tailieunhanh - Báo cáo khoa học: "Why is early goal-directed therapy successful – is it the technology"

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: Why is early goal-directed therapy successful – is it the technology? | Available online http content 9 4 307 Editorial Why is early goal-directed therapy successful - is it the technology Martin Chapman1 David Gattas2 and Ganesh Suntharalingam3 Assistant Professor University of Toronto Sunnybrook Women s College Health Sciences Centre Toronto Canada 2Staff Specialist Intensive Care Services Royal Prince Alfred Hospital Sydney Australia 3Consultant in Intensive Care Medicine and Anaesthesia Northwick Park St Marks Hospitals Harrow UK Corresponding author Martin Chapman Published online 27 May This article is online at http content 9 4 307 2005 BioMed Central Ltd Critical Care 2005 9 307-308 DOI cc3726 See review by Gunn and Fink page 349 http content 9 4 349 When assessing outcome studies the beneficial portion of any therapeutic strategy may not be clearly identified especially in a condition as complex as sepsis. In the randomized controlled trial conducted by Rivers and coworkers 1 early goal-directed therapy EGDT was associated with significantly improved outcomes in sepsis. The study group received a package of care that focused on early resuscitation for the first 6 hours as an inpatient. This comprised fluid including blood pressors and inotropes. The goals of resuscitation were based on hemodynamic variables and central venous oxygen saturation ScvO2 . The technology used to measure this was a central venous catheter with integrated oximetry. This device is examined in this issue of Critical Care 2 . In keeping with the style we previously adopted for technology assessment reviews the article begins with a Q A from the industry. Early resuscitation in sepsis is standard practice 3 . If the treatment effect reported by Rivers and coworkers is not due to bias in the study design then to what part s of the resuscitation package is the benefit attributable Opinions vary regarding the contribution an oximetric catheter makes in severe sepsis 4 . Previous studies of