Goal-Directed Resuscitation in Septic Shock: A Critical Analysis

Daniel J Henning; Nathan I Shapiro

doi:10.1016/j.ccm.2016.01.016

Goal-Directed Resuscitation in Septic Shock: A Critical Analysis

Clin Chest Med. 2016 Jun;37(2):231-9. doi: 10.1016/j.ccm.2016.01.016. Epub 2016 Mar 7.

Authors

Daniel J Henning¹, Nathan I Shapiro²

Affiliations

¹ Division of Emergency Medicine, Harborview Medical Center, University of Washington School of Medicine, 325 9th Avenue, Box 359702, Seattle, WA 98104, USA. Electronic address: henning2@uw.edu.
² Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, One Deaconess Road, W-CC2, Boston, MA 02215, USA.

PMID: 27229640
DOI: 10.1016/j.ccm.2016.01.016

Abstract

The Early Goal-Directed Therapy versus Standard Care for Sepsis trial by Rivers and colleagues in 2001 suggested that a significant mortality reduction may be realized through goal-directed interventions early in the care of patients with septic shock. However, the recent publication of the Protocol-Based Care for Early Septic Shock (ProCESS), Australasian Resuscitation in Sepsis Evaluation (ARISE), and Protocolised Management in Sepsis (ProMISE) trials did not demonstrate the superiority of early goal-directed therapy over usual care. If usual care includes timely and meticulous care, a protocol may not be needed to realize the continued lowering mortality rates.

Keywords: Goal-directed therapy; Resuscitation; Septic shock; Severe sepsis.

Publication types

Research Support, Non-U.S. Gov't
Review
Comment

MeSH terms

Disease Management
Goals*
Humans
Resuscitation
Sepsis
Shock, Septic*