EBQ:ProMISe Trial: Difference between revisions
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==Population== | ==Population== | ||
56 hospitals in the UK | |||
===Patient Demographics=== | ===Patient Demographics=== | ||
===Inclusion Criteria=== | ===Inclusion Criteria=== | ||
*≥18 years of age | |||
*Within 6 hours of presenting to ED | |||
*Known or presumed infection | |||
*2 or more SIRS criteria | |||
*Refractory hypotension (<90 SBP or <65 MAP after 1L IVF trial) or hyperlactatemia (≥4.0) | |||
===Exclusion Criteria=== | ===Exclusion Criteria=== | ||
*CVA | |||
*ACS | |||
*Cardiac dysrhythmia | |||
*Acute pulmonary edema | |||
*GI bleed | |||
*Seizure | |||
*Drug overdose | |||
*Burn or trauma | |||
*Immediate surgery needed | |||
*CD4 count <50 | |||
*Advance directive that restricts either protocol | |||
Contraindication to interventions including refusal of blood transfusions | |||
*Pregnant | |||
*Transfer patient | |||
==Interventions== | ==Interventions== |
Revision as of 04:35, 7 May 2015
incomplete Journal Club Article
Mouncey PR, Osborn TM, Power GS, et al. "Trial of Early, Goal-Directed Resuscitation for Septic Shock". NEJM. 2015. 14(372):1301-1311.
PubMed Full text
PubMed Full text
Clinical Question
Is there a different between EGDT versus “usual care” in 90-day mortality?
Conclusion
Using EGDT did not lead to an improved outcome
Major Points
Study Design
Population
56 hospitals in the UK
Patient Demographics
Inclusion Criteria
- ≥18 years of age
- Within 6 hours of presenting to ED
- Known or presumed infection
- 2 or more SIRS criteria
- Refractory hypotension (<90 SBP or <65 MAP after 1L IVF trial) or hyperlactatemia (≥4.0)
Exclusion Criteria
- CVA
- ACS
- Cardiac dysrhythmia
- Acute pulmonary edema
- GI bleed
- Seizure
- Drug overdose
- Burn or trauma
- Immediate surgery needed
- CD4 count <50
- Advance directive that restricts either protocol
Contraindication to interventions including refusal of blood transfusions
- Pregnant
- Transfer patient