speaking to two of the lead investigators. So we will be able to get

even more information. We will be able to delve deep. So this is the primer. Next week is the explosion.

The paper we're going to be discussing is the Andromeda Shock 2 RCT, which just was published a day ago.

And it is personalized, hemodynamic resuscitation targeting cap refill time in early septic shock, published in the JAMA.

So we will dive right in just a second. Before that, a quick mention.

Hey, folks, super quick plug for the awake and aware conference that I'm putting on with a bunch

of my buddies in Scottsdale, Arizona, March 2026. This conference is going to be amazing. It's going to create a bubble. It's going to be a

retreat. It is so good from everything we've done in the past and everything we have planned

for the future. You should come if you're burnt out. If you want to feel more joy in your life,

if you want to just hang out for three days with an amazing group of people and chill and eat dinner and drink wine and enjoy life. If you want to just hang out for three days with an amazing group of people and chill and

eat dinner and drink wine and enjoy life, just go to the conference site. If you're even mildly

interested and check it out, see what you think. You could just go to Awake Aware Conference. All one word,

awakeawareconference.com. That address again, awakeawareconference.com. Please, please just go check it out. You don't have to sign up. Just go look. See if it peaks your interest. All right, let's get to the show. All right, let's get into it. So, Andromeda Shock 2. Let's do a pico. So the patients include in this trial were adults with septic shock. So they had

septic shock as defined by a suspected or confirmed infection. They had elevated lactate greater than

equal to two, and they were on noraepinephrine to maintain amaphyp after an initial fluid load

of 1,000 MLs. So that's a very legitimate entry criteria for septic shock.

And they could be identified at any point in the hospital, whether it be the ICU, the ED,

the operating room, or the inpatient floors. Patients could be recruited up to four hours

after they met those inclusion criteria. They wound up after all of the wherewithal

with 720 patients in the intervention group and 747 in the usual care group. And to get those numbers,

they had 86 sites in 19 countries. So this is not a single center RCT. This is an 86 center RCT.

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