Tag Archive for: EGDT

REBELCast: Sepsis Care in 2015

04 May
May 4, 2015

Sepsis Care in 2015So I was recently invited to the Texas College of Emergency Physicians meeting in Austin, TX (April 23rd – 26th, 2015) and was asked to give a lecture on sepsis, titled “Optimizing ED Management of Sepsis.” I was able to record my audio from that lecture and will summarize it on this blogpost and attach the audio to the lecture as well. Now usually on REBELCast I do a mini-critical appraisal of recent literature with Swami and Matt, but in this episode I am going to try and give you a succinct summary of the recent sepsis trials that have been released over the past 6 – 12 months. Read more →

The New Age of Sepsis Management

16 Mar
March 16, 2015

SepsisThere are more than 750,000 cases of severe sepsis and septic shock in the US each year.  Most patients who present with sepsis receive their initial care in the emergency department.  In 2001, there was a landmark study by Rivers et al that reported that among patients with severe sepsis or septic shock mortality was significantly lower among those who received a 6 hour protocol of Early Goal-Directed Therapy (EGDT) (i.e. 30.5% vs 46.5%). The premise of EGDT was that “usual care” lacked aggressive, timely assessment and treatment. The EGDT protocol used central venous catheterization (CVC) to monitor central venous pressure (CVP) and central venous oxygen saturation (SCVO2) to guide the use of intravenous fluids (IVFs), vasopressors, packed red blood cell (PRBC) transfusions, and dobutamine in order to achieve pre-specified physiological targets.  Since the publication of this landmark article, physicians have become more aggressive in the management of sepsis which raises the question of whether all elements of the protocol are still necessary.  Read more →