Early goal-directed resuscitation of patients with septic shock: current evidence and future directions

Critical Care : the Official Journal of the Critical Care Forum
Ravi G GuptaGonzalo M L Bearman

Abstract

Severe sepsis and septic shock are among the leading causes of mortality in the intensive care unit. Over a decade ago, early goal-directed therapy (EGDT) emerged as a novel approach for reducing sepsis mortality and was incorporated into guidelines published by the international Surviving Sepsis Campaign. In addition to requiring early detection of sepsis and prompt initiation of antibiotics, the EGDT protocol requires invasive patient monitoring to guide resuscitation with intravenous fluids, vasopressors, red cell transfusions, and inotropes. The effect of these measures on patient outcomes, however, remains controversial. Recently, three large randomized trials were undertaken to re-examine the effect of EGDT on morbidity and mortality: the ProCESS trial in the United States, the ARISE trial in Australia and New Zealand, and the ProMISe trial in England. These trials showed that EGDT did not significantly decrease mortality in patients with septic shock compared with usual care. In particular, whereas early administration of antibiotics appeared to increase survival, tailoring resuscitation to static measurements of central venous pressure and central venous oxygen saturation did not confer survival benefit to most patients...Continue Reading

References

Feb 1, 1995·Critical Care Medicine·M E AstizE C Rackow
Mar 19, 1999·Acta Anaesthesiologica Scandinavica·K A Kirkebøen, O A Strand
May 10, 2000·Microcirculation : the Official Journal of the Microcirculatory Society, Inc·C W Lush, P R Kvietys
Jun 14, 2000·American Journal of Respiratory and Critical Care Medicine·J L VincentJ C Preiser
Aug 31, 2000·Critical Care Medicine·D LeDouxE C Rackow
Jan 17, 2002·The New England Journal of Medicine·E RiversUNKNOWN Early Goal-Directed Therapy Collaborative Group
Jul 2, 2002·American Journal of Respiratory and Critical Care Medicine·Daniel De BackerJean-Louis Vincent
Mar 21, 2003·The New England Journal of Medicine·David C McGee, Michael K Gould
Apr 12, 2003·Critical Care Medicine·Mitchell M LevyUNKNOWN SCCM/ESICM/ACCP/ATS/SIS
Apr 18, 2003·The New England Journal of Medicine·Greg S MartinMarc Moss
Aug 19, 2005·Current Infectious Disease Reports·Pajman Danai, Greg S Martin
Jan 31, 2006·American Journal of Epidemiology·Lise Lotte Gluud
Feb 18, 2006·Critical Care Medicine·Nathan I ShapiroAlan Lisbon
Feb 18, 2006·Critical Care Medicine·Andreas KortgenMichael Bauer
Sep 1, 2006·Critical Care Medicine·Scott T MicekMarin H Kollef
Sep 1, 2007·Current Opinion in Critical Care·Xavier Monnet, Jean-Louis Teboul
Feb 29, 2008·The New England Journal of Medicine·James A RussellUNKNOWN VASST Investigators
May 22, 2008·JAMA : the Journal of the American Medical Association·Ricard FerrerUNKNOWN Edusepsis Study Group
Feb 25, 2009·Critical Care Medicine·Steven W ThielMarin H Kollef
Jul 28, 2009·Current Opinion in Critical Care·Sergio L Zanotti-Cavazzoni, Steven M Hollenberg
Sep 5, 2009·Critical Care : the Official Journal of the Critical Care Forum·Massimo GirardisUNKNOWN Sopravvivere alla Sepsi Group of the Modena-University Hospital
Feb 11, 2010·Critical Care : the Official Journal of the Critical Care Forum·Charalampos Pierrakos, Jean-Louis Vincent
Feb 25, 2010·JAMA : the Journal of the American Medical Association·Alan E JonesUNKNOWN Emergency Medicine Shock Research Network (EMShockNet) Investigators
Mar 24, 2010·Critical Care Medicine·Bradford D WintersJonathan E Sevransky
May 13, 2010·Critical Care : the Official Journal of the Critical Care Forum·Teresa CardosoAltamiro Costa-Pereira
May 14, 2010·American Journal of Respiratory and Critical Care Medicine·Tim C JansenUNKNOWN LACTATE study group
Nov 3, 2010·Journal of Critical Care·Glauco A WestphalAnderson R Roman Gonçalves
Dec 24, 2010·American Journal of Respiratory and Critical Care Medicine·Keith R Walley
Jun 8, 2011·Critical Care : the Official Journal of the Critical Care Forum·Julie BadinDominique Perrotin
Sep 13, 2011·Annals of Intensive Care·Paul E MarikJean-Louis Teboul
Sep 22, 2011·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Narani SivayohamSarah Krishnanandan

❮ Previous
Next ❯

Citations

Feb 4, 2016·Veterinary Immunology and Immunopathology·Iulia KarlssonSara Wernersson
May 9, 2016·Clinical Therapeutics·Carola LedderoseWolfgang G Junger
Jul 28, 2016·Topics in Companion Animal Medicine·Francesca Miranda Di Mauro, Gretchen Lee Schoeffler
Oct 6, 2016·BioMed Research International·Bernd SaugelJulia Y Wagner
Mar 10, 2019·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Steven M Lemieux, Alexander R Levine
Nov 7, 2015·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Sarah A DayMegan A Rech
Jan 27, 2017·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Adrian WongSarah Day
Jul 20, 2018·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Patrick S HumeChanu Rhee
Nov 23, 2019·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Olivia C R HessGonzalo Bearman
Jun 17, 2016·Anesthesia and Analgesia·Philip BicklerLingzhong Meng
May 10, 2018·Frontiers in Immunology·Aleksandra LeligdowiczKevin C Kain
Mar 24, 2020·Journal of Medical Internet Research·Subendhu RongaliHong Yu
Apr 9, 2020·Critical Care : the Official Journal of the Critical Care Forum·Bo HuKianoush Kashani
May 10, 2017·BioMed Research International·Feng ZhaoWei Wang
Aug 2, 2017·Seminars in Cardiothoracic and Vascular Anesthesia·Akila RajakumarM Susan Mandell
Dec 30, 2015·Critical Care : the Official Journal of the Critical Care Forum·Derek S Wheeler
Aug 25, 2021·The American Journal of Emergency Medicine·Hua-Ling WangQi-Hong Chen

❮ Previous
Next ❯

Software Mentioned

ARISE
PRoMISe
ProCESS

Related Concepts

Related Feeds

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Cardiovascular Inflammation

Inflammation plays a significant role in the development of cardiovascular diseases, an understanding of these endogenous processes is critical for evaluating the risks and potential treatment strategies. Discover the latest research on cardiovascular inflammation here.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Related Papers

The New England Journal of Medicine
Donald M YealyDerek C Angus
Seminars in Respiratory and Critical Care Medicine
Andrew T LevinsonMitchell M Levy
Medizinische Klinik, Intensivmedizin und Notfallmedizin
U Janssens
JAMA : the Journal of the American Medical Association
Alan E JonesEmergency Medicine Shock Research Network (EMShockNet) Investigators
© 2021 Meta ULC. All rights reserved