Evaluation of a modified early goal-directed therapy protocol

The American Journal of Emergency Medicine
Colleen A CroweChristine E Kulstad

Abstract

The study aimed to determine mortality in septic patients 2 years after introduction of a modified early goal-directed therapy (EGDT) protocol and to measure compliance with the protocol. This was an observational study of prospectively identified patients treated with EGDT in our emergency department (ED) from May 2007 through May 2008 and compared with retrospectively obtained data on patients treated before protocol implementation, from May 2004 to May 2005. This study was conducted at a large tertiary-care suburban community hospital with more than 85 000 ED visits annually and 700 inpatient beds. Patients with severe sepsis or septic shock were included in the study. A modified EGDT protocol was implemented. A total of 216 patients were treated with our EGDT protocol, with 32.9% mortality (95% confidence interval [CI], 26.6%-39.2%); 183 patients (84.7%) had septic shock, with a mortality of 34.4% (95% CI, 28%-41%). Our control group of 205 patients had a 27.3% mortality (95% CI, 21.2%-33.5%), of which 123 had septic shock with a mortality of 43.1% (95% CI, 34%-52%). Early goal-directed therapy protocol compliance was as follows: 99% received adequate intravenous fluids, 99% had a central line, 98% had antibiotics in the fi...Continue Reading

References

Jan 17, 2002·The New England Journal of Medicine·E RiversUNKNOWN Early Goal-Directed Therapy Collaborative Group
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Citations

Nov 11, 2010·Journal of Emergencies, Trauma, and Shock·Colleen A CroweChristine E Kulstad
Mar 19, 2013·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Paul M PalevskySteven D Weisbord
Dec 30, 2011·The American Journal of Emergency Medicine·Aveh BastaniWilliam Anderson
Jan 13, 2015·BMC Anesthesiology·Paul A van BeestThomas W L Scheeren
Jul 2, 2016·Critical Care : the Official Journal of the Critical Care Forum·H Bryant NguyenEmanuel P Rivers
Oct 19, 2016·Current Medical Research and Opinion·Bing LiuJiong Yang
Oct 22, 2018·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Stacy A TrentJason S Haukoos
Apr 21, 2018·Frontiers in Pediatrics·Benjamin Louis MorescoUtpal Bhalala

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