Difference between revisions of "EBQ:ProMISe Trial"

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*CD4 count <50
 
*CD4 count <50
 
*Advance directive that restricts either protocol
 
*Advance directive that restricts either protocol
Contraindication to interventions including refusal of blood transfusions
+
*Contraindication to interventions including refusal of blood transfusions
 
*Pregnant
 
*Pregnant
 
*Transfer patient
 
*Transfer patient

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