Journal Article

Goal-Directed Resuscitation for Patients with Early Septic Shock

Cooper, D James, Webb, Steven A R, Peake, Sandra L, Cameron, Peter A, Higgins, Alisa M, Howe, Belinda D, Bellomo, Rinaldo, Bailey, Michael, Holdgate, Anna, Delaney, Anthony, Williams, Patricia

2014

Overview

For more than a decade, early treatment of sepsis has been driven by algorithms. In this study conducted predominantly in Australia and New Zealand, the use of algorithm-based treatment was not superior to usual care. Severe sepsis has a reported annual incidence in adults of up to 300 cases per 100,000 population. 1 – 3 Despite decreasing mortality from sepsis in recent years, 4 the risk of death remains high. 5 , 6 The fundamental principles for the management of sepsis include early recognition, control of the source of infection, appropriate and timely administration of antimicrobial drugs, and resuscitation with intravenous fluids and vasoactive drugs. Patients presenting to the emergency department account for a large proportion of patients with severe sepsis. 7 Reported in-hospital mortality ranges in this subgroup from 20 to 50%. 3 , 8 – 10 In 2001, a proof-of-concept, randomized trial . . .

• Publisher: Massachusetts Medical Society
• Subject: Adult / Aged / Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy / Biological and medical sciences / Combined Modality Therapy / Critical Illness / Dobutamine - therapeutic use / Drug therapy / Emergency and intensive care: infection, septic shock / Emergency medical care / Emergency Service, Hospital / Erythrocyte Transfusion / Female / Fluid Therapy / General aspects / Hospitals / Humans / Intensive care / Intensive care medicine / Intravenous administration / Length of Stay / Male / Medical research / Medical sciences / Middle Aged / Mortality / Renal Replacement Therapy / Respiration, Artificial / Sepsis / Septic shock / Shock, Septic - mortality / Shock, Septic - therapy / Survival Analysis / Vasoconstrictor Agents - therapeutic use