A Randomized Trial of Protocol-Based Care for Early Septic Shock

In septic shock, the first few hours of care are critical for survival. In this study, two protocols for the care of patients with septic shock were compared with usual care with respect to 60-day mortality and other outcomes. There were no significant differences in outcome. There are more than 750...

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Bibliographic Details
Published in:The New England journal of medicine Vol. 370; no. 18; pp. 1683 - 1693
Main Authors: YEALY, Donald M, KELLUM, John A, FILBIN, Michael R, SHAPIRO, Nathan I, ANGUS, Derek C, HUANG, David T, BARNATO, Amber E, WEISSFELD, Lisa A, PIKE, Francis, TERNDRUP, Thomas, WANG, Henry E, HOU, Peter C, LOVECCHIO, Frank
Format: Journal Article
Language:English
Published: Waltham, MA Massachusetts Medical Society 01.05.2014
Subjects:
Adult
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anti-Bacterial Agents - therapeutic use
Biological and medical sciences
Blood Transfusion
Cardiotonic Agents - therapeutic use
Clinical Protocols
Clinical trials
Combined Modality Therapy
Emergency and intensive care: infection, septic shock
Emergency Service, Hospital
Evidence-based medicine
Female
Fluid Therapy
General aspects
Hospital Mortality
Humans
Intensive care medicine
Intravenous administration
Male
Medical sciences
Medical treatment
Middle Aged
Mortality
Outcome Assessment (Health Care)
Protocol
Resuscitation - standards
Sepsis
Septic shock
Shock, Septic - diagnosis
Shock, Septic - mortality
Shock, Septic - therapy
Vasoconstrictor Agents - therapeutic use
United States > US
Pittsburgh Pennsylvania
Infection
Medicine
Septic shock
ISSN:0028-4793, 1533-4406, 1533-4406
Online Access:Get full text
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Summary:In septic shock, the first few hours of care are critical for survival. In this study, two protocols for the care of patients with septic shock were compared with usual care with respect to 60-day mortality and other outcomes. There were no significant differences in outcome. There are more than 750,000 cases of severe sepsis and septic shock in the United States each year. 1 Most patients who present with sepsis receive initial care in the emergency department, and the short-term mortality is 20% or more. 2 , 3 In 2001, Rivers et al. reported that among patients with severe sepsis or septic shock in a single urban emergency department, mortality was significantly lower among those who were treated according to a 6-hour protocol of early goal-directed therapy (EGDT) than among those who were given standard therapy (30.5% vs. 46.5%). 4 On the basis of the premise that usual care . . .
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A complete list of investigators in the Protocolized Care for Early Septic Shock (ProCESS) study is provided in the Supplementary Appendix, available at NEJM.org
ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa1401602