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Báo cáo y học: " Perioperative goal directed haemodynamic therapy – do it, bin it, or finally investigate it properly"

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: Perioperative goal directed haemodynamic therapy – do it, bin it, or finally investigate it properly? | Available online http ccforum.eom content 11 5 170 Commentary Perioperative goal directed haemodynamic therapy - do it bin it or finally investigate it properly Stephen Drage and Owen Boyd The General Intensive Care Unit Brighton and Sussex University Hospitals Eastern Road Brighton BN2 5BE UK Corresponding author Owen Boyd owen.boyd@bsuh.nhs.uk Published 26 October 2007 This article is online at http ccforum.com content 11 5 170 2007 BioMed Central Ltd Critical Care 2007 11 170 doi 10.1186 cc6130 See related research by Lopes et al. http ccforum.com content 11 5 R100 Abstract The literature concerning the use of goal directed haemodynamic therapy GDHT in high risk surgical patients has been importantly increased by the study of Lopes and colleagues. Using a minimally invasive assessment of fluid status and pulse pressure variation monitoring during mechanical ventilation improvements were seen in post-operative complications duration of mechanical ventilation and length of hospital and intensive care unit ICU stay. Many small studies have shown improved outcome using various GDHT techniques but widespread implementation has not occurred. Those caring for perioperative patients need to accept the published evidence base or undertake a larger multi-centre study. In this issue Lopes and colleagues 1 add to the list of studies investigating the concept of goal directed haemodynamic therapy GDHT . GDHT in high risk surgical patients has been investigated for over 20 years 2 . A variety of strategies and monitoring modalities have been applied and in general have resulted in improved patient outcomes 3 . We have worked through pulmonary artery catheters Doppler probes and less invasive methods of cardiac output measurement but the recent paper is the first to use a truly minimally invasive technique to assess the requirement for further fluid infusions above normal perioperative care. In their study of goal directed fluid management based on pulse pressure variation .