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Korean J Crit Care Med > Volume 25(2); 2010 > Article
Korean Journal of Critical Care Medicine 2010;25(2): 61-70. doi: https://doi.org/10.4266/kjccm.2010.25.2.61
패혈성 쇼크 환자에서 응급실 기반 조기목표지향치료의 효과 (중증 패혈증 캠페인)
신형진ㆍ이강현ㆍ황성오ㆍ김현ㆍ신태용*ㆍ김상철†
연세대학교 원주의과대학 응급의학교실, *분당제생병원 응급의학과, †건국대학교병원 응급의학과
The Efficacy of Early Goal-directed Therapy in Septic Shock Patients in the Emergency Department: Severe Sepsis Campaign
Hyung Jin Shin, Kang Hyun Lee, Sung Oh Hwang, Hyun Kim, Tae Yong Shin, Sang Chul Kim
1Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea. ed119@yonsei.ac.kr
2Department of Emergency Medicine, Bundang Jesang General Hospital, Seongnam, Korea.
3Department of Emergency Medicine, Konkuk University Hospital, Chungju, Korea.
ABSTRACT
BACKGROUND: Early goal-directed therapy (EGDT) has been used for patients with severe sepsis and septic shock in the emergency department (ED). In 2003, international management guidelines for severe sepsis and septic shock were developed under the auspices of the Surviving Sepsis Campaign (SSC); however, EGDT based on the SSC was not fully evaluated in the ED. The purpose of this study was to evaluate the efficacy of EGDT based on the SSC in the ED in Korea. METHODS: We randomly assigned patients who arrived at our ED in septic shock to receive EGDT before admission to the intensive care unit between May 2007 and July 2007, and we retrospectively assigned patients in septic shock to receive standard therapy between May 2006 and July 2006. The in-hospital mortality for 24 hours and 28 days, the MODS, SAPS II, and APACHE II scores were obtained and compared between the study groups. RESULTS: Of the 60 enrolled patients, 30 were assigned to EGDT and 30 were assigned to standard therapy. There was no significant difference between the groups with respect to the baseline characteristics. In-hospital mortality at 28 days was 13% in the group assigned to EGDT as compared to 40% in the group assigned to standard therapy (p = 0.020) and in-hospital mortality at 24 hours was 0% and 13%, respectively (p = 0.038). CONCLUSIONS: EGDT provides significant benefits with respect to outcome in patients in septic shock.
Key Words: infection; sepsis syndrome; septic shock; severe sepsis
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