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Table 1 Comparison of selected randomized, controlled trials assessing the effects of therapeutic interventions on sepsis-related mortality between 2001 and 2013

From: Residual rates of mortality in patients with severe sepsis: a fatality or a new challenge?

1st author and year of publication

Therapeutic intervention assessed (inclusion time window)

Mortality rate in control arm (%)

Impact on mortality

Impact on adverse events

Effect of studied therapy*

Rivers 2001 [2]

Early goal guided therapy (As soon as possible)

49.2

Decreased mortality

No difference

Better

Bernard 2001 [3]

Drotrecogin alfa (24 h)

30.8

Decreased mortality

Serious bleeding event

Annane 2002 [6]

Hydrocortisone + fludrocortisone (3 h)

63

Decreased mortality

No difference

Cruz 2009 [7]

Polymyxin B hemoperfusion (6 h)

53

Decreased mortality

Cartridge clotting Hypotension and tachycardia

 

Warren 2001 [8]

Antithrombin III (6 h)

38.7

No difference

No difference

No difference

Reinhart 2004 [9]

Extracorporeal endotoxin adsorber (24 h)

26

 

No difference

Heinrich 2006 [10]

IG-MA enriched Ig** (not available)

28.2

 

Not available

Annane 2007 [12]

Norepinephrine plus dobutamine (24 h)

34

 

No difference

Russel 2008 [14]

Vasopressin (24 h)

39

 

No difference

Ranieri 2012 [1]

Drotrecogin alfa (24 h)

24.2

 

No difference

Opal 2013 [15]

Eritoran (12 h)

26.9

 

No difference

 

Lopez 2004 [16]

NO synthase inhibitor LNMA (72 h)

49

Increased mortality

Low cardiac output

Worse

Abraham 2005 [11]

Drotrecogin alfa (48 h)

17

No difference

Bleeding events

Brunkhorst 2008 [17]

Insulin/pentastarch (12 h)

26

No difference

Hypoglycemia

Renal failure

Coagulopathy

Sprung 2008 [18]

Hydrocortisone (72 h)

31.5

No difference

Increased infections events

Stephens 2008 [13]

G-CSF*** (24 h)

25

No difference

Higher rate of new organ failure

Patel 2010 [19]

Dopamine Early goal guided therapy

43

No difference

Arrhythmias

Annane 2010 [20]

Corticosteroid/Insulin (not available)

45.8

No difference

Superinfection

Hypoglycemia

Perner 2012 [21]

6% HES 130/0.42 (24 h)

43

Increased mortality

Not available

 
  1. The selected trials were categorized in three groups depending on whether the effect of the studied intervention on mortality and/or serious adverse events was “better”: studied intervention leading to a significant reduction in mortality; “not different”: similar impact of the studied intervention on mortality and no severe adverse events; “worse”: studied intervention leading to a significant increase in mortality and/or to a significant increase in serious adverse events.
  2. *Statistically significant difference vs. control arm: **neutropenic patients; ***granulocyte colony-stimulating factor.