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Defining goals of resuscitation in the critically ill patient
Alexandre Joosten1, Brenton Alexander2, Maxime Cannesson2
1Department of Anesthesiology and Perioperative Care, University of California, Irvine, 101 The City Drive South, Orange, CA 92868, USA; Department of Anesthesiology and Critical Care, Erasme University Hospital, Free University of Brussels, 808 Lennick Road, Brussels 1070, Belgium.
Abstract:
There is still no "universal" consensus on an optimal endpoint for goal directed therapy (GDT) in the critically ill patient. As in other areas of medicine, this should help providers to focus on a more "individualized approach" rather than a protocolized approach to ensure proper patient care. Hemodynamic optimization needs more than simply blood pressure, heart rate, central venous pressure and urine output monitoring. It is essential to also monitor flow variables (cardiac output/stroke volume) and dynamic parameters of fluid responsiveness whenever available. This article will provide a review of current and trending approaches of the goals of resuscitation in the critically ill patient.
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