TY - JOUR
T1 - Early management of sepsis with emphasis on early goal directed therapy
T2 - AME evidence series 002
AU - Zhang, Zhongheng
AU - Hong, Yucai
AU - Smischney, Nathan J.
AU - Kuo, Han Pin
AU - Tsirigotis, Panagiotis
AU - Rello, Jordi
AU - Kuan, Win Sen
AU - Jung, Christian
AU - Robba, Chiara
AU - Taccone, Fabio Silvio
AU - Leone, Marc
AU - Spapen, Herbert
AU - Grimaldi, David
AU - Poucke, Sven Van
AU - Simpson, Steven Q.
AU - Honore, Patrick M.
AU - Hofer, Stefan
AU - Caironi, Pietro
N1 - Publisher Copyright:
© Journal of Thoracic Disease. All rights reserved.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Severe sepsis and septic shock are major causes of morbidity and mortality in patients entering the emergency department (ED) or intensive care unit (ICU). Despite substantial efforts to improve patient outcome, treatment of sepsis remains challenging to clinicians. In this context, early goal directed therapy (EGDT) represents an important concept emphasizing both early recognition of sepsis and prompt initiation of a structured treatment algorithm. As part of the AME evidence series on sepsis, we conducted a systematic review of all randomized controlled EGDT trials. Focus was laid on the setting (emergency department versus ICU) where EGDT was carried out. Early recognition of sepsis, through clinical or automated systems for early alert, together with well-timed initiation of the recommended therapy bundles may improve patients' outcome. However, the original "EGDT" protocol by Rivers and coworkers has been largely modified in subsequent trials. Currently, many investigators opt for an "expanded" EGDT (as suggested by the Surviving Sepsis Campaign). Evidence is also presented on the effectiveness of automated systems for early sepsis alert. Early recognition of sepsis and well-timed initiation of the SSC bundle may improve patient outcome.
AB - Severe sepsis and septic shock are major causes of morbidity and mortality in patients entering the emergency department (ED) or intensive care unit (ICU). Despite substantial efforts to improve patient outcome, treatment of sepsis remains challenging to clinicians. In this context, early goal directed therapy (EGDT) represents an important concept emphasizing both early recognition of sepsis and prompt initiation of a structured treatment algorithm. As part of the AME evidence series on sepsis, we conducted a systematic review of all randomized controlled EGDT trials. Focus was laid on the setting (emergency department versus ICU) where EGDT was carried out. Early recognition of sepsis, through clinical or automated systems for early alert, together with well-timed initiation of the recommended therapy bundles may improve patients' outcome. However, the original "EGDT" protocol by Rivers and coworkers has been largely modified in subsequent trials. Currently, many investigators opt for an "expanded" EGDT (as suggested by the Surviving Sepsis Campaign). Evidence is also presented on the effectiveness of automated systems for early sepsis alert. Early recognition of sepsis and well-timed initiation of the SSC bundle may improve patient outcome.
KW - Early goal directed therapy (EGDT)
KW - Evidence
KW - Sepsis
KW - Septic shock
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U2 - 10.21037/jtd.2017.02.10
DO - 10.21037/jtd.2017.02.10
M3 - Article
AN - SCOPUS:85014121208
SN - 2072-1439
VL - 9
SP - 392
EP - 405
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
IS - 2
ER -