In Search of the Optimal End Points of Resuscitation in Trauma Patients
- 1 May 1998
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Journal of Trauma and Acute Care Surgery
- Vol. 44 (5), 908-914
- https://doi.org/10.1097/00005373-199805000-00028
Abstract
Complete resuscitation from shock is one of the primary concerns of the surgeon taking care of injured patients.Traditionally, the return to normalcy of blood pressure, heart rate, and urine output has been the end point of resuscitation. Using these end points may leave a substantial number of patients, up to 50 to 85% in some series, in "compensated" shock, which if it persists may ultimately lead to the death of the patient. Because of this potential other end points are being used and include supernormal values for oxygen transport variables (cardiac index, oxygen delivery, and oxygen consumption), lactate, base deficit, and gastric intramucosal pH. We believe that the current data support the use of lactate, base deficit, and/or gastric intramucosal pH as the appropriate end points of resuscitation of trauma patients. The goal should be to correct one or all of three of these markers of tissue perfusion to normal within the initial 24 hours after injury.Keywords
This publication has 42 references indexed in Scilit:
- Maximizing oxygen delivery in critically ill patientsCritical Care Medicine, 1996
- Prospective, Randomized Trial of Survivor Values of Cardiac Index, Oxygen Delivery, and Oxygen Consumption as Resuscitation Endpoints in Severe TraumaThe Journal of Trauma and Acute Care Surgery, 1995
- Resuscitation of multiple trauma and head injury: Role of crystalloid fluids and inotropesCritical Care Medicine, 1994
- Hemodynamic responses to shock in young trauma PatientsCritical Care Medicine, 1994
- The Gastrointestinal Tract The “Undrained Abscess” of Multiple Organ FailureAnnals of Surgery, 1993
- Prospective Trial of Supranormal Values of Survivors as Therapeutic Goals in High-Risk Surgical PatientsSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1988
- Tissue oxygen debt as a determinant of lethal and nonlethal postoperative organ failureCritical Care Medicine, 1988
- Use of physiologic monitoring to predict outcome and to assist in clinical decisions in critically ill postoperative patientsThe American Journal of Surgery, 1983
- Physiologic Patterns in Surviving and Nonsurviving Shock PatientsArchives of Surgery, 1973
- SHOCKArchives of Surgery, 1934