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Early goal-directed therapy (EGDT) for sepsis — which specifies somewhat arbitrary goals for physiologic parameters such as central venous pressure and central venous oxygen saturation —had been the standard of care for more than a decade until 2014–2015. Then, three international trials found that “usual care” of septic patients was as effective as EGDT, at less cost and with fewer interventions. In an impressive collaboration, the investigators from these trials had standardized enrollment criteria, protocols, and outcomes to facilitate a meta-analysis of their data. Now, researchers report results of this meta-analysis, which included 3723 septic patients at 138 hospitals.
All patients received early antibiotics and intravenous fluids. At…