A study examining the efficacy of three different sepsis treatments found no significant differences in survival rate based on the treatment received, according to a study in the New England Journal of Medicine.
Over five years in 31 academic hospital emergency apartments, researchers randomly assigned patients to one of three treatment groups.
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The first group, protocol-based early goal-directed therapy, had central venous catheters placed to continuously monitor blood pressure and blood oxygen levels. The second treatment was protocol-based standard therapy, which employed standard bedside measures to monitor the patient and administer fluids without using a CVC (unless peripheral venous access was insufficient). Finally, patients in the standard care group received regular care from providers not requiring any study protocols.
The 60-day mortality rate did not significantly differ among the three groups, at 21 percent in the protocol-based EDGT group, 18.2 percent in protocol-based standard therapy group and 18.9 percent in the standard care group.
Similarly, the 90-day mortality rate was not significantly different among the groups, at 31.9 percent for protocol-based EDGT, 30.8 percent for protocol-based standard therapy and 33.7 percent for standard care.
Additionally, while acute renal failure was slightly higher in the protocol-based standard therapy group, 6 percent versus 3.1 percent in EDGT group and 2.8 percent in standard care, the duration of therapy for acute renal failure patients was not significantly different among all groups.
Researchers conclude their study found no significant advantage to protocol-based care over physician-led care.
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