title: [The effects of early goal-directed therapy on mortality rate in patients with severe sepsis and septic shock: a systematic literature review and Meta-analysis].
abstract: OBJECTIVE
  To investigate whether early goal-directed therapy (EGDT) could lower the mortality rate in patients with severe sepsis and septic shock.
  
  
  METHODS
  Articles with items sepsis, severe sepsis, septic shock, EGDT were retrieved from MEDLINE, EMBASE, Cochrane, Wanfang Data and CNKI. Inclusion criteria included randomized controlled trial, subjects concerning patients with severe sepsis or septic shock, endpoints with short-term mortality [ in-hospital, intensive care unit (ICU) or 28-day] and long-term mortality (60-day or 90-day). Related risk (RR) and 95% confidence interval (95%CI) were used as indices to judge the difference in mortality rate between EGDT group and standard treatment group. RevMan 5.2 software was used for Meta analysis.
  
  
  RESULTS
  There were 8 studies meeting inclusive criteria with a total of 4,853 patients. For patients with severe sepsis and septic shock, compared with the group with routine treatment, EGDT showed a decrease in the short-term mortality (RR=0.74, 95%CI=0.66-0.82, P<0.00001), but did not decrease the long-term mortality (RR=0.99, 95%CI=0.92-1.06, P=0.81).
  
  
  CONCLUSIONS
  EGDT strategy may decrease the short-term mortality in patients with severe sepsis and septic shock, but it showed no influence on the long-term mortality.
authors.affiliation: Department of Critical Care Medicine, Zhejiang Hospital, Hangzhou 310013, Zhejiang, China. Corresponding author: Yan Jing, Email: zjicu@vip.163.com.
authors.forename: Guolong
authors.initials: G
authors.lastname: Cai
authors.forename: Hongjie
authors.initials: H
authors.lastname: Tong
authors.forename: Xuejing
authors.initials: X
authors.lastname: Hao
authors.forename: Caibao
authors.initials: C
authors.lastname: Hu
authors.forename: Molei
authors.initials: M
authors.lastname: Yan
authors.forename: Jin
authors.initials: J
authors.lastname: Chen
authors.forename: Jing
authors.initials: J
authors.lastname: Yan
mesh_terms: D006801:Humans; D007362:Intensive Care Units; D018805:Sepsis; D012772:Shock, Septic