tailieunhanh - Báo cáo khoa học: "Goal directed therapy: how long can we wait"

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: Goal directed therapy: how long can we wait? | Available online http content 9 6 647 Commentary Goal directed therapy how long can we wait Anthony C Gordon1 and James A Russell2 1Clinical Research Fellow Critical Care Research Laboratories Centre for Cardiovascular and Pulmonary Research University of British Columbia Vancouver BC Canada 2Professor of Medicine Critical Care Research Laboratories Centre for Cardiovascular and Pulmonary Research University of British Columbia Vancouver BC Canada Corresponding author James A Russell jrussell@ Published online 23 November 2005 This article is online at http content 9 6 647 2005 BioMed Central Ltd Critical Care 2005 9 647-648 DOI cc3951 See related research by Pearse et al. in this issue http content 9 6 R687 and http content 9 6 R694 Abstract Intensive monitoring and aggressive management of perioperative haemodynamics goal directed therapy have repeatedly been reported to reduce the significant morbidity and mortality associated with high risk surgery. It may not matter what particular monitor is used to assess cardiac output but it is essential to ensure adequate oxygen delivery. If this management cannot begin preoperatively it is still worth beginning goal directed therapy in the immediate postoperative period. Haemodynamic monitoring and manipulation are cornerstones of critical care management. In this issue of Critical Care Pearse et al. report two interesting related studies in this area examining the effectiveness of postoperative goal directed therapy following major surgery 1 and the use of central venous saturation ScvO2 monitoring in these patients 2 . As the authors at St George s Hospital London point out despite their own work 3 and that of others 4 5 demonstrating the benefit of preoperative goal directed therapy GDT for high risk surgery patients GDT has not become routine practice. One can speculate why this might be. A lack of intensive care beds to allow preoperative admission .