title: Goal-Directed Resuscitation in Septic Shock: A Critical Analysis.
abstract: The Early Goal-Directed Therapy versus Standard Care for Sepsis trial by Rivers and colleagues in 2001 suggested that a significant mortality reduction may be realized through goal-directed interventions early in the care of patients with septic shock. However, the recent publication of the Protocol-Based Care for Early Septic Shock (ProCESS), Australasian Resuscitation in Sepsis Evaluation (ARISE), and Protocolised Management in Sepsis (ProMISE) trials did not demonstrate the superiority of early goal-directed therapy over usual care. If usual care includes timely and meticulous care, a protocol may not be needed to realize the continued lowering mortality rates.
authors.affiliation: Division of Emergency Medicine, Harborview Medical Center, University of Washington School of Medicine, 325 9th Avenue, Box 359702, Seattle, WA 98104, USA. Electronic address: henning2@uw.edu.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Henning
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, One Deaconess Road, W-CC2, Boston, MA 02215, USA.
authors.forename: Nathan I
authors.initials: NI
authors.lastname: Shapiro
mesh_terms: D019468:Disease Management; D006040:Goals; D006801:Humans; D012151:Resuscitation; D018805:Sepsis; D012772:Shock, Septic
keywords: Goal-directed therapy; Resuscitation; Septic shock; Severe sepsis