The effect of early quantitative resuscitation on organ function in survivors of septic shock

Abstract

ObjectiveThe objective of this study is to determine if early quantitative resuscitation (QR) attenuates organ dysfunction in survivors of septic shock. MethodsThis is a secondary analysis of a completed implementation study. Inclusion criteria are suspected infection, greater than or equal to 2 systemic inflammatory response syndrome criteria and either systolic blood pressure less than 90 mm Hg after a fluid bolus or lactate more than 4 mmol/L and survival to hospital discharge. Data were prospectively collected on eligible patients for 1 year before and 3 years after implementation of early QR. Patients in the before phase received nonprotocolized care (NPC) at physician discretion. Survivors who received QR were compared with survivors who received NPC. The primary outcome was the worst sequential organ failure assessment (SOFA) score during hospitalization. ResultsTwo hundred sixty patients in the QR group and 41 patients in the NPC group were included. There were no significant differences in demographics between the 2 groups. The initial SOFA score in the QR group was 6 and in the NPC group was 6 (P = .17). There was no significant difference in the worst SOFA score during hospitalization between the QR and NPC groups (6 vs 6, respectively; P = .16). ConclusionsIn survivors of septic shock, we found no difference in maximal organ dysfunction during hospitalization between patients who received QR vs NPC.