Why is early goal-directed therapy successful – is it the technology?

Excerpt

When assessing outcome studies, the beneficial portion of any therapeutic strategy may not be clearly identified, especially in a condition as complex as sepsis. In the randomized controlled trial conducted by Rivers and coworkers [1], early goal-directed therapy (EGDT) was associated with significantly improved outcomes in sepsis. The study group received a package of care that focused on early resuscitation for the first 6 hours as an inpatient. This comprised fluid, including blood, pressors and inotropes. The goals of resuscitation were based on hemodynamic variables and central venous oxygen saturation (Scvo₂). The technology used to measure this was a central venous catheter with integrated oximetry. This device is examined in this issue of Critical Care [2]. In keeping with the style we previously adopted for technology assessment reviews, the article begins with a Q&A from the industry. …