Two Sepsis Treatments Look Equally Effective
TUESDAY, Feb. 23 -- Two treatment methods for severe sepsis achieve similar short-term survival rates, a new study shows.
Researchers at the Carolinas Medical Center in Charlotte, N.C., compared lactate clearance (using lactate levels measured in blood samples) with a treatment involving central venous oxygen saturation (ScvO2) measured using a catheter connected to a computerized system. The Surviving Sepsis Campaign guidelines recommend the use of ScvO2, but there is ongoing debate about which of the two methods is better.
The study looked at outcomes of early resuscitation in 300 patients with either severe sepsis and evidence of hypoperfusion (decreased blood flow to the body tissues) or septic shock who were admitted to a hospital emergency department and randomly assigned to receive one of the two treatments.
The Carolinas Medical Center team found that 34 patients (23 percent) in the ScvO2 group died while in hospital, compared with 25 (17 percent) of patients in the lactate clearance group. There were no differences in treatment-related adverse events.
"These data support the substitution of lactate measurements in peripheral venous blood as a safe and efficacious alternative to a computerized spectrophotometric catheter in the resuscitation of sepsis," the researchers concluded.
The study appears in the Feb. 24 issue of the Journal of the American Medical Association.
Each year in the United States, at least 750,000 people are hospitalized with severe sepsis, and about 500,000 of them are initially treated in emergency departments.
The U.S. National Institute of General Medical Sciences has more about sepsis.
Posted: February 2010
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