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My approach has always been to start peripheral vasopressors asap, given that mortality increases about 2-5% for every hour delay of vasopressor initiation in shock patients. Overall solid study, and there are no RCTs on this, but I’d use this as good evidence to stat pressors quickly, esp given that 60% of these patients avoided CVC placement, which carries its own non-negligible risk. What’s your approach? #doctor #nurse #icu #criticalcare #icunurse