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
Nov 21, 1997·Critical Care Medicine·D J Muckart, S Bhagwanjee
Jul 11, 2001·Critical Care Medicine·D C AngusM R Pinsky
Jan 17, 2002·The New England Journal of Medicine·E RiversUNKNOWN Early Goal-Directed Therapy Collaborative Group
Apr 18, 2003·The New England Journal of Medicine·Greg S MartinMarc Moss
Aug 13, 2005·Critical Care Medicine·Alan E Jones, Jeffrey A Kline
Dec 21, 2005·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·H Bryant NguyenWilliam A Wittlake
Feb 16, 2006·Chest·Emanuel P Rivers
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
Nov 14, 2006·Chest·Ronny M OteroEmanuel P Rivers
Apr 7, 2007·Critical Care Medicine·Viktor Y DombrovskiyHarold L Paz
Jun 22, 2007·Critical Care Medicine·Henry E WangDonald M Yealy
Dec 14, 2007·Critical Care Medicine·David J Carlbom, Gordon D Rubenfeld
Jul 9, 2008·The American Journal of Emergency Medicine·Alan E JonesJeffrey A Kline
Citations
Nov 11, 2010·Journal of Emergencies, Trauma, and Shock·Colleen A CroweChristine E Kulstad
Jun 3, 2014·Critical Care : the Official Journal of the Critical Care Forum·Takeo AzuhataKatsuhisa Tanjho
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
Jul 29, 2017·PloS One·Teresa Bleakly KortzSaraswati Kache
Jul 13, 2016·Yonsei Medical Journal·Woo Kyung LeeSungwon Na
Mar 16, 2019·PloS One·Thansinee SaetaeRujipat Samransamruajkit
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
Jul 22, 2016·Critical Care Medicine·Michael P ThompsonSam R Watson