A randomized trial of protocol-based care for early septic shock

A randomized trial of protocol-based care for early septic shock. N E Jnl Med 2014; 370:1683-93.

The ProCESS Investigators

http://www.nejm.org/doi/full/10.1056/NEJMoa1401602

In a single-center study published more than a decade ago involving patients presenting to the emergency department with severe sepsis and septic shock, mortality was markedly lower among those who were treated according to a 6-hour protocol of early goal-directed therapy (EGDT), in which intravenous fluids, vasopressors, inotropes, and blood transfusions were adjusted to reach central hemodynamic targets, than among those receiving usual care. We conducted a trial to determine whether these findings were generalizable and whether all aspects of the protocol were necessary.