Septic shock: ECMO beyond ARDS? Introducing the Simon two-stage protocol when randomisation is considered unethical

摘要

One of the great disappointments during the past decades has been the failure to convert advances in our understanding of the biologic features of sepsis into new therapies. Although numerous multicenter, randomized controlled trials have been conducted in the last 30 years, no reduction of septic shock mortality was achieved [1] [2]. [3] Taking together available evidence suggests that no sepsis specific therapies are available until today, although a roadmap on the way to a specific septic shock therapy might be on the horizon [3] [4] including artificial intelligence.