Standard sepsis algorithms have suggested completing a fluid bolus before starting vasopressors in patients with septic shock, but multiple observational trials have shown an association between early vasopressor use and improved outcomes.

CENSER was the first randomized controlled trial to examine this.

The researchers enrolled adults 18 and older with a mean arterial blood pressure lower than 65 mm Hg with infection as the suspected cause.

Patients were excluded if they were in septic shock for more than one hour or had a stroke, an acute coronary syndrome, acute pulmonary edema, status asthmaticus, active arrhythmias, active GI hemorrhage, pregnancy, seizure, drug overdose, trauma, need for immediate surgery, or advanced staged cancer.

Read More