The Crystalloid Liberal or Vasopressors Early Resuscitation in Sepsis (CLOVERS) study has been published. This is an adult-study, so of course cannot be directly extrapolated into the paediatric world, we know that there are different co-morbidities and physiological responses to shock in adults compared with children, but it involves an important question for paediatrics. A question the paediatric world is having difficulties addressing since the publication of the FEAST study which questioned liberal use of fluids in resuscitation in children in shock (Maitland K et al, N Engl J Med 2011;364:2483-2495). In another example of using huge networks to recruit sufficient numbers of patients in order to answer simple yet important questions, The National Heart, Lung, and Blood Institute Network (NEJM January 21, 2023 DOI: 10.1056/NEJMoa2212663) recruited 1563 patients from 60 centres in USA in an open superiority study comparting a restrictive fluid strategy (prioritising inotropes and lower intravenous fluid volumes) or a liberal fluid strategy (prioritising higher volumes of intravenous fluids before inotrope use) for a 24-hour period.
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