Early Goal-Directed Therapy Trial

About the Trial

Emanuel Rivers and colleagues at Henry Ford Hospital randomized 263 patients with severe sepsis or septic shock in the emergency department to six hours of protocolized resuscitation, guided by central venous pressure, blood pressure, and central venous oxygen saturation, or to standard care. In hospital mortality fell from 46.5 to 30.5 percent, and the protocol became the backbone of the Surviving Sepsis Campaign bundles. More than a decade later, three large multicenter trials, ProCESS, ARISE, and ProMISe, found no benefit of the protocol over contemporary usual care, likely because early recognition and fluids had become standard practice everywhere.