title: The end of early-goal directed therapy?
abstract: Emergency medicine practitioners around the world have been confronted with the increasing challenge of managing patients in severe sepsis and septic shock. Introduction of early goal-directed therapy (EGDT) revolutionized sepsis care and was adopted worldwide. Since then, multiple randomized controlled trials have been published questioning the superiority of EGDT. The purpose of this article is to review and provide clinical commentary on the ProCESS, ARISE, and ProMISE trials, which address whether invasive, expensive interventions are needed to achieve mortality reduction goals in septic patients. This article discusses that EGDT bundled care is not necessary to achieve mortality reduction goals.
authors.affiliation: Department of Medicine, McMaster University, Hamilton, ON, Canada. Electronic address: sameer.sharif@medportal.ca.
authors.forename: Sameer
authors.initials: S
authors.lastname: Sharif
authors.affiliation: Department of Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: Julian J
authors.initials: JJ
authors.lastname: Owen
authors.affiliation: Department of Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: Suneel
authors.initials: S
authors.lastname: Upadhye
mesh_terms: D002985:Clinical Protocols; D019468:Disease Management; D004636:Emergency Service, Hospital; D006040:Goals; D006801:Humans; D057285:Precision Medicine; D016032:Randomized Controlled Trials as Topic; D012151:Resuscitation / Q000379:methods; D018805:Sepsis / Q000628:therapy*; D012772:Shock, Septic / Q000628:therapy