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Clinical review: Goal-directed therapy in high risk surgical patients

Authors :
Lees, Nicholas
Hamilton, Mark
Rhodes, Andrew
Source :
Critical Care; October 2009, Vol. 13 Issue: 5 p1-8, 8p
Publication Year :
2009

Abstract

A small group of patients account for the majority of peri-operative morbidity and mortality. These 'high-risk' patients have a poor outcome due to their inability to meet the oxygen transport demands imposed on them by the nature of the surgical response during the peri-operative period. It has been shown that by targeting specific haemodynamic and oxygen transport goals at any point during the peri-operative period, the outcomes of these patients can be improved. This goal directed therapy includes the use of fluid loading and inotropes, in order to optimize the preload, contractility and afterload of the heart whilst maintaining an adequate coronary perfusion pressure. Despite the benefits seen, it remains a challenge to implement this management due to difficulties in identifying these patients, scepticism and lack of critical care resources.

Details

Language :
English
ISSN :
13648535 and 1466609X
Volume :
13
Issue :
5
Database :
Supplemental Index
Journal :
Critical Care
Publication Type :
Periodical
Accession number :
ejs19925116
Full Text :
https://doi.org/10.1186/cc8039