지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2016.1
- 수록면
- 1,260 - 1,270 (11page)
이용수
초록· 키워드
오류제보하기
Purpose: Owing to the recommendations of the Surviving Sepsis Campaign guidelines, protocol-based resuscitation or goal-directedtherapy (GDT) is broadly advocated for the treatment of septic shock. However, the most recently published trials showed no survival benefit from protocol-based resuscitation in septic shock patients. Hence, we aimed to assess the effect of GDT on clinical outcomes in such patients.
Materials and Methods: We performed a systematic review that included a meta-analysis. We used electronic search engines includingPubMed, Embase, and the Cochrane database to find studies comparing protocol-based GDT to common or standard care in patients with septic shock and severe sepsis.
Results: A total of 13269 septic shock patients in 24 studies were included [12 randomized controlled trials (RCTs) and 12 observationalstudies]. The overall mortality odds ratio (OR) [95% confidence interval (CI)] for GDT versus conventional care was 0.746 (0.631–0.883). In RCTs only, the mortality OR (95% CI) for GDT versus conventional care in the meta-analysis was 0.93 (0.75–1.16). The beneficial effect of GDT decreased as more recent studies were added in an alternative, cumulative meta-analysis. No significant publication bias was found.
Conclusion: The result of this meta-analysis suggests that GDT reduces mortality in patients with severe sepsis or septic shock. However, our cumulative meta-analysis revealed that the reduction of mortality risk was diminished as more recent studies were added.
목차
등록된 정보가 없습니다.
참고문헌 (30)
참고문헌 신청
Rivers E / 2001 / Early goal-directed therapy in the treatment of severe sepsis and septic shock / N Engl J Med 345:1368~1377
Zambon M / 2008 / Implementation of the Surviving Sepsis Campaign guidelines for severe sepsis and septic shock: we could go faster / J Crit Care 23:455~460
Castellanos-Ortega A / 2010 / Impact of the Surviving Sepsis Campaign protocols on hospital length of stay and mortality in septic shock patients: results of a three-year follow-up quasi-experimental study / Crit Care Med 38:1036~1043
ARISE Investigators / 2014 / Goal-directed resuscitation for patients with early septic shock / N Engl J Med 371:1496~1506
ProCESS Investigators / 2014 / A randomized trial of protocol-based care for early septic shock / N Engl J Med 370:1683~1693
Zambon M / 2008 / Implementation of the Surviving Sepsis Campaign guidelines for severe sepsis and septic shock: we could go faster / J Crit Care 23:455~460
Castellanos-Ortega A / 2010 / Impact of the Surviving Sepsis Campaign protocols on hospital length of stay and mortality in septic shock patients: results of a three-year follow-up quasi-experimental study / Crit Care Med 38:1036~1043
ARISE Investigators / 2014 / Goal-directed resuscitation for patients with early septic shock / N Engl J Med 371:1496~1506
ProCESS Investigators / 2014 / A randomized trial of protocol-based care for early septic shock / N Engl J Med 370:1683~1693
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