End-points of resuscitation how much is enough?
Fluid resuscitation after traumatic hemorrhage has historically been instituted as soon after injury as possible. Patients suffering from hemorrhagic shock may receive several liters of crystalloid, in addition to colloid solutions, in an attempt to normalize blood pressure, heart rate, urine output, and mental status, which are the traditional end-points of resuscitation. Current theory and recent investigations have questioned this dogma. Resuscitation goals may be different between when the patient is actively hemorrhaging, and once bleeding has been controlled. Newer markers of tissue and organ system perfusion may allow a more precise determination of adequate resuscitation.
McCunn
M
M
Department of Anesthesiology, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. mmcunn@stc1.ummc.umaryland.edu
Dutton
R
R