ARISE FLUIDS

In a multicenter RCT across 51 sites in Australia, New Zealand, and the UK, adults presenting to the ED with septic shock (SBP <90 or MAP <65 despite ≥1L IV fluid, lactate >2 mmol/L, on antibiotics) were randomized to restricted fluids + early vasopressors vs. liberal fluids + delayed vasopressors for up to 24 hrs. Days alive and out of hospital at day 90 were identical (76 vs. 76 days; difference 0.0, 95% CI −2.7 to 2.7; P=1.00). 90-day mortality was similar (16.4% vs. 14.4%; RR 1.14, 95% CI 0.85–1.54). Pulmonary edema was less frequent with the vasopressor strategy (0.6% vs. 5.0%; P<0.001). n=963.