Table 2 Observational controlled trials of bundled goal-directed therapy
From: Conservative fluid therapy in septic shock: an example of targeted therapeutic minimization
| Study and country | Sign score | Goal-directed therapy (goals) | Time and fluid quantification (L)a | ||
|---|---|---|---|---|---|
| Control | Bundled GDT | ||||
| Cardoso et al. 2010, Portugal [42] | (−) | 500 ml to 1000 ml crystalloid bolus, or 300 ml to 500 ml colloid bolus to achieve CVP ≥12 mmHg | Quantified but not reported. | ||
| Castellanos-Ortega et al. 2010, Spain [35] | (−) | 500-1000 ml crystalloid bolus, additional fluid to achieve CVP ≥8 mmHg | Quantified but not reported. | ||
| El Solh et al. 2008, USA [31] | (−) | 500 ml crystalloid bolus, repeat until CVP 8–12 mmHg | 6 h: | 2.5 ± 1.0 | 3.9 ± 2.0 |
| 24 h: | 3.2 ± 1.3 | 4.9 ± 2.5 | |||
| Ferrer et al. 2008, Spain [33] | (−) | 500 ml crystalloid bolus, repeat until CVP 8–12 mmHg | Quantified but not reported | ||
| Gao et al. 2005, UK [36] | (−) | Immediate fluid bolus of 0.5 L | Quantified but not reported | ||
| Girardis et al. 2009, Italy [34] | (−) | Fluids targeting CVP >6 mmHg or a global end-diastolic volume by trans-pulmonary thermodilution >700 ml/m2 | Quantified but not reported | ||
| Heppner et al. 2012, Germany [39] | (−) | 500 ml crystalloid bolus, repeat until CVP 8–12 mmHg | Quantified but not reported. | ||
| Jones et al. 2007, USA [30] | (−) | 500 ml crystalloid bolus, repeat until CVP 8–12 mmHg | 6 h: | 2.5 ± 2.4 | 4.7 ± 1.8 |
| Kortgen et al. 2006, Germany [27] | (−) | CVP 8–12 mmHg or intrathoracic blood volume index 850–1000 ml/m2 | 6 h: | 2.8 [1.8,3.8] | 2.5 [1.6,3.9] |
| Lefrant et al. 2010, France [41] | (−) | ≥20 ml/kg crystalloids or colloids within 6 hours | 6 h crystalloid: | 1.0 [0.5,2.0] | 1.5 [0.5,2.0] |
| 6 h colloid: | 0.5 [0.5,1.0] | 1.0 [0.5,1.1] | |||
| Micek et al. 2006, USA [25] | (−) | 500 ml crystalloid bolus, repeat until CVP 8–12 mmHg | In ED: | 2.8 ± 1.6 | 3.8 ± 1.7 |
| Miller et al. 2013, USA [38] | (−) | 500 ml crystalloid bolus, repeat until CVP 8–12 mmHg | Quantified but not reported. | ||
| Na et al. 2012, Asia [40]b | (−) | Fluid bolus to achieve CVP >8 mmHg by 6 hours | In ED: | 1.5 [1.0,2.5] | 1.5 [0.9,2.7] |
| In ICU: | 7.8 [5.2,11.6] | 5.6 [3.3,9.2] | |||
| Nguyen et al. 2007, USA [29] | (−) | CVP ≥8 mmHg | In ED: | 2.8 ± 1.5 | 2.8 ± 2.1 |
| 72 h: | 7.8 ± 5.2 | 7.9 ± 6.1 | |||
| Pestaña et al. 2010, Spain [37] | (−) | Crystalloid within 6 hours to achieve CVP ≥8 mmHg or global end-diastolic volume index ≥680 ml/m2 | Quantified but not reported. | ||
| Sebat et al. 2005, USA [32] | (−) | 1000 ml crystalloid in ED, 600 ml increments per MAP & UO protocol | Quantified but not reported. | ||
| Shapiro et al. 2006, USA [28] | (−) | 500 ml crystalloid bolus, repeat until CVP 8–12 mmHg | 6 h: | 2.9 ± 1.8 | 4.1 ± 2.6 |
| 24 h: | 6.5 ± 4.5 | 7.6 ± 3.9 | |||
| Trzeciak et al. 2006, USA [26] | (−) | 250-1000 ml crystalloid bolus until CVP ≥8 mmHg | ED: | 3.5 ± 2.3 | 5.7 ± 3.0 |
| ICU 24 h: | 5.5 ± 4.9 | 2.8 ± 1.7 | |||
| ED and ICU 24 h: | 9.1 ± 5.1 | 7.9 ± 3.4 | |||