Outcomes from implementing early goal-directed therapy for severe sepsis and septic shock : a 4-year observational cohort study

Narani Sivayoham, Andrew Rhodes, Thiagarajan Jaiganesh, Nellis van Zyl Smit, Samer Elkhodhair, Sarah Krishnanandan
European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine 2012, 19 (4): 235-40

OBJECTIVES: The aim of this study was to determine the outcome of patients with severe sepsis and septic shock who did and did not receive early goal-directed therapy (EGDT) in the emergency department (ED). The primary end point was the in-hospital mortality rate. The secondary end points were lengths of stay in the ICU and in hospital.

METHOD: Patients with sepsis who satisfied two of the four systemic inflammatory response criteria and who either had a lactate of greater than 4 mmol/l or a systolic blood pressure of less than 90 mmHg after 20-30 ml/kg of fluid, were included. Patients who had EGDT commenced, and all patients who were admitted to ICU who met EGDT criteria over a 4-year period from 1 January 2006 to 31 December 2009, were studied.

RESULTS: One hundred and seventy-four patients with sepsis met the criteria for EGDT. Ninety-seven patients had EGDT commenced in the ED. The mortality rate in the EGDT group was 22.7% compared with 42.9% in the non-EGDT group (P=0.004). The length of stay in ICU was [(median and interquartile range)] 3D(5) versus 4D(8), P value less than 0.0001. There was no difference in the length of in-hospital stay.

CONCLUSION: Initiating EGDT in the ED in patients with severe sepsis and septic shock was associated with a significant reduction in in-hospital mortality and length of stay in ICU.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"