ReviewCritical care (London, England)2016
Early goal-directed therapy in severe sepsis and septic shock: insights and comparisons to ProCESS, ProMISe, and ARISE.
Review in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 4 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
65 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Assessment of hemodynamic dysfunction in septic newborns by functional echocardiography: a systematic review.Pediatric research · 2024Pooled it
- Early goal-directed and lactate-guided therapy in adult patients with severe sepsis and septic shock: a meta-analysis of randomized controlled trials.Journal of translational medicine · 2018Pooled it
- Liberal Versus Restrictive Intravenous Fluid Therapy for Early Septic Shock: Rationale for a Randomized Trial.Annals of emergency medicine · 2018Pooled it
- Efficacy of Ascorbic Acid, Thiamine, and Hydrocortisone Combination Therapy: Meta-analysis of Randomized Controlled Trials.In vivo (Athens, Greece)Pooled it
- Therapeutic Effect and Prognosis of PiCCO in the Treatment of Myocardial Injury Complicated with Septic Shock.Computational and mathematical methods in medicine · 2022Trial
- Trial
- Review
- The Sepsis ImmunoScore Predicts Sepsis, Mortality, and Deterioration Better than Clinical Scores and Widely Available Biomarkers.Diagnostics (Basel, Switzerland) · 2026Article
- An interpretable early intensive care unit model for predicting in-hospital mortality in trauma patients combined with rib fractures: development and external validation.Journal of thoracic disease · 2026Article
- Article
- Hemodynamic monitoring: basic principles in operation room and intensive care unit.Journal of clinical monitoring and computing · 2026Review
- The Physiology, Pathophysiology, and Clinical Implications of Fluid Resuscitation in Critically Ill Patients.Cureus · 2026Review
- Aetiology of sepsis in adults living with HIV in East Africa: a secondary analysis of an open-label, multicentre, randomised, controlled phase 3 trial.EClinicalMedicine · 2026Article
- Association of hemoglobin level trajectories with clinical outcomes in patients with sepsis or shock: a retrospective observational study.BMC infectious diseases · 2025Observational
- Connection between Impaired Fasting Glucose or Type 2 Diabetes Mellitus and Sepsis: A 10-Year Observational Data from the National Health Screening Cohort.Diabetes & metabolism journal · 2025Observational
- Identification and validation of autophagy-related genes in sepsis based on bioinformatics studies.Virology journal · 2025Article
- Sepsis: An Overview of Current Therapies and Future Research.Journal of clinical practice and research · 2025Review
- Should Liberal Fluid Therapy (Compared to Restrictive Fluid Therapy) be Used in Children with Septic Shock? Yes.Indian pediatrics · 2025Article
- Enough is Enough: Continuous Beta-Lactam Infusions for Treating Serious Infections.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2024Article
- Identifying the Bundle/Care Development Process in Clinical Risk Management: A Systematic Review.Healthcare (Basel, Switzerland) · 2024Review
5 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
22 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prior to 2001 there was no standard for early management of severe sepsis and septic shock in the emergency department. In the presence of standard or usual care, the prevailing mortality was over 40-50 %. In response, a systems-based approach, similar to that in acute myocardial infarction, stroke and trauma, called early goal-directed therapy was compared to standard care and this clinical trial resulted in a significant mortality reduction. Since the publication of that trial, similar outcome benefits have been reported in over 70 observational and randomized controlled studies comprising over 70,000 patients. As a result, early goal-directed therapy was largely incorporated into the first 6 hours of sepsis management (resuscitation bundle) adopted by the Surviving Sepsis Campaign and disseminated internationally as the standard of care for early sepsis management. Recently a trio of trials (ProCESS, ARISE, and ProMISe), while reporting an all-time low sepsis mortality, question the continued need for all of the elements of early goal-directed therapy or the need for protocolized care for patients with severe and septic shock. A review of the early hemodynamic pathogenesis, historical development, and definition of early goal-directed therapy, comparing trial conduction methodology and the changing landscape of sepsis mortality, are essential for an appropriate interpretation of these trials and their conclusions.
Indexed as
Identifiers
What 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.