title: The New Usual Care.
abstract: Recent literature continues to refine which components of the early goal-directed therapy (EGDT) algorithm are necessary. Given it utilizes central venous pressure, continuous central venous oxygen saturation, routine blood transfusions, and inotropic medications, this algorithm can be timely, invasive, costly, and potentially harmful. New trials highlight early recognition, early fluid resuscitation, appropriate antibiotic treatment, source control, and the application of a multidisciplinary evidence-based approach as essential components of current sepsis management. This article discusses the landmark sepsis trials that have been published over the past several decades and offers recommendations on what should currently be considered 'usual care'.
authors.affiliation: Division of Pulmonary and Critical Care, Department of Medicine, Rutgers Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place/MEB 568, New Brunswick, NJ 08901, USA.
authors.forename: Jared
authors.initials: J
authors.lastname: Radbel
authors.affiliation: Department of Emergency Medicine, Saint Peters University Hospital, 254 Easton Ave, New Brunswick, NJ 08901, USA; Division of Pulmonary and Critical Care, Department of Medicine, Rutgers Robert Wood Johnson Medical School, One Robert Johnson Place, New Brunswick, NJ 08903, USA. Electronic address: boutsida@rwjms.rutgers.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Boutsikaris
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002405:Catheterization, Central Venous; D002985:Clinical Protocols / Q000592:standards; D019317:Evidence-Based Medicine; D005440:Fluid Therapy; D006801:Humans; D018805:Sepsis / Q000175:diagnosis / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents
keywords: ARISE trial; Early goal-directed therapy (EGDT); ProCESS trial; ProMISe trial; Sepsis; Usual care