The New England Journal of Medicine released three landmark trials this week. Each trial directly addresses controversies in sepsis management that have been debated for a decade or longer: high versus low MAP goals (SEPSISPAM), a challenge to early goal-directed therapy (ProCESS), and albumin replacement (ALBIOS).
These trials will undoubtedly have a significant impact on future sepsis guidelines from SCCM, which is incredibly exciting. Perhaps even more exciting is to see the dramatic improvement in early sepsis mortality between Rivers in 2001 (30.5 to 46.5%) and ProCESS (18.2 to 21%).
In pouring through each of these trials to provide a timely update to the ICU Trials mobile application, I was absolutely shocked by the failure of the peer review process in the ALBIOS trial.