Clinical Advisor is reporting that a study published in the New England Journal of Medicine found that early, goal-directed therapy for septic shock patients resulted in higher costs but did not lead to better outcomes.
Duration of stay in the intensive care unit and receipt of cardiovascular support were greater in the early, goal-directed therapy group than in the usual-care group.
Duration of stay in the emergency department was shorter in the early, goal-directed therapy group than in the usual-care group in one of three clinical trials.
Subgroup analyses showed no benefit from EGDT for patients with worse shock (higher serum lactate level, combined hypotension and hyperlactatemia, or higher predicted risk of death) or for hospitals with a lower propensity to use vasopressors or fluids during usual resuscitation.
