Between November 2018 and November 2022, 1,010 ICU patients presenting with acute circulatory failure within the first 24 hours after admission were randomised.
In the noninvasive-strategy group, arterial catheterisation was avoided in 85 % of patients (15 % received one according to prespecified safety criteria).

For the primary outcome of all-cause death at day 28, mortality was 34 % in the noninvasive group and 37 % in the invasive group (absolute risk difference –3.2 % [–8.9 to 2.5]; p = 0.006 for non-inferiority, margin = 5 %).
There were no significant differences in SOFA-score evolution, ventilator-free days, vasopressor-free days, or use of renal replacement therapy.

I would like to express my sincere gratitude to the patients and their families for their trust and participation.
Heartfelt thanks to all CRICS-TriggerSep network investigators and research teams for their outstanding dedication, to Orléans University Hospital for its invaluable institutional support, and to Tours University Hospital, the study sponsor for the promotion, the methodological support and the statistical analysis.