Evaluation of early goal directed therapy in patients with septic shock

Abstract

Objective To probe into the treatment effect and the influencing factors of early goal directed therapy(ECDT)in patients with septic shock.Method One hundred and twenty-six patients with septic shock were assigned into the treatment group(n=62)and the control group(n=64).The treatment group was administrated with EGDT,while the control group used conventional therapy for cycle and capacity support.Then sequential organ failure assessment(SOFA)score,APACHE Ⅱ score before treatment and 28-dav-mortality were respectively recorded before the above-mentioned treatment and at 24 hours after the therapy in the two groups.The treatment group was again subdivided into two groups after 6 hours recovery according to the resuscitation results:the sufficiently resuscitated group(n=40)and insufficiently resuscitated group(n=22).Age,genders,correlated haemodynamic parameter,SOFA score,APACHE Ⅱ score and serum lactic acid concentration before resuscitation and 28 d mortality were compared between the two groups.Results There was no significant difference in SOFA score and APACHE Ⅱ score before resuscitation between the treatment group and the control group[SOFA:(12.26±4.37)vs.(12.54±5.21);APACHE Ⅱ:(21.26±6.03)vs.(21.64±6.80)].The two scores at 24 hours after resuscitation[SOFA:(9.18±3.63)vs.(10.62±4.27);APACHEⅡ:(14.92±3.81)vs.(18.21±4.25);P＜0.05]and 28-day-mortality rate(48.39%vs.76.56%,P＜0.05)of the treatment group were significantly lower than those in the control group.There was significant difference in the age,mean arterial pressure (MAP),APACHEⅡ score between the sufficiently restoring group and the insufficiental resuscitated group.The 28-day-mortality of the sufficiently restoring group was significantly lower than that in the insufficiently restoring group.Conclusions EGDT can improve the prognosis in patients with septic shock.Ages,MAP and APPCHE Ⅱ score before resuscitation can be the important factors of EGDT. Key words: Septic shock; Early goal directed therapy SOFA; APACHE Ⅱ; Mortality rate