Emerging concepts in the care of patients with cirrhosis and septic shock

Table 1 Patients with liver disease in randomized controlled trials of sepsis and septic shock

Trial	Intervention	n	Liver disease present (%)	Cirrhosis excluded	Comments
Rivers (2001)	EGDT vs Standard	263	61 (23)	No
ProMISe Trial (2014)	EGDT vs Standard	1260	22 (1.8)	No
ARISE Trial (2014)	EGDT vs Standard	1600	83 (5)	No
ProCESS (2014)	EGDT vs Standard	1341	11 (0.8)	No
ANDROMEDA-SHOCK (2019)	CRT vs Lactate clearance	424	0 (0)	Yes	Excluded Child B and C
SMART Study (2018)	Balanced crystalloids vs 0.9% NS	15802	180 (11)	No
BaSICS Trial (2021)	Balanced crystalloids vs 0.9% NS and Slow vs Fast bolus	11052	266 (2.4)	No
PLUS Study (2022)	Balanced crystalloids vs 0.9% NS	5037	NR	No
Classic Trial (2022)	Restrictive vs Liberal fluids	1554	NR	No
SAFE Trial (2004)	4% Albumin vs 0.9% NS	6997	NR	No
ALBIOS Study (2014)	20% Albumin + Crystalloids vs Crystalloids alone	1818	27 (1.4)	No	Excluded cirrhotic patients with cirrhosis and ascites
VASST Trial (2008)	Vasopressin vs NE	778	88 (11)	No	Excluded Na < 130 mEq/L and irreversible disease with less than six-month survival
VANISH Trial (2016)	Vasopressin vs NE - AKI	409	14 (4)	No	Factorial design (vasopressin/hydrocortisone)
ATHOS-3 (2018)	Angiotensin-II vs Placebo	344	NR	Yes	Excluded MELD > 30
CENSER (2019)	Early NE vs Placebo	310	27 (9)	No
CORTICUS Trial (2008)	Hydrocortisone vs Placebo	499	40 (8)	No
ADRENAL Trial (2018)	Hydrocortisone vs Placebo	3800	NR	No
APROCCHSS Trial (2018)	Hydrocortisone + Fludrocortisone vs Placebo	1241	NR	Yes	Excluded Child C

AKI: Acute kidney injury; CRT: Capillary refill time; EGDT: Early goal-directed therapy; NE: Norepinephrine; NR: Not reported; NS: Normal saline.