Rivers EGDT

Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock

Patient / Population Intervention / Exposure Comparison Outcome

In 263 emergency-department patients with severe sepsis or septic shock, a 6-hour protocol targeting CVP, MAP, ScvO₂ and haematocrit reduced in-hospital mortality compared with standard care.

263

Design

Single-centre RCT, Detroit

Endpoint

In-hospital mortality

Relevance

Result30.5% vs 46.5% (absolute reduction 16.0%; p=0.009). 28-d 33.3% vs 49.2%; 60-d 44.3% vs 56.9%.

Rivers E, et al. N Engl J Med. 2001;345(19):1368-1377. 10.1056/NEJMoa010307

Discussion & critique

Single-centre, single-investigator with atypically high control mortality. The benefit is now attributed to early recognition and antibiotics, not the bundle itself; ProCESS/ARISE/ProMISe later overturned the protocol.