"Confirmed: Aggressive Septic Shock Protocol Does Not Reduce Deaths," a piece in the March 23rd edition of MedPage Today, features the commentary of Derek C. Angus, MD, MPH, FRCP, regarding findings recently published in the New England Journal of Medicine.
"Early, Goal-Directed Therapy for Septic Shock - A Patient-Level Meta-Analysis," published in the NEJM on March 21st, details the efforts of the PRISM study (ProCESS, ARISE, and ProMISe trial investigators in collaboration with the CRISMA Center, the Australian and New Zealand Intensive Care Research Centre, and the Intensive Care National Audit and Research Centre) to determine the benefit of early, goal-directed therapy (EGDT), a 6-hour resuscitation protocol reported in a 2001 single-center study to lower patient mortality rates.
Researchers noted in the NEJM article that no evidence of benefit was found when using EGDT protocols over usual care in patients with severe illness despite the use of subgroups considerably larger than the population of the original trial. Dr. Angus was quoted as saying, "It's time to roll things back and focus on the basics."
Funding for the PRISM study was provided by the U.S. National Institute of General Medical Sciences, the National Institutes of Health, and the National Health and Medical Research Council of Australia, among others.