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Báo cáo khoa học: "Equipment review: The success of early goal-directed therapy for septic shock prompts evaluation of current approaches for monitoring the adequacy of resuscitation"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Equipment review: The success of early goal-directed therapy for septic shock prompts evaluation of current approaches for monitoring the adequacy of resuscitation. | Available online http ccforum.eom content 9 4 349 Review Equipment review The success of early goal-directed therapy for septic shock prompts evaluation of current approaches for monitoring the adequacy of resuscitation Scott R Gunn1 Mitchell P Fink2 and Benjamin Wallace3 1 Departments of Critical Care Medicine and Emergency Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA 2Departments of Critical Care Medicine and Surgery University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA 3European Marketing Manager Critical Care Edwards Lifesciences Corresponding author Mitchell P Fink finkmp@ccm.upmc.edu Published online 27 May 2005 This article is online at http ccforum.com content 9 4 349 2005 BioMed Central Ltd See editorial page 307 http ccforum.com content 9 4 307 Critical Care 2005 9 349-359 DOI 10.1186 cc3725 Abstract A recent trial utilizing central venous oxygen saturation Scvo2 as a resuscitation marker in patients with sepsis has resulted in its inclusion in the Surviving Sepsis Campaign guidelines. We review the evidence behind Scvo2 and its relationship to previous trials of goal-directed therapy. We compare Scvo2 to other tools for assessing the adequacy of resuscitation including physical examination biochemical markers pulmonary artery catheterization esophageal Doppler pulse contour analysis echocardiography pulse pressure variation and tissue capnometry. It is unlikely that any single technology can improve outcome if isolated from an organized pattern of early recognition algorithmic resuscitation and frequent reassessment. This article includes a response to the journal s Health Technology Assessment questionnaire by the manufacturer of the Scvo2 catheter. Introduction In 2001 Rivers and coworkers 1 reported findings from a landmark investigation of early goal-directed therapy EGDT for septic shock. They hypothesized that current resuscitation strategies rely on inadequate indices of the adequacy of .