Trial reportThe New England journal of medicine2014
Goal-directed resuscitation for patients with early septic shock.
Trial report in The New England journal of medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 12 registered trials, which are not on this map. Cited by 768 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Multi-centre, Randomised Controlled Trial of Early Goal-directed Therapy in Patients Presenting to the Emergency Department With Severe Sepsis in Australasia
Volemic Resuscitation in Sepsis and Septic Shock
Does Intravenous Lactated Ringer Solution Raise Measured Serum Lactate?
Assessing Targeted Fluid Resuscitation Strategies Among Patients With Severe Sepsis and Septic Shock
Controlled Fluid Resuscitation Strategy in Sepsis Patient
Outcomes of Metabolic Resuscitation Using Ascorbic Acid, Thiamine, and Glucocorticoids in the Early Treatment of Sepsis.
Days Alive and Out of Hospital for Patients With Sepsis
Dosing of Extracorporeal Cytokine Removal In Septic Shock (DECRISS): a Prospective, Randomized, Multicenter Clinical Trial
To Compare the Effectiveness of Various Methods of Estimating Volume Resuscitation in Patients With Cirrhosis With Sepsis Induced Hypotension
To Compare 20% Albumin vs. Balanced Salt Solution as Resuscitation Fluid and Identify Fluid Responsiveness Criteria in Critically Ill Patients With Cirrhosis With Sepsis Induced Hypotension; a Prospective Randomized Controlled Trial.
Efficacy and Safety of Balanced Gelatin Solution for Fluid Infusion in Sepsis Patients Undergoing Emergency Abdominal Surgery: A Multicenter, Adaptive Designed, Randomized Controlled Trial
Veno-arterial Carbon Dioxide Partial Pressure Difference (CO2gap) for Early Resuscitation of Septic Shock: A Multicenter Prospective Randomized Trial (CARBON)
Who cites it
768 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.Intensive care medicine · 2026Pooled it
- [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Early norepinephrine for patients with septic shock: an updated systematic review and meta-analysis with trial sequential analysis.Critical care (London, England) · 2025Pooled it
- Early management of adult sepsis and septic shock: Korean clinical practice guidelines.Acute and critical care · 2024Guideline
- Research trends and hotspots on septic shock: a bibliometric study and visualization analysis.Frontiers in medicine · 2024Pooled it
- Positive single-center randomized trials and subsequent multicenter randomized trials in critically ill patients: a systematic review.Critical care (London, England) · 2023Pooled it
- Effect of goal-directed fluid therapy on renal function in critically ill patients: a systematic review and meta-analysis.Renal failure · 2022Pooled it
- Renal resistive index-guided mean arterial pressure titration in sepsis: a prospective single-center, single-blind, parallel-group randomized controlled trial.Nature communications · 2026Trial
- Antibiotics for Delirium in Older Adults With No Clear Urinary Tract Infection: A Multicentre, Pragmatic, Randomized Trial-Vanguard Results.Journal of the American Geriatrics Society · 2026Trial
- Impact of renal vein doppler ultrasound-guided CVP titration in sepsis: a pilot randomized controlled trial.Critical care (London, England) · 2026Trial
- Relationship Between Phenotyping and Individualized Absolute Risk Differences in Sepsis: A Secondary Analysis of Two Approaches in Two Multicenter Trials.Critical care explorations · 2025Trial
- Restrictive fluid management with early de-escalation versus usual care in critically ill patients (reduce trial): a feasibility randomized controlled trial.Critical care (London, England) · 2025Trial
- Heterogeneity in the Effect of Early Goal-Directed Therapy for Septic Shock: A Secondary Analysis of Two Multicenter International Trials.Critical care medicine · 2025Trial
- Ringer's lactate administered at 15 °C leads to a greater and more prolonged increase in blood pressure compared to 37 °C.Scientific reports · 2024Trial
- Mega-dose sodium ascorbate: a pilot, single-dose, physiological effect, double-blind, randomized, controlled trial.Critical care (London, England) · 2023Trial
- Optimizing left ventricular-arterial coupling during the initial resuscitation in septic shock - a pilot prospective randomized study.BMC anesthesiology · 2022Trial
- Lactate in acute kidney injury: pathobiology, risk stratification, and clinical interpretation.Renal failure · 2026Review
- Oral vs Intravenous Fluid Therapy in Emergency Department Patients: Protocol for a Randomized Controlled Feasibility and Noninferiority Trial.JMIR research protocols · 2026Article
- Personalized fluid resuscitation may reduce mortality in septic shock as compared with fixed-volume approach - a systematic review and meta-analysis of randomized controlled trials.Intensive care medicine experimental · 2026Article
- Letter to the Editor: Magnesium supplementation in sepsis: A promising metabolic resuscitation strategy.World journal of critical care medicine · 2026Article
708 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly goal-directed therapy (EGDT) has been endorsed in the guidelines of the Surviving Sepsis Campaign as a key strategy to decrease mortality among patients presenting to the emergency department with septic shock. However, its effectiveness is uncertain.
methodsIn this trial conducted at 51 centers (mostly in Australia or New Zealand), we randomly assigned patients presenting to the emergency department with early septic shock to receive either EGDT or usual care. The primary outcome was all-cause mortality within 90 days after randomization.
resultsOf the 1600 enrolled patients, 796 were assigned to the EGDT group and 804 to the usual-care group. Primary outcome data were available for more than 99% of the patients. Patients in the EGDT group received a larger mean (±SD) volume of intravenous fluids in the first 6 hours after randomization than did those in the usual-care group (1964±1415 ml vs. 1713±1401 ml) and were more likely to receive vasopressor infusions (66.6% vs. 57.8%), red-cell transfusions (13.6% vs. 7.0%), and dobutamine (15.4% vs. 2.6%) (P<0.001 for all comparisons). At 90 days after randomization, 147 deaths had occurred in the EGDT group and 150 had occurred in the usual-care group, for rates of death of 18.6% and 18.8%, respectively (absolute risk difference with EGDT vs. usual care, -0.3 percentage points; 95% confidence interval, -4.1 to 3.6; P=0.90). There was no significant difference in survival time, in-hospital mortality, duration of organ support, or length of hospital stay.
conclusionsIn critically ill patients presenting to the emergency department with early septic shock, EGDT did not reduce all-cause mortality at 90 days. (Funded by the National Health and Medical Research Council of Australia and the Alfred Foundation; ARISE ClinicalTrials.gov number, NCT00975793.).
Indexed as
Identifiers
25272316What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.