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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Tuesday, March 17, 2015

ProMISe (Protocolised Management in Sepsis) St. Emlyn´s

St Emlyn´s - March 17, 2015 by Richard Body
"Today is another landmark in the history of sepsis research. The long awaited results of the ProMISe trial are finally published in the New England Journal of Medicine. At 56 hospitals across the United Kingdom we’ve been working tirelessly to recruit patients to this awesome, cutting edge randomised controlled trial comparing early goal directed therapy to standard care for patients with severe sepsis.
This last year has been amazing for research into early goal directed therapy. We’ve been lucky enough to have two huge randomised controlled trials published from Australasia and the United States. They ARISE and ProCESS trials both found no difference in 90-day mortality between patients who were randomised to receive early goal directed therapy and those who received standard care. But would things be different in the United Kingdom? Could there be a small treatment effect that was not detected in the previous two randomised control trials? Despite their large sample sizes the 95% confidence intervals from those trials could not exclude the possibility of a 20% relative risk reduction for 90 day mortality. If there really is a treatment effect of that magnitude then early goal directed therapy could still be useful."