Noninvasive Cardiac Output Monitors: A State-of the-Art Review
2012; Elsevier BV; Volume: 27; Issue: 1 Linguagem: Inglês
10.1053/j.jvca.2012.03.022
ISSN1532-8422
Autores Tópico(s)Sepsis Diagnosis and Treatment
ResumoDESPITE IMPROVEMENTS in resuscitation and supportive care, progressive organ dysfunction occurs in a large proportion of patients with acute, life-threatening illnesses and those undergoing major surgery. 1 Sakr Y. Dubois M.J. De Backer D. et al. Persistent microcirculatory alterations are associated with organ failure and death in patients with septic shock. Crit Care Med. 2004; 32: 1825-1831 Crossref PubMed Scopus (475) Google Scholar , 2 Dewar D. Moore F.A. Moore E.E. et al. Postinjury multiple organ failure. Injury. 2009; 40: 912-918 Abstract Full Text Full Text PDF PubMed Scopus (74) Google Scholar , 3 Cohn S.M. Nathens A.B. Moore F.A. et al. Tissue oxygen saturation predicts the development of organ dysfunction during traumatic shock resuscitation. J Trauma. 2007; 62: 44-55 Crossref PubMed Scopus (133) Google Scholar , 4 Patila T. Kukkonen S. Vento A. et al. Relation of the sequential organ failure assessment score to morbidity and mortality after cardiac surgery. 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N Engl J Med. 2001; 345: 1368-1377 Crossref PubMed Scopus (4386) Google Scholar showed that a protocol of early goal-directed therapy reduces organ failure and improves survival in patients with severe sepsis and septic shock. Similarly, optimization of cardiac output (CO) in patients undergoing major surgery has been shown to reduce postoperative complications and the length of stay. 8 Lopes M.R. Oliveira M.A. Pereira V.O. et al. Goal-directed fluid management based on pulse pressure variation monitoring during high-risk surgery: A pilot randomized controlled trial. Crit Care. 2007; 11: R100 Crossref PubMed Scopus (169) Google Scholar , 9 Polonen P. Ruokonen E. Hippelainen M. et al. A prospective, randomized study of goal-oriented hemodynamic therapy in cardiac surgical patients. Anesth Analg. 2000; 90: 1052-1059 Crossref PubMed Google Scholar , 10 Gan T.J. Soppitt A. Maroof M. et al. 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Anesth Analg. 2011; 112: 1392-1402 Crossref PubMed Scopus (163) Google Scholar By contrast, excessive fluid resuscitation has been associated with increased complications, increased lengths of intensive care unit and hospital stay, and increased mortality. 14 Boyd J.H. Forbes J. Nakada T. et al. Fluid resuscitation in septic shock: A positive fluid balance and elevated central venous pressure increase mortality. Crit Care Med. 2011; 39: 259-265 Crossref PubMed Scopus (163) Google Scholar , 15 Maitland K. Kiguli S. Opoka R.O. et al. Mortality after fluid bolus in African children with severe infection. N Engl J Med. 2011; 364: 2483-2495 Crossref PubMed Scopus (205) Google Scholar , 16 de-Madaria E. Soler-Sala G. Sanchez-Paya J. et al. Influence of fluid therapy on the prognosis of acute pancreatitis: A prospective cohort study. Am J Gastroenterol. 2011; 106: 1843-1850 Crossref PubMed Scopus (32) Google Scholar , 17 Rosenberg A.L. Dechert R.E. Park P.K. et al. 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