Shooting for the bull's eye in septic shock.

The sine qua non of septic shock is hemodynamic failure, and it is expected that therapy for septic shock is directed at stabilizing the blood pressure, while avoiding complications such as volume overload. Some prior evidence existed to suggest that hyperoxia could induce vasoconstriction (1), while hypertonic saline could be used as a volume-sparing agent for fluid resuscitation. To simultaneously investigate the effectiveness of both hyperoxia and hypertonic saline in septic shock to reduce mortality, Asfar and colleagues conducted the HYPERS2S two-by-two factorial randomized controlled trial (2).