Monitoring resuscitation of the injured patient

Physicians are being called on with increasing frequency to initiate resuscitation of the severely injured patient. The medical literature is confusing regarding the best way that this can be done. A study was undertaken to evaluate simultaneously four common, easily measured indexes--blood pressure, pulse rate, central venous pressure, and pulmonary artery pressure. A shock-trauma model employing laboratory-bred beagle dogs was developed. Results indicate that the best single index is pulmonary artery pressure. Certain physiologic principles make central venous pressure an unreliable index.