Circulatory optimization of the patient with or at risk for shock

摘要: We reviewed the current literature on perioperative "optimization" of circulation and circulatory resuscitation goals in critically ill patients after (non-cardiac) surgery, sepsis or trauma, with help variables obtained by a pulmonary artery catheter. Optimization that include maximal stroke work to filling pressure relationship, an elevated (supranormal) cardiac output (>4.5 l/min/m2), O2 delivery (>600 ml/min/m2) uptake (>150-170 ml/min/m2), may ameliorate prevent tissue deficit be associated less organ failures improved survival at risk for shock. However, this policy not benefit severe deterioration preterminal illness, where increase only load heart systemic uptake. In fact, course trauma sepsis, boosting thereby decrease mortality, if prevented extrac...