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Clinical review: Goal-directed therapy in high risk surgical patients

Lees, N; Hamilton, M; Rhodes, A (2009) Clinical review: Goal-directed therapy in high risk surgical patients. CRITICAL CARE, 13 (5). ISSN 1466-609X https://doi.org/10.1186/cc8039
SGUL Authors: Hamilton, Mark Rhodes, Andrew

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Abstract

A small group of patients account for the majority of peri-operative morbidity and mortality. These 'high-risk' patients have a poor outcome due to their inability to meet the oxygen transport demands imposed on them by the nature of the surgical response during the peri-operative period. It has been shown that by targeting specific haemodynamic and oxygen transport goals at any point during the peri-operative period, the outcomes of these patients can be improved. This goal directed therapy includes the use of fluid loading and inotropes, in order to optimize the preload, contractility and afterload of the heart whilst maintaining an adequate coronary perfusion pressure. Despite the benefits seen, it remains a challenge to implement this management due to difficulties in identifying these patients, scepticism and lack of critical care resources.

Item Type: Article
Additional Information: © 2009 BioMed Central Ltd Licensed under the Creative Commons Attribution License 4.0
Keywords: General Surgery, Goals, Hemodynamics, Humans, Oxygen Consumption, Perioperative Care, Postoperative Complications, Science & Technology, Life Sciences & Biomedicine, Critical Care Medicine, General & Internal Medicine, CRITICAL CARE MEDICINE, RANDOMIZED CONTROLLED-TRIAL, CRITICALLY ILL PATIENTS, ORIENTED HEMODYNAMIC THERAPY, PULMONARY-ARTERY CATHETERS, ESOPHAGEAL DOPPLER MONITOR, INTRATHORACIC BLOOD-VOLUME, CARDIAC-SURGERY PATIENTS, CENTRAL VENOUS-PRESSURE, OF-THE-LITERATURE, OXYGEN DELIVERY, 11 Medical And Health Sciences
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Journal or Publication Title: CRITICAL CARE
ISSN: 1466-609X
Related URLs:
Dates:
DateEvent
25 October 2009Published
Web of Science ID: WOS:000272226000058
URI: http://openaccess.sgul.ac.uk/id/eprint/107169
Publisher's version: https://doi.org/10.1186/cc8039

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