So metabolic resuscitation is a topic that both Josh (@Pulmcrit) and I are really interested in. We were looking forward to the CITRUS-ALI study. The results, to me, are good. They continue to establish the fact that there are no real side effects, particularly renal, as this was a concern to some (despite the already large data sets – particularly in the Matsuda study), and in an even higher dose than the Marik study.
Of course since the study was not designed to show a mortality benefit, it wouldn’t be clean to tout their results from that angle, but it certainly should be hypothesis-generating (imagine the cheers from the pundits who would certainly have used it in reverse had the mortality been increased instead!!!). So for me, it changes nothing, because – if my institution hadn’t decreed (for no legitimate reason I can see) that I cannot use it in patients that I feel would benefit – I would still use it as an adjunct to septic shock management.
There are more studies around the corner, and hope they will come out before next may, so that Josh can give us an update for H&R2020 (#Hresus20)!
Here is our chat: