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| The limitations，controversies and improvements of early goal - directed therapy |
| ZHOU Xian-shi，TANG Guang-hua，LI Jun |
| Emergency Department，Guangdong Provincial Hospital of Traditional Chinese Medicine，Guangzhou 510120，China |
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Abstract [Abstract] It is a widely accepted truth that early goal-directed therapy（EGDT）can reduce sig⁃nificantly the mortality of severe sepsis and septic shock by the academic circles，which was proposed by Rivers et all in an article on the New England Journal of Medicine in 2001 and soon recommended by all versions of Surviving Sepsis Campaign Guidelines. However，in the same magazine，three larger sample，multi-center，randomized controlled trials（ARISE，ProCESS，ProMISe）came out between 2014 and 2015，stating that EGDT did not have the ability to reduce significantly the mortality of severe sepsis and septic shock by comparing with the‘usual group’.The opinion was confirmed by some meta-analysis published afterwards which incurs extensive attention and heated discussion among the academic
circles. So is EGDT really effective? What are the limitations and controversies inside it? How can we make improvements to make it more effective and scientific? Now let' s talk about these issues.
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Received: 27 September 2015
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Corresponding Authors:
TANG Guang-hua，E-mail：tgh1973@163.com
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