Severe Sepsis and Septic Shock Trials (ProCESS, ARISE, ProMISe): What is Optimal Resuscitation?

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26 Scopus citations

Abstract

Between 2014 and 2015, 3 independent, multicenter, randomized controlled trials evaluated early goal-directed therapy (EGDT) in severe sepsis and septic shock: Protocolized Care for Early Septic Shock (ProCESS) from the United States; Australasian Resuscitation in Sepsis Evaluation (ARISE), and Protocolised Management in Sepsis (ProMISe) in the United Kingdom. All 3 trials confirmed that there was no survival benefit of EGDT compared to usual resuscitation. How should we define usual care for sepsis given these study findings? Furthermore, the definition of sepsis has now been updated. This article reviews key findings of these 3 trials and discusses these important issues in sepsis management.

Original languageEnglish
Pages (from-to)323-344
Number of pages22
JournalCritical Care Clinics
Volume33
Issue number2
DOIs
StatePublished - Apr 1 2017

Keywords

  • Hyperlactatemia
  • Lactate
  • Resuscitation
  • Sepsis
  • Septic shock
  • Severe sepsis
  • Usual care

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