Refractory septic shock: our updated pragmatic approach

Journal of Anesthesia Analgesia and Critical Care 2026 Open access

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Authors: Filippo Palmesino, Adam Woodman-Bailey, Fraser Hanks, Stephanie Khoo, Marlies Ostermann, Nicholas Ioannou, Christopher I. S. Meadows, Duncan L. A. Wyncoll
DOI: 10.1186/s44158-025-00336-w
Cited by: 0
References: 68

Abstract

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.

Fields of Study & Subjects

Sepsis Diagnosis and Treatment Immune Response and Inflammation Trauma Hemostasis Coagulopathy Resuscitation

Publication details

Journal / source
Journal of Anesthesia Analgesia and Critical Care
Volume
6
Issue
1
Pages
21–21
Publication date
9 January 2026
Language
EN