Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Shockingly complex: the difficult road to introducing new ideas to critical care. | Available online http content 8 6 419 Commentary Shockingly complex the difficult road to introducing new ideas to critical care William J Sibbald Professor of Medicine Critical Care Physician-in-Chief Department of Medicine Sunnybrook and Women s College Health Science Centre Toronto Ontario Canada Corresponding author William J Sibbald Published online 1 October 2004 This article is online at http content 8 6 419 2004 BioMed Central Ltd See Review page 462 Critical Care 2004 8 419-421 DOI cc2962 Abstract Resuscitation of critically ill patients with trauma or sepsis continues to challenge clinicians. Early imperatives include diagnostic judgment as to the presenting problem - sepsis or trauma. Subsequently the clinician decides on the phase of resuscitation required for support - ebb versus flow . Finally the clinician needs to determine what therapeutic strategies to employ and then judge when resuscitation is complete. Shortcomings of current approaches to determining the adequacy of circulatory resuscitation have prompted the evaluation of new technologies purported to directly assess microcirculatory flow as a clinical endpoint for the adequacy of resuscitation. While early studies are intriguing this technology requires much more study before it can be considered for widespread adoption by the clinician. Keywords circulatory resuscitation microcirculatory resuscitation sepsis therapeutic strategies In their review Spronk and colleagues 1 address some of the very real dilemmas faced by clinicians during the resuscitation of critically ill patients with trauma or sepsis. Having made a diagnostic judgment as to the presenting problem - sepsis or trauma - the clinician must next decide on the phase of resuscitation that the patient is in - flow phase versus ebb phase 2 . Finally the clinician must determine what therapeutic strategies to employ and judge when resuscitation is complete. In this commentary I .
