EMCrit Wee - EVERDAC RCT on Arterial Line Placement in the Medically Critically Ill--Let's hear from the lead author, Gregoire Muller.

I love having arterial lines on my crashing patients, but is there any evidence that it makes a difference on outcomes??

[#FOAMed for now]
emcrit.org/everdac

EVERDAC trial: In patients with shock, arterial catheterization is recommended to detect hypotensive episodes, but whether noninvasive blood-pressure monitoring could be a safe alternative is unclear. Research findings are summarized in a new Quick Take video. nej.md/47drZnr

#LIVES2025

🚨EVERDAC Trial Post is out! 🚨

💉Is non-invasive BP an acceptable alternative to arterial lines in critically ill patients?

🟰 NIBP monitoring is noninferior to a-line when comparing 28 day mortality rates.

#FOAMed

EVERDAC(PMID: 41159885)
-Early art line didn’t affect mortality in shock(mainly sepsis)

Reasons for early art line
-Non-invasive cuff unreliable
-Vasoconstrictive shock(trauma, cardiogenic)
-Need reliable beat to beat SBP (ICH, aortic dissection)
-Cardiac arrest

youtube.com/shorts/BlKbx...
#EMIMCC

EMCrit 414 - HyperCRITical - @PulmCrit on BICARICU-2 and EVERDAC.
-Should we be treating acidosis with BICARB?
-Are a-lines dead?

Place the venous catheter first. Sweat about the arterial line later

And yes. I place a lot of arterial lines and I was not pleased with how many people interpreted the EVERDAC trial
(NEJM 2025; 393: 1875-88 -
DOI: 10.1056/NEJMoa2502136)

EVERDAC is hot off press @esicm.bsky.social #Lives2025 in @nejm.org open access currently:
www.nejm.org/doi/full/10....
Reports that in (non-blinded trial) patients with shock, management *without* early a-line insertion was noninferior to early catheter insertion…. #Lives2025 #criticalcare

In the EVERDAC trial involving patients with shock, results for death at day 28 indicated that management without early arterial catheter insertion was noninferior to early catheter insertion. Full trial results: nej.md/3LmOO0D

#LIVES2025 | @esicm.bsky.social

In the EVERDAC trial involving patients with shock, results for death at day 28 indicated that management without early arterial catheter insertion was noninferior to early catheter insertion. Full trial results and Research Summary: nej.md/3LmOO0D 

#MedSky #PulmSky

🚨EVERDAC Trial Post is out! 🚨

💉Is non-invasive BP an acceptable alternative to arterial lines in critically ill patients?

🟰 NIBP monitoring is noninferior to a-line when comparing 28 day mortality rates.

#FOAMed

New in the November 13, 2025, issue of NEJM:

Deferring Arterial Catheterization in Shock (EVERDAC trial) nej.md/3LmOO0D 

Beta-Blockers after MI without Reduced EF (REBOOT trial) nej.md/45QYbws

#MedSky

Avec le Podcast explicatif de l’étude pour celles et ceux intéressé(e)s.

open.spotify.com/episode/4xUf...

🚨EVERDAC Trial Post is out! 🚨

💉Is non-invasive BP an acceptable alternative to arterial lines in critically ill patients?

🟰 NIBP monitoring is noninferior to a-line when comparing 28 day mortality rates.

#FOAMed

EVERDAC est publié : www.nejm.org/doi/full/10....

Bravo à Grégoire et à toute l’équipe d’Orleans et des autres centres.

Finally, my warmest thanks to the CRICS-TriggerSep Scientific Board for their crucial role in designing and conducting this trial.

https://www.nejm.org/doi/full/10.1056/NEJMoa2502136

#everdac #CriticalCare #esicm2025 #nejm #icu #research #cricstriggersep

🎉 Thrilled to share the results of the EVERDAC trial, published today in the New England Journal of Medicine following its presentation in the Hot Topics session at the ESICM Congress in Munich!

Among critically ill patients with acute circulatory failure, noninvasive blood pressure monitoring […]

Arterial lines for shock: harms exceed benefits (EVERDAC trial) • Does this remove yet another brick in the wall of critical care dogma?

CORRECTION to "Arterial lines for shock: harms exceed benefits (EVERDAC trial)" • Tartrate, schmartrate