Septic Shock Treatment Protocols Challenged

Cheryl Clark, for HealthLeaders Media , March 19, 2014

Craig Lilly, MD, a pulmonary medicine and critical care specialist at the University of Massachusetts Memorial Medical Center, who was not one of the trial results authors, reacted to the study. "This trial tells us that the catheter, the monitoring, the central venous pressure and looking at central venous saturation—a lot of stuff [that we do now] that's inconvenient and expensive—doesn't lead to better outcomes."

"With these catheters, when you put them in, there's patient risk (of infection), and it would lower cost to not put them in. So that's really what agencies like the National Quality Forum and others should be focusing on," Lilly says.

Septic shock and severe sepsis affect 750,000 patients in the U.S. a year and results in death for 15,000. It is increasingly the focus of hospital interventions because of its debilitating consequences and high 30-day and 60-day mortality rates.

Sepsis also has received increased attention because of media coverage surrounding the death of 12-year-old Rory Staunton in April 2012. Staunton sought care at NYU Langone for a cut on his arm after playing basketball. Emergency department clinicians failed to detect a telltale lab result and other symptoms of sepsis and sent him home.

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