ESICM: Early Goal-Directed Tx No Benefit in Early Septic Shock
No reduction in 90-day mortality for patients presenting to ER with early septic shock
THURSDAY, Oct. 2, 2014 (HealthDay News) -- Early goal-directed therapy (EGDT) does not reduce 90-day mortality for patients presenting to the emergency department with early septic shock, according to a study published online Oct. 1 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the European Society of Intensive Care Medicine, held from Sept. 27 to Oct. 1 in Barcelona, Spain.
Sandra L. Peake, M.D., Ph.D., from the Australian and New Zealand Intensive Care Research Centre School of Public Health and Preventive Medicine in Melbourne, and colleagues randomized patients presenting to the emergency department with early septic shock to receive EGDT (796 patients) or usual care (804 patients).
The researchers found that in the first six hours after randomization, patients in the EGDT group received a larger mean volume of intravenous fluids than those in the usual-care group. Patients in the EGDT group were also more likely to receive vasopressor infusions, red-cell transfusions, and dobutamine (all P < 0.001). The rates of death at 90 days after randomization were 18.6 and 18.8 percent in the EGDT group and usual-care group, respectively (absolute risk difference, −0.3 percentage points; P = 0.90). There was no significant between-group difference noted in survival time, in-hospital mortality, duration of organ support, or length of hospital stay.
"In critically ill patients presenting to the emergency department with early septic shock, EGDT did not reduce all-cause mortality at 90 days," the authors write.