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Effect of myocardial preservation of early goal-directed therapy on severe sepsis/septic shock patients in the ICU
Critical Care volume 14, Article number: P399 (2010)
To investigate the effect of myocardial preservation of early goal-directed therapy (EGDT) on severe sepsis/septic shock patients in the ICU.
This is a prospective and randomized controlled study, in which the total 158 severe sepsis/septic shock patients from the ICU were randomly assigned into two groups (EGDT group, n = 81 and control group, n = 77). Then the concentration of serum cardiac troponin I (cTnI), high sensitivity C-reactive protein (hs-CRP) and APACHE II score of patients were obtained on the 0, 3rd, 7th, and 14th day after fluid resuscitation therapy.
The levels of cTnI were the same between the EGDT and control groups on day 0 (exceeded normal cTnI patients in two groups 0.41 vs 0.42, normal cTnI patients in two groups 0.05 vs 0.04, P > 0.05), there was a dramatic decrease in exceeded normal cTnI patients of the EGDT group, in which cTnI returned to normal after EGDT (14th day: exceeded normal cTnI patients in two groups 0.08 vs 0.16, P < 0.05); however, only a little difference in normal cTnI patients of the two groups (P > 0.05). The level of hs-CRP changed like cTnI (P < 0.05), and there was positive correlation between cTnI and hs-CRP on each time (P < 0.05); APACHE II scores obviously decrease in the EGDT group (P < 0.05). Meanwhile, the EGDT group have an obviously higher 28-day survival rate and longer survival time than that of the control group (74.1% vs 55.8%; 23.5 vs 19.6, P < 0.05).
EGDT has an effect of myocardial preservation and improves the survival rate for severe sepsis/septic shock patients in the ICU.
Richard S, Hotchkiss RS, Karl IE, et al.: The pathophysiology and treatment of sepsis. N Engl J Med 2003, 348: 138-150. 10.1056/NEJMra021333
Rivers E, Nguyen B, Havstad S, et al.: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001, 345: 1368-1377. 10.1056/NEJMoa010307
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Cai, G., Yan, J. & Qiao, S. Effect of myocardial preservation of early goal-directed therapy on severe sepsis/septic shock patients in the ICU. Crit Care 14, P399 (2010). https://doi.org/10.1186/cc8631
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- Longe Survival
- Dramatic Decrease