Sepsis

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Major Sepsis Trials

Sections

EDGT | Corticosteroids | Fluids | Duration of Therapy | Circulatory Support | Anticoagulants

Early Goal Directed Therapy

Infusion pumps in the ICU

Image: Shutterstock | Medical-R

Original Trial

Rivers. Early goal directed therapy in the treatment of severe sepsis and septic shock. N Eng J Med 2001;345:1368-77

Triumvirate

Mouncey. Trial of Early, Goal-Directed Resuscitation for Septic Shock. (ProMISe Trial). N Engl J Med 2015;epublished March 17th
The ARISE Investigators. Goal-Directed Resuscitation for Patients with Early Septic Shock. New Engl J Med 2014;epublished October 1st
The ProCESS Investigators. A Randomized Trial of Protocol-Based Care for Early Septic Shock (ProCESS study). New Engl J Med 2014;epublished March 18th

Zambia

Andrews. Effect of an Early Resuscitation Protocol on In-hospital Mortality Among Adults With Sepsis and Hypotension. A Randomized Clinical Trial. JAMA 2017;epublished September 27th

Corticosteroids

Nurse administering an IV medication

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Hydrocortisone

Hydrocortisone & Fludrocortisone

Hydrocortisone, Thiamine & Vitamin C

see also Endocrine Trials

Fluids

Bag of 0.9% saline

Image: Shutterstock | AlteredR

See Also Major Fluid Trials

Volume

Albumin

Caironi. Albumin Replacement in Patients with Severe Sepsis or Septic Shock (ALBIOS study). New Engl J Med 2014;epublished March 18th

Sepsis

Duration of Therapy

Procalcitonin marker

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Procalcitonin

Bouadma. Use of procalcitonin to reduce patients' exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomized controlled trial. Lancet. 2010;375:463-474.

Ventilator-Associated Pneumonia

Gastrointestinal

Sawyer. Trial of Short-Course Antimicrobial Therapy for Intraabdominal Infection (STOP-IT trial). N Engl J Med 2015; 372:1996-2005

Circulatory Support

Adrenaline ampoule

Image: Shutterstock | Komsan Loonprom

Adrenergic Agonism

Beta Adrenergic Antagonism

Morelli. Effect of Heart Rate Control With Esmolol on Hemodynamic and Clinical Outcomes in Patients With Septic Shock. A Randomized Clinical Trial. JAMA 2013;epublished October 9th

Anticoagulants

Insulin infusion in the ICU

Image: Shutterstock | AlteredR

Protein C

Activated Protein C

Zymogen Protein C

Pappalardo. Protein C zymogen in severe sepsis: a double-blinded, placebo-controlled, randomized study. Intensive Care Med 2016;epublished June 25th

Thrombomodulin

Vincent. Effect of a Recombinant Human Soluble Thrombomodulin on Mortality in Patients With Sepsis-Associated Coagulopathy. The SCARLET Randomized Clinical Trial. JAMA 2019;epublished May 19th

Miscellaneous Therapies

Insulin infusion in the ICU

Image: Shutterstock | Komsan Loonprom

Statins

Kruger. A Multicentre Randomised Trial of Atorvastatin Therapy in Intensive Care Patients with Severe Sepsis. Am J Respir Crit Care Med 2013;187(7):743-750

G-CSF

Stephens. Randomized, double-blind, placebo-controlled trial of granulocyte colony-stimulating factor in patients with septic shock. Crit Care Med. 2008;36(2):448-54

Mental Health

Schmidt. Effect of a Primary Care Management Intervention on Mental Health–Related Quality of Life Among Survivors of Sepsis. A Randomized Clinical Trial. JAMA 2016;315(24):2703-2711

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