Septic Shock Treatment Protocols Challenged
In light of new data, "the National Quality Forum-endorsed measure and the International Surviving Sepsis Campaign guidelines for treatment of septic shock are going to have to be modified," says a critical care researcher.
Derek C. Angus, MD
UPMC/University of Pittsburgh
Schools of the Health Sciences
A long-awaited study of septic shock treatments has found that expensive and risky parts of a widely accepted resuscitation protocol now in place in many hospitals do not improve outcomes when compared with standard of care.
The study, conducted in 31 emergency departments in the U.S., over five years should result in some hospitals revising their regulations and guidelines governing sepsis care in, says lead author Derek C. Angus, MD, of the Department of Critical Care Medicine at the University of Pittsburgh and UPMC Health System.
"New York State is now demanding some regulations of its hospitals, and they're going to have to modify those," Angus said in a telephone interview this week. "The National Quality Forum-endorsed measure, and the International Surviving Sepsis Campaign guidelines are going to have to be modified as well."
He emphasized the federally funded trial, called ProCESS (Protocol-Based Care for Early Septic Shock) "does not invalidate the value of early recognition of sepsis, or the value of giving early antibiotics and fluids. Rather, he said, "What we have said is that after you recognize the patient has sepsis, and you start antibiotics, and done all these things, taken care of the A, B, and C for sepsis itself, then there's no additional value to adding D, E and F."