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Báo cáo y học: "Recently published papers: More about EGDT, experimental therapies and some inconvenient truths"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Recently published papers: More about EGDT, experimental therapies and some inconvenient truths. | Available online http ccforum.eom content 11 5 171 Commentary Recently published papers More about EGDT experimental therapies and some inconvenient truths Jonathan Ball General Intensive Care Unit St George s Hospital London SW17 0QT UK Corresponding author Jonathan Ball jball@sgul.ac.uk Published 26 October 2007 This article is online at http ccforum.com content 11 5 171 2007 BioMed Central Ltd Critical Care 2007 11 171 doi 10.1186 cc6145 Abstract This issue s recently published papers concentrates on early goal directed therapy starting with new data from the original study through to new studies that may have a major bearing on the treatment of septic shock in years to come. A timely reminder about talking walking and teaching clinical medicine completes the roundup. Early goals No one is likely to argue with the belief that prompt and appropriate treatment is effective and should be the standard of care. Back in 2001 Emmanuel Rivers and colleagues published their landmark study of Early Goal Directed Therapy EGDT 1 . Perhaps the central concept behind EGDT is that of oxygen debt and the secondary inflammatory insult inflicted by tissue hypoxia which is modifiable with timely and aggressive cardiovascular support. A series of recently published papers emphasise and further elucidate this idea. Firstly Rivers and colleagues have published the results of a study of serum biomarkers of systemic inflammation from the majority of patients from their original study 2 . Patients had multiple biomarkers measured periodically over the first 72 hours of their illness. Two separate comparative analyses were performed. First the protocol group are considered against the standard care group. Second the whole patient population has been stratified into three groups by severity of admission global dysoxia serum lactate and central venous oxygen saturations and compared. Unfortunately no third analysis of these three groups separated into those in the protocol and standard .