The effects of early goal-directed therapy on mortality rate in patients with severe sepsis and septic shock:a systematic literature review and Meta-analysis
10.3760/cma.j.issn.2095-4352.2015.06.005
- VernacularTitle:早期目标导向治疗对严重脓毒症/脓毒性休克患者病死率的影响：系统文献回顾与Meta分析
- Author:
Guolong CAI
;
Hongjie TONG
;
Xuejing HAO
;
Caibao HU
;
Molei YAN
;
Jin CHEN
;
Jing YAN
- Publication Type:Journal Article
- Keywords:
Sepsis;
Severe sepsis;
Septic shock;
Early goal-directed therapy;
Fluid resuscitation;
Mortality
- From:
Chinese Critical Care Medicine
2015;(6):439-442
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate whether early goal-directed therapy ( EGDT ) could lower the mortality rate in patients with severe sepsis and septic shock. Methods Articles with items sepsis, severe sepsis, septic shock, EGDT were retrieved from MEDLINE, EMBASE, Cochrane, Wanfang Data and CNKI. Inclusion criteria included randomized controlled trial, subjects concerning patients with severe sepsis or septic shock, endpoints with short-term mortality [ in-hospital, intensive care unit ( ICU ) or 28-day ] and long-term mortality ( 60-day or 90-day ). Related risk ( RR ) and 95% confidence interval ( 95%CI ) were used as indices to judge the difference in mortality rate between EGDT group and standard treatment group. RevMan 5.2 software was used for Meta analysis. Results There were 8 studies meeting inclusive criteria with a total of 4 853 patients. For patients with severe sepsis and septic shock, compared with the group with routine treatment, EGDT showed a decrease in the short-term mortality ( RR = 0.74, 95%CI=0.66-0.82, P<0.000 01 ), but did not decrease the long-term mortality ( RR=0.99, 95%CI=0.92-1.06, P=0.81 ). Conclusion EGDT strategy may decrease the short-term mortality in patients with severe sepsis and septic shock, but it showed no influence on the long-term mortality.
