Severe Sepsis and Septic Shock Trials (ProCESS, ARISE, ProMISe): What is Optimal Resuscitation?

Tiffany M Osborn

doi:10.1016/j.ccc.2016.12.004

Severe Sepsis and Septic Shock Trials (ProCESS, ARISE, ProMISe): What is Optimal Resuscitation?

Crit Care Clin. 2017 Apr;33(2):323-344. doi: 10.1016/j.ccc.2016.12.004.

Author

Tiffany M Osborn¹

Affiliation

¹ Section of Acute and Critical Care Surgery, Washington University School of Medicine, 4901 Forest Park Avenue, St. Louis, MO 63108, USA. Electronic address: osbornt@wustl.edu.

PMID: 28284298
DOI: 10.1016/j.ccc.2016.12.004

Abstract

Between 2014 and 2015, 3 independent, multicenter, randomized controlled trials evaluated early goal-directed therapy (EGDT) in severe sepsis and septic shock: Protocolized Care for Early Septic Shock (ProCESS) from the United States; Australasian Resuscitation in Sepsis Evaluation (ARISE), and Protocolised Management in Sepsis (ProMISe) in the United Kingdom. All 3 trials confirmed that there was no survival benefit of EGDT compared to usual resuscitation. How should we define usual care for sepsis given these study findings? Furthermore, the definition of sepsis has now been updated. This article reviews key findings of these 3 trials and discusses these important issues in sepsis management.

Keywords: Hyperlactatemia; Lactate; Resuscitation; Sepsis; Septic shock; Severe sepsis; Usual care.

Publication types

Review

MeSH terms

Humans
Patient Care Planning
Randomized Controlled Trials as Topic
Resuscitation / methods*
Sepsis / mortality
Sepsis / therapy*
Shock, Septic / mortality
Shock, Septic / therapy*

Grants and funding

07/37/47/DH_/Department of Health/United Kingdom