Septic shock and severe sepsis: Protocol-based care versus usual care
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2001 Nov 8;345(19):1368-77 Randomized Controlled Trial
IN sepsis, septic shock The Use of
early goal-directed therapy for 6 h (transfusion, dobutamine directed by central venous oxygen saturation) added to standard therapy
As Treatment, Acute
Is better Than
standard therapy (crystalloid and vaso-pressor / dilators drugs directed by arterial pressure)
To reduce in-hospital mortality (30.5% in intv. VS 46.5% in ctrl.). Improve central venous oxygen saturation, acidosis and APACHE score
N Engl J Med. 2014 May 1;370(18):1683-93 Randomized Controlled Trial, Multicenter Study
IN sepsis, septic shock The Use of
protocol-based care, early goal-directed therapy protocol (fluids, vasopressors, and blood transfusions adjusted to central hemodynamic targets), or a protocol standard therapy (did not require central venous catheter, inotropes, or blood transfusion)
As Treatment, Acute
Is equal Than
usual care
To modify mortality at 2 months (21% EGDT, 18% protocol-based, 19% usual care) or at 1 year