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Early goal-directed therapy in severe sepsis and septic shock
| Title: | Early goal-directed therapy in severe sepsis and septic shock: insights and comparisons to ProCESS, ProMISe, and ARISE. |
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| Name(s): |
Nguyen, H Bryant, author Jaehne, Anja Kathrin, author Jayaprakash, Namita, author Semler, Matthew W, author Hegab, Sara, author Yataco, Angel Coz, author Tatem, Geneva, author Salem, Dhafer, author Moore, Steven, author Boka, Kamran, author Gill, Jasreen Kaur, author Gardner-Gray, Jayna, author Pflaum, Jacqueline, author Domecq, Juan Pablo, author Hurst, Gina, author Belsky, Justin B, author Fowkes, Raymond, author Elkin, Ronald B, author Simpson, Steven Q, author Falk, Jay L, author Singer, Daniel J, author Rivers, Emanuel P, author |
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| Type of Resource: | text | |
| Genre: |
Journal Article Text |
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| Date Issued: | 2016-07-01 | |
| Physical Form: |
computer online resource |
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| Extent: | 1 online resource | |
| Language(s): | English | |
| Abstract/Description: | Prior to 2001 there was no standard for early management of severe sepsis and septic shock in the emergency department. In the presence of standard or usual care, the prevailing mortality was over 40-50 %. In response, a systems-based approach, similar to that in acute myocardial infarction, stroke and trauma, called early goal-directed therapy was compared to standard care and this clinical trial resulted in a significant mortality reduction. Since the publication of that trial, similar outcome benefits have been reported in over 70 observational and randomized controlled studies comprising over 70,000 patients. As a result, early goal-directed therapy was largely incorporated into the first 6 hours of sepsis management (resuscitation bundle) adopted by the Surviving Sepsis Campaign and disseminated internationally as the standard of care for early sepsis management. Recently a trio of trials (ProCESS, ARISE, and ProMISe), while reporting an all-time low sepsis mortality, question the continued need for all of the elements of early goal-directed therapy or the need for protocolized care for patients with severe and septic shock. A review of the early hemodynamic pathogenesis, historical development, and definition of early goal-directed therapy, comparing trial conduction methodology and the changing landscape of sepsis mortality, are essential for an appropriate interpretation of these trials and their conclusions. | |
| Identifier: | FSU_pmch_27364620 (IID), 10.1186/s13054-016-1288-3 (DOI), PMC4929762 (PMCID), 27364620 (RID), 27364620 (EID), 10.1186/s13054-016-1288-3 (PII) | |
| Publication Note: | This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4929762. | |
| Subject(s): |
Hemodynamics/physiology Humans Patient Care Planning Resuscitation/methods Sepsis/mortality Sepsis/physiopathology Sepsis/therapy Shock, Septic/mortality Shock, Septic/physiopathology Shock, Septic/therapy |
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| Persistent Link to This Record: | http://purl.flvc.org/fsu/fd/FSU_pmch_27364620 | |
| Host Institution: | FSU | |
| Is Part Of: |
Critical care (London, England). 1466-609X |
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| Issue: | iss. 1, vol. 20 |
Nguyen, H. B., Jaehne, A. K., Jayaprakash, N., Semler, M. W., Hegab, S., Yataco, A. C., … Rivers, E. P. (2016). Early goal-directed therapy in severe sepsis and septic shock: insights and comparisons to ProCESS, ProMISe, and ARISE. Critical Care (London, England). Retrieved from http://purl.flvc.org/fsu/fd/FSU_pmch_27364620
