{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1361418520614736128.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.1164/rccm.200812-1912oc"}},{"identifier":{"@type":"URI","@value":"https://academic.oup.com/ajrccm/article-pdf/180/9/861/67441680/ajrccm_180_9_861.pdf"}}],"dc:title":[{"@value":"Effectiveness of Treatments for Severe Sepsis: A Prospective, Multicenter, Observational Study"}],"description":[{"type":"abstract","notation":[{"@value":"<jats:title>Abstract</jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale</jats:title>\n                    <jats:p>Several Surviving Sepsis Campaign Guidelines recommendations are reevaluated.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives</jats:title>\n                    <jats:p>To analyze the effectiveness of treatments recommended in the sepsis guidelines.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>In a prospective observational study, we studied all adult patients with severe sepsis from 77 intensive care units. We recorded compliance with four therapeutic goals (central venous pressure 8 mm Hg or greater for persistent hypotension despite fluid resuscitation and/or lactate greater than 36 mg/dl, central venous oxygen saturation 70% or greater for persistent hypotension despite fluid resuscitation and/or lactate greater than 36 mg/dl, blood glucose greater than or equal to the lower limit of normal but less than 150 mg/dl, and inspiratory plateau pressure less than 30 cm H2O for mechanically ventilated patients) and four treatments (early broad-spectrum antibiotics, fluid challenge in the event of hypotension and/or lactate greater than 36 mg/dl, low-dose steroids for septic shock, drotrecogin alfa [activated] for multiorgan failure). The primary outcome measure was hospital mortality. The effectiveness of each treatment was estimated using propensity scores.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results</jats:title>\n                    <jats:p>Of 2,796 patients, 41.6% died before hospital discharge. Treatments associated with lower hospital mortality were early broad-spectrum antibiotic treatment (treatment within 1 hour vs. no treatment within first 6 hours of diagnosis; odds ratio, 0.67; 95% confidence interval, 0.50–0.90; P = 0.008) and drotrecogin alfa (activated) (odds ratio, 0.59; 95% confidence interval, 0.41–0.84; P = 0.004). Fluid challenge and low-dose steroids showed no benefits.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>In severe sepsis, early administration of broad-spectrum antibiotics in all patients and administration of drotrecogin alfa (activated) in the most severe patients reduce mortality.</jats:p>\n                  </jats:sec>"}]}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1381418520614736132","@type":"Researcher","foaf:name":[{"@value":"Ricard Ferrer"}],"jpcoar:affiliationName":[{"@value":"Critical Care Center, Hospital de Sabadell, CIBER Enfermedades Respiratorias, and"}]},{"@id":"https://cir.nii.ac.jp/crid/1381418520614736128","@type":"Researcher","foaf:name":[{"@value":"Antonio Artigas"}],"jpcoar:affiliationName":[{"@value":"Critical Care Center, Hospital de Sabadell, CIBER Enfermedades Respiratorias, and"}]},{"@id":"https://cir.nii.ac.jp/crid/1381418520614736129","@type":"Researcher","foaf:name":[{"@value":"David Suarez"}],"jpcoar:affiliationName":[{"@value":"Epidemiology and Assessment Unit, Instituto Universitario Fundación Parc Taulí, Universidad Auto´noma de Barcelona, Sabadell, Spain"}]},{"@id":"https://cir.nii.ac.jp/crid/1381418520614736134","@type":"Researcher","foaf:name":[{"@value":"Eduardo Palencia"}],"jpcoar:affiliationName":[{"@value":"Servicio de Medicina Intensiva, Hospital Infanta Leonor, Madrid, Spain"}]},{"@id":"https://cir.nii.ac.jp/crid/1381418520614736135","@type":"Researcher","foaf:name":[{"@value":"Mitchell M. Levy"}],"jpcoar:affiliationName":[{"@value":"Medical ICU, Rhode Island Hospital, Brown University School of Medicine, Providence, Rhode Island"}]},{"@id":"https://cir.nii.ac.jp/crid/1381418520614736133","@type":"Researcher","foaf:name":[{"@value":"Angel Arenzana"}],"jpcoar:affiliationName":[{"@value":"Servicio de Medicina Intensiva, Hospital Virgen de la Macarena, Sevilla"}]},{"@id":"https://cir.nii.ac.jp/crid/1381418520614736131","@type":"Researcher","foaf:name":[{"@value":"Xose Luis Pérez"}],"jpcoar:affiliationName":[{"@value":"Servicio de Medicina Intensiva, Hospital Universitari de Bellvitge, Hospitalet de Llobregat; and"}]},{"@id":"https://cir.nii.ac.jp/crid/1381418520614736130","@type":"Researcher","foaf:name":[{"@value":"Josep-Maria Sirvent"}],"jpcoar:affiliationName":[{"@value":"Servicio de Medicina Intensiva, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"1073449X"},{"@type":"EISSN","@value":"15354970"}],"prism:publicationName":[{"@value":"American Journal of Respiratory and Critical Care Medicine"}],"dc:publisher":[{"@value":"Oxford University Press (OUP)"}],"prism:publicationDate":"2009-11-01","prism:volume":"180","prism:number":"9","prism:startingPage":"861","prism:endingPage":"866"},"reviewed":"false","dc:rights":["https://academic.oup.com/pages/standard-publication-reuse-rights"],"url":[{"@id":"https://academic.oup.com/ajrccm/article-pdf/180/9/861/67441680/ajrccm_180_9_861.pdf"}],"createdAt":"2009-08-20","modifiedAt":"2026-03-21","relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360002217753078784","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 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