Sepsis, ventilation,and what is new and trustworthyin the literature.

A randomized, controlled trial conducted across the Americas, Asia, and Europe between March 2022 and April 2025. Patients with early septic shock were allocated to resuscitation guided by capillary refill time (CRT ≤ 3 seconds as target) versus usual care based on current guidelines.

The primary outcome was a hierarchical composite of 28-day mortality, duration of vital support, and hospital length of stay — an analytical method that captures gradations of clinical benefit that traditional binary endpoints miss.

A systematic review with meta-analysis of randomized clinical trials comparing ventilation strategies targeting driving pressure (DP ≤ 15 cmH₂O) versus conventional lung-protective ventilation (low tidal volume without DP as a primary target) in patients with ARDS or acute respiratory failure.

Search across major databases from inception through June 2025. Primary outcome: short-term mortality. Methodological quality assessed using Cochrane RoB 2 tool and GRADE framework.

An update to the SSC 2021 guidelines, developed by international panels with representation from all continents, including patients and family members. GRADE methodology with support from the GUIDE group. Simultaneously published in Intensive Care Medicine and Critical Care Medicine.

The 46 new statements include antibiotic optimization, blood pressure targets in older adults, fluid removal after resuscitation, and post-discharge continuity of care — with explicit attention to physical and psychological rehabilitation.