ArticleOpen access emergency medicine : OAEM2021
USER Protocol as a Guide to Resuscitation of the Patient with Septic Shock in the Emergency Department.
Article in Open access emergency medicine : OAEM, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Comparison of non-invasive strategies to drive fluid resuscitation in sepsis or septic shock: a meta-analysis of RCTs.Internal and emergency medicine · 2026Pooled it
- Hemodynamic assessment of the common carotid artery and radial artery in healthy human subjects: a comparison of continuous wave patch ultrasound and conventional pulse wave ultrasound.Journal of ultrasound · 2026Article
- Implementation of a Sepsis Code Protocol at an Academic Institution in Colombia: A Pilot Study.Journal of clinical medicine · 2026Article
- Critical care ultrasound evaluation of snuffbox artery vascular tension: a prospective observational study between healthy volunteers and intensive care unit patients.Frontiers in medicine · 2026Article
- A standardized educational implementation strategy improves operational Code Sepsis knowledge in a high-complexity hospital in Colombia.Frontiers in health services · 2026Article
- Review
- Norepinephrine Onset Time and Mortality in Patients with Septic Shock Treated in the Emergency Department.Journal of clinical medicine · 2025Article
- Evaluating Sepsis Mortality Predictions from the Emergency Department: A Retrospective Cohort Study Comparing qSOFA, the National Early Warning Score, and the International Early Warning Score.Journal of clinical medicine · 2025Article
- Value of lung ultrasound scores in assessing extravascular lung water in septic shock patients.Scientific reports · 2025Article
- Correlation between the radial artery resistance index and the systemic vascular resistance index: a cross-sectional study.The ultrasound journal · 2024Article
- The left ventricular outflow tract and carotid artery velocity time integrals.Frontiers in medical technology · 2024Article
- Ultrasound in Sepsis and Septic Shock-From Diagnosis to Treatment.Journal of clinical medicine · 2023Review
- Point of Care Ultrasonography for the Septic Patient in the Emergency Department: A Literature Review.Journal of clinical medicine · 2023Review
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSepsis is a disease that is still associated with high mortality, in which timely interventions are related to better results.
objectiveTo determine if there is a difference in in-hospital mortality, fluid balances, norepinephrine initiation and recovery time of blood pressure, when comparing the resuscitation of the patient who is admitted to the emergency room in septic shock by applying the ultrasound protocol (USER) versus the standard of care. PATIENTS AND
methodsThis is a prospective, cohort study conducted in the emergency room of a highly complex hospital of patients with septic shock.
results83 patients recruited in total. The groups were comparable in demographics, mean baseline blood pressure, disease severity given by the SOFA value, and arterial lactate. A statistically significant difference was documented in the fluid balances at 4 hours, median 1325mL (IQR:451-2455mL) in Group C versus 900mL (IQR:440-1292) in Group U (p=0.048) and at 6 hours, median 1658mL (IQR:610-2925mL) versus 1107mL (IQR:600-1500mL), p=0.026, as well as in the total fluid balance of hospital stay, median 14,564mL (IQR:8660-18,705mL) versus 8660mL (IQR:5309-16,974mL), p=0.049. On the other hand, in the USER Group, the mean blood pressure ≥ 65mmHg was achieved in 97.4% of the patients 4 hours after the start of the protocol versus 50% in Group C (p=<0.001). Mortality with the use of the protocol compared with conventional therapy was (56.4% vs 61.36%, p=0.647).
conclusionThe use of the USER protocol in patients with septic shock in the emergency room showed lower fluid balances at 4 and 6 hours, and of the total hospital stay, as well as earlier initiation of norepinephrine and statistically significant faster improvement in blood pressure. Although a statistically significant difference was not found in the days of ICU stay, hospitalization and in-hospital mortality, a trend was observed in the reduction of these parameters.
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