April 2014 Tucson critical care journal club: early goal-directed therapy

Abstract

No abstract available. Article truncated at 150 words. In 2001, Early Goal Directed Therapy (EGDT) was demonstrated to improve 60 day mortality as compared to usual care practices, 44.3% vs. 56.9%, respectively (p=0.03) (1). EGDT and its components have since been incorporated into the major guidelines for the treatment of sepsis (2,3). The subsequent critical care literature has focused on adherence to EGDT protocols, the value of individual protocol components, and alternative protocols that are less standardized (4-6). The ProCESS trial was conducted to assess the continued benefit of protocol-based sepsis treatment strategies in a contemporary setting. ProCESS randomized 1351 adult patients who were suspected to have septic shock (≥2 SIRS criteria plus refractory hypotension and/or elevated lactate) to the original EGDT protocol, a newer simplified protocol, or usual care. The study took place in 31 academic centers in the United States; these centers could not have been previously using septic shock treatment protocols. The simplified protocol differed ...

Keywords

• sepsis
• septic shock
• shock
• fluid resuscitation
• central venous pressure
• venous oxygen saturation
• ScVO2
• mortality
• goal-directed therapy
• guidelines