Goal-directed resuscitation for patients with early septic shock

Sandra Lois Peake, Anthony Delaney, Michael John Bailey, Rinaldo Bellomo, Peter Cameron, David James Cooper, Alisa Higgins, Anna Holdgate, Belinda Duval Howe, Steven A R Webb, Patricia Williams

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Abstract

Background: Early goal-directed therapy (EGDT) has been endorsed in the guidelines of the Surviving Sepsis Campaign as a key strategy to decrease mortality among patients presenting to the emergency department with septic shock. However, its effectiveness is uncertain. Results: Of the 1600 enrolled patients, 796 were assigned to the EGDT group and 804 to the usual-care group. Primary outcome data were available for more than 99 of the patients. Patients in the EGDT group received a larger mean (?SD) volume of intravenous fluids in the first 6 hours after randomization than did those in the usual-care group (1964?1415 ml vs. 1713?1401 ml) and were more likely to receive vasopressor infusions (66.6 vs. 57.8 ), red-cell transfusions (13.6 vs. 7.0 ), and dobutamine (15.4 vs. 2.6 ) (P
Original languageEnglish
Pages (from-to)1496 - 1506
Number of pages11
JournalThe New England Journal of Medicine
Volume371
Issue number16
DOIs
Publication statusPublished - 2014

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