The results of the PRISM trials confirm that early intervention strategies, including early detection of sepsis, risk stratification, early administration of antibiotics, and appropriate fluid resuscitation, improve the outcomes in patients with severe sepsis and septic shock. All these steps were components of the original EGDT protocol and led to historically low mortality rates in both the control groups and the intervention groups in the PRISM studies.2 However, because of the limitations of the PRISM trials with respect to the patient populations and trial methods, the potential benefit of the EGDT steps that involved effective hemodynamic management was diminished, which increased the probability of equivalency among the treatment groups.

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