title: The effect of early quantitative resuscitation on organ function in survivors of septic shock.
abstract: OBJECTIVE
  The objective of this study is to determine if early quantitative resuscitation (QR) attenuates organ dysfunction in survivors of septic shock.
  
  
  METHODS
  This is a secondary analysis of a completed implementation study. Inclusion criteria are suspected infection, greater than or equal to 2 systemic inflammatory response syndrome criteria and either systolic blood pressure less than 90 mm Hg after a fluid bolus or lactate more than 4 mmol/L and survival to hospital discharge. Data were prospectively collected on eligible patients for 1 year before and 3 years after implementation of early QR. Patients in the before phase received nonprotocolized care (NPC) at physician discretion. Survivors who received QR were compared with survivors who received NPC. The primary outcome was the worst sequential organ failure assessment (SOFA) score during hospitalization.
  
  
  RESULTS
  Two hundred sixty patients in the QR group and 41 patients in the NPC group were included. There were no significant differences in demographics between the 2 groups. The initial SOFA score in the QR group was 6 and in the NPC group was 6 (P = .17). There was no significant difference in the worst SOFA score during hospitalization between the QR and NPC groups (6 vs 6, respectively; P = .16).
  
  
  CONCLUSIONS
  In survivors of septic shock, we found no difference in maximal organ dysfunction during hospitalization between patients who received QR vs NPC.
authors.affiliation: Department of Emergency Medicine, University of Mississippi Medical Center School of Medicine, 2500 N State St, Jackson, MS 39216, USA. Electronic address: sasterling@umc.edu.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Sterling
authors.affiliation: Department of Emergency Medicine, University of Mississippi Medical Center School of Medicine, 2500 N State St, Jackson, MS 39216, USA. Electronic address: mpuskarich@umc.edu.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Puskarich
authors.affiliation: Department of Emergency Medicine, University of Mississippi Medical Center School of Medicine, 2500 N State St, Jackson, MS 39216, USA. Electronic address: rsummers@umc.edu.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Summers
authors.affiliation: Department of Emergency Medicine, University of Mississippi Medical Center School of Medicine, 2500 N State St, Jackson, MS 39216, USA. Electronic address: aejones@umc.edu.
authors.forename: Alan E
authors.initials: AE
authors.lastname: Jones
mesh_terms: D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D065187:Controlled Before-After Studies; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D020127:Recovery of Function / Q000502:physiology*; D012151:Resuscitation / Q000379:methods*; D012772:Shock, Septic / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D017741:Survivors
keywords: Organ dysfunction; Organ failure; Resuscitation; Sepsis; Septic shock