Does Early Goal Directed Therapy Decrease Mortality in Patients with Septic Shock?

Reviewed and approved by the AAEM Board of Directors 2/14/2010

1. Define the Issue and State the Question
   • A. Topic Area: Sepsis
   • B. General Issue: Early goal directed therapy
   • C. Specific Question: Does early goal directed therapy decrease mortality in patients with septic shock?
   • D. Executive Summary:

Answer: Yes. Though adoption of EGDT has been slow and multiple barriers exist, it appears that EGDT improves mortality in adult patients with septic shock. Further study is needed, however, to quantify the exact effect size of each individual component and the protocol in its entirety. It is important to highlight that, with the distinct exception of the original trial, the remaining references are Grade C or below thus limiting the level of recommendation which can be assigned to this body of evidence. (Level of Recommendation: Class B2)