RecentRCT

TRICYCLE

Early multimodal vasopressor strategy in septic shock: results of the TRICYCLE randomized controlled trial.

Critical care (London, England), 2026 · Phase II randomized physiological strategy trial

Population: 79 septic-shock patients on norepinephrine ≥0.15 µg/kg/min
Intervention: Early angiotensin II, vasopressin and norepinephrine
Comparator: Stepwise vasoactive escalation
Primary outcome: Change in plasma renin
Result: Faster renin decline; mortality comparisons imprecise and not significant.

What the trial found

Faster renin decline; mortality comparisons imprecise and not significant.

Clinical interpretation

Phase-II physiology findings justify further study, not routine survival-benefit claims or obligatory triple therapy.

Low certainty

Clinical Context & Relevant Topics (1)

Disease Reference

Shock: Foundational Critical Care Framework

Cellular dysoxia, DO2/VO2 physiology, the 4 shock phenotypes, dynamic fluid responsiveness (PLR/PPV) vs fluid tolerance (VExUS), and vasoactive pharmacology.

View Topic Context →