Early management of sepsis with emphasis on early goal directed therapy: AME evidence series 002

Zhongheng Zhang, Yucai Hong, Nathan J. Smischney, Han Pin Kuo, Panagiotis Tsirigotis, Jordi Rello, Win Sen Kuan, Christian Jung, Chiara Robba, Fabio Silvio Taccone, Marc Leone, Herbert Spapen, David Grimaldi, Sven Van Poucke, Steven Q. Simpson, Patrick M. Honore, Stefan Hofer, Pietro Caironi

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)392-405
Number of pages14
JournalJournal of Thoracic Disease
Volume9
Issue number2
DOIs
Publication statusPublished - Jan 1 2017
Externally publishedYes

Keywords

  • Early goal directed therapy (EGDT)
  • Evidence
  • Sepsis
  • Septic shock

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Zhang, Z., Hong, Y., Smischney, N. J., Kuo, H. P., Tsirigotis, P., Rello, J., Kuan, W. S., Jung, C., Robba, C., Taccone, F. S., Leone, M., Spapen, H., Grimaldi, D., Poucke, S. V., Simpson, S. Q., Honore, P. M., Hofer, S., & Caironi, P. (2017). Early management of sepsis with emphasis on early goal directed therapy: AME evidence series 002. Journal of Thoracic Disease, 9(2), 392-405. https://doi.org/10.21037/jtd.2017.02.10