EBQ:ProMISe Trial: Difference between revisions

Revision as of 04:47, 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

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

Interventions

Outcomes

Primary Outcome

Secondary Outcomes

Subgroup analysis

Criticisms & Further Discussion

External Links

Funding

Sources

Authors:

@@ Line 45: / Line 45: @@
 *CD4 count <50
 *Advance directive that restricts either protocol
-Contraindication to interventions including refusal of blood transfusions
+*Contraindication to interventions including refusal of blood transfusions
 *Pregnant
 *Transfer patient