Clinical trials provide only part of the necessary framework for clinical decision-making. In practice, a detailed understanding of each patient’s hemodynamic profile is essential.

We believe that the echocardiography-guided approach to arrhythmia management, long advocated by Dr. Balík, can be effectively extended to sinus tachycardia in septic shock.

Practicing intensivists tailor therapies to the individual pathophysiological characteristics of each patient, and future clinical trials should be designed to help predict the effects of the therapeutic tools available to us rather than trying to prove mortality benefit in heterogeneous syndromes such as sepsis.

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