Sepsis & septic shock · Protocolised early resuscitation
Goal-directed resuscitation for patients with early septic shock
| Design | Multicentre randomised controlled trial |
|---|---|
| Treatment | Early goal-directed therapy |
| Control | Usual care |
| Population | 1600 patients presenting to the emergency department with early septic shock |
| Follow-up | 90 days |
| Primary endpoint | All-cause mortality at 90 days |
| Result | 796 patients were assigned to early goal-directed therapy and 804 to usual care, with primary outcome data available for over 99%. The EGDT group received a larger mean volume of intravenous fluid and more vasopressors and transfusions, without any reduction in 90-day mortality. |
| Secondary endpoints | Organ support, length of stay, quality of life |
In critically ill patients presenting to the emergency department with early septic shock, EGDT did not reduce all-cause mortality at 90 days.
The trial authors, in the published abstract
The second replication failure, in Australasia. Together with ProCESS and ProMISe it produced an unusually clean verdict on a practice that had already been embedded in international guidelines and quality metrics.
Peake SL, Delaney A, Bailey M, et al. Goal-directed resuscitation for patients with early septic shock. N Engl J Med 2014 Oct 16;371(16):1496-506.