To the Editor: In reporting the results of their meta-analysis of individual patient data from three trials, the Protocolized Resuscitation in Sepsis Meta-Analysis (PRISM) investigators (June 8 issue)1 conclude that early, goal-directed therapy (EGDT) did not result in better outcomes than usual care in the resuscitation of patients with septic shock. I was hoping that the meta-analysis would answer an important question — what is usual care? EGDT is a well-defined intervention to guide hemodynamic resuscitation according to targets for central venous pressure, mean arterial blood pressure, urinary output, and central venous oxygen saturation. Which monitoring tools and hemodynamic targets . . .

中文翻译：

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败血性休克的早期，针对目标的疗法-患者水平的荟萃分析

致编辑：脓毒症荟萃分析（PRISM）研究者（6月8日发行）1在报告他们对三项试验的单个患者数据进行荟萃分析的结果时得出的结论是，早期的目标导向疗法（EGDT）在感染性休克患者的复苏中，没有比常规治疗更好的结果。我希望荟萃分析能够回答一个重要的问题-什么是通常的护理？EGDT是一项明确定义的干预措施，可根据中心静脉压，平均动脉血压，尿量和中心静脉血氧饱和度的指标指导血流动力学复苏。有哪些监测工具和血流动力学指标。。。