Does early goal-directed therapy reduce mortality among patients with severe sepsis or septic shock?

BEEM Bottom Line

Why is this study important?

The pooled estimate from study-level data of the 3 largest multi-center studies showed no difference in 90-day mortality between early goal directed therapy (EGDT) and standard sepsis care.[1] However, the substantial reduction in mortality for septic shock observed since the original EGDT study[2] has meant that contemporary attempts to examine that intervention likely would be under-powered and vulnerable to claims that sicker patients were not enrolled. This pre-planned analysis of pooled individual patient data from the 3 main trials was designed to mitigate the risk of bias and increase the power for a priori subgroup analyses.[3][4][5] 

Which, if any, threats to validity are most likely to have an impact on the results and how?

Thank you for your interest in the BEEM Journal!

To read the rest of this article or to access the entire collection of BEEM Critical Appraisals, please purchase a subscription at the link below.

If you would like a pre-view, click here to view some sample articles

Premium Content Available Through Subscription

BEEM is a knowledge translation project which aims to extract the most recent, EM relevant, and valid evidence from the volumes of available medical research and deliver it to EM practitioners in an easily consumable format to help guide their clinical practice. This valuable distilled information provided by BEEM is available through BEEM's accredited CME courses or through our online journal.

A BEEM Journal Subscription will provide you with unlimited access to our entire collection of Critical Appraisals for 1 year.