Early goal-directed therapy in the management of severe sepsis/septic shock in an academic emergency department in Malaysia

Sepsis continues to be a major cause of mortality and morbidity throughout the world. The annual incidence of severe sepsis was approximately 3.0 cases per 1,000 of the population. (1) In the United States alone, the incidence of severe sepsis will see an annual increase of 1.5% which may be attributable to an increasing ageing population. (1) Early goal-directed therapy (EGDT) was proposed by Rivers et al in 2001. This protocol advocates aggressive treatment commencing in the emergency department to achieve certain haemodynamic goals. This achieved a 16% absolute risk reduction for in-hospital mortality. (2)