@article{JECCM3775,
author = {Jae Chol Yoon and Won Young Kim},
title = {Progression in optimal sepsis care: the sooner, the better?},
journal = {Journal of Emergency and Critical Care Medicine},
volume = {1},
number = {8},
year = {2017},
keywords = {},
abstract = {After the landmark study of Rivers et al. (1) proposed the concept of the “golden hour” in the management of severe sepsis and septic shock, early goal-directed therapy (EGDT) became the practice in emergency departments (EDs). EGDT includes the early detection of sepsis, early obtainment of blood culture and administration of broad spectrum antibiotics, risk stratification using lactate measurement and fluid challenge for hypotensive patients, and hemodynamic optimization guided by pre-determined targets for preload (central venous pressure), afterload (mean arterial pressure), and finding a balance between oxygen delivery and oxygen consumption reflected by central venous oxygen saturation. However, three recent large studies, ProCESS (Protocolized Care for Early Septic Shock), ARISE (Australasian Resuscitation in Sepsis Evaluation), and ProMISe (Protocolized Management in Sepsis) have challenged the benefits of this approach to improving survival in severe sepsis (2). Although there have been concerns about protocolized therapy, recent guidelines still recommend the prompt identification of sepsis and treatment with broad-spectrum antibiotic agents and intravenous fluids (3). However, considerable controversy exists over how rapidly sepsis must be treated.},
issn = {2521-3563}, url = {https://jeccm.amegroups.org/article/view/3775}
}