sis and Septic ShockРWe randomly assigned patients who arrived at an urban emergency department with severe sepsis or septic shock to receive either six hours of early goal-directed therapy or standard therapy (as a control) before admission to the intensive care unitРRivers E, et al. N Engl J Med ?2001; 345:1368–1377Рfluid management is a matter of timing.Р标准治疗:CVP≥8 ~12 mm Hg、MAP≥ 65 mm Hg?EGDT: 6 h达标,ScvO2≥ 70% ?结果:EGDT需大量补液(4,981±2,984 mL vs 3,499±2,438 mL;P<0.001),需要更多的多巴酚丁胺和RBC? 标准治疗使乳酸酸中毒持续时间长、器官功能障碍多,院内病死率高(46.5% vs 30.5%).РRivers E, et al. N Engl J Med ?2001; 345:1368–1377РICUРFigure 4. Comparing the Pao2/Fio2 ratios between the EGDT and standard-care groups.?Despite more volume resuscitation in the EGDT group during?initial 6 h, there was difference in Pao2/Fio2 ratio?(p =0.34).
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