Echo vs. EGDT in Severe Sepsis and Septic Shock

Inclusion Criteria

• •At least 18 years of age
• •Suspected infection
• •Two or more systemic inflammatory response syndrome (SIRS) criteria
• •* White blood cell count less than 4,000 per mm3, greater than 12,000 per mm3, or differential with greater than 10% immature forms
• •* Heart rate greater than 90 beats per minute
• •* Respiratory rate greater than 20 breaths per minute or paCO2 less than 32 mmHg
• •* Temperature less than 36°C or greater than 38°C
• •Evidence of refractory hypoperfusion attributed to sepsis (one or more of the following):
• •* Systolic blood pressure less than 90 mmHg despite an intravenous fluid challenge of at least 30ml/kg (a portion of this may be albumin equivalent)
• •* Blood lactate level at least 4 mmol/L.
• •Intention to place an arterial catheter.
• •Intention to place a central venous catheter.