Endpoints of Resuscitation of Critically Injured Patients: Normal or Supranormal?

Velmahos, George C.; Δημητριάδης, Δημήτριος; Shoemaker, William C.; Chan, Linda S.; Tatevossian, Raymond; Wo, Charles C.J.; Vassiliu, Pantelis; Cornwell, Edward E.; Murray, James A.; Roth, Bradley J.; Belzberg, Howard; Asensio, Juan A.; Berne, Thomas V.

doi:10.1097/00000658-200009000-00013

Cited by 192 publications

(105 citation statements)

References 22 publications

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“…Supporters of early aggressive resuscitation in acute bleeding thought that the need to improve perfusion of vital organs was more important than any risk of aggravating hemorrhage. 39 Patients in severe hemorrhagic shock benefit from the use of intravenous crystalloids and colloids along with blood products. 40 In patients whose hemorrhage can not be controlled, infusion of large volumes of fluid results in increased blood loss.…”

Section: Discussionmentioning

confidence: 99%

Permissive Hypotension in Bleeding Trauma Patients: Helpful or Not and When?

Gourgiotis

Gemenetzis

Kocher

et al. 2013

Critical Care Nurse

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T rauma remains the leading cause of mortality among persons 1 to 44 years old in the United States 1 and accounts for almost 9% of total mortality worldwide. 2 In 2008 a total of 663000 injury-related deaths occurred in Europe (6.9% of total deaths). 2 Uncontrolled bleeding and exsanguination are the leading cause of preventable death after trauma 3 and require early detection of potential bleeding sources and prompt action to minimize blood loss, restore tissue perfusion, and achieve a stable hemodynamic status. Permissive Hypotension in CNE Continuing Nursing EducationCover Severity of hemorrhage and rate of bleeding are fundamental factors in the outcomes of trauma. Intravenous administration of fluid is the basic treatment to maintain blood pressure until bleeding is controlled. The main guideline, used almost worldwide, Advanced Trauma Life Support, established by the American College of Surgeons in 1976, calls for aggressive administration of intravenous fluids, primarily crystalloid solutions. Several other guidelines, such as Prehospital Trauma Life Support, Trauma Evaluation and Management, and Advanced Trauma Operative Management, are applied according to a patient's current condition. However, the ideal strategy remains unclear. With permissive hypotension, also known as hypotensive resuscitation, fluid administration is less aggressive. The available models of permissive hypotension are based on hypotheses in hypovolemic physiology and restricted clinical trials in animals. Before these models can be used in patients, randomized, controlled clinical trials are necessary. (Critical Care Nurse. 2013;33[6]:18-25)

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Section: Discussionmentioning

confidence: 99%

Permissive Hypotension in Bleeding Trauma Patients: Helpful or Not and When?

Gourgiotis

Gemenetzis

Kocher

et al. 2013

Critical Care Nurse

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“…Compensatory mechanisms for progressive euvolemic anemia include not only an increase in cardiac output (increased left ventricular emptying and tachycardia) but also a change in the oxygen extraction ratio from the erythrocyte itself. Prospective randomized trials [42][43][44] and an additional meta-analyses [38][39][40][41][42][43][44] have failed to confirm the benefit of achieving supranormal values of oxygen delivery and oxygen use. They have also raised the possibility that this strategy may result in worse clinical outcomes and increased mortality.…”

Section: Oxygen Transportmentioning

confidence: 99%

Blood Tranfusion in Critically Ill Patients: State of the Art

Hajjar¹,

Jo²,

Santos³

et al. 2007

Clinics

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“…Study or Subgroup Bishop, 1995Boldt, 1998Chytra, 2007Fleming, 1992Lobo, 2000Lobo, 2006Lopes, 2007Shoemaker, 1988Shultz, 1985 Total (95% CI) Total events Heterogeneity: Chi² = 3.01, df = 6 (P = 0.81); I² = 0% Test for overall effect: Z = 4.92 (P < 0.00001) Bender, 1997Berlauk, 1991Bishop, 1995Boldt, 1998Bonazzi, 2002Boyd, 1993Fleming, 1992Lobo, 2000Lobo, 2006Polonen, 2000Sandham, 2003Shoemaker, 1988Shultz, 1985Takala, 2000Ueno, 1998Valentine, 1997Velmahos, 2000Wilson, 1999 Ziegler, 1997…”

Section: Resultado: Disfunções Orgânicasmentioning

confidence: 99%

“…Bender, 1997 Berlauk, 1991Bishop, 1995Boldt, 1998Bonazzi, 2002Boyd, 1993Chytra, 2007Conway, 2002Donati, 2007Fleming, 1992Gan, 2002Kapoor, 2008Lobo, 2000Lobo, 2006Lopes, 2007Mythen, 1995Pearse, 2005Polonen, 2000Sandham, 2003Shoemaker, 1988Shultz, 1985Sinclair, 1997Stone, 2003Takala, 2000Ueno, 1998Valentine, 1997Velmahos, 2000Venn, 2002Wakeling, 2005Wilson, 1999 Ziegler, 1997…”

Section: Study or Subgroupmentioning

confidence: 99%

“…Total events Heterogeneity: Chi² = 36.08, df = 17 (P = 0.004); I² = 53% Test for overall effect: Z = 3.01 (P = 0.003) Bender, 1997Berlauk, 1991Bishop, 1995Boldt, 1998Bonazzi, 2002Boyd, 1993Fleming, 1992Kapoor, 2008Lobo, 2000Lobo, 2006Pearse, 2005Sandham, 2003Shoemaker, 1988Takala, 2000Ueno, 1998Valentine, 1997Velmahos, 2000Wilson, 1999 Total (95% CI) Total events Heterogeneity: Chi² = 29.12, df = 15 (P = 0.02); I² = 48% Test for overall effect: Z = 2.54 (P = 0.01) Heyland (1996), talvez a primeira revisão sistemática sobre estudos clínicos aleatórios designados para atingir valores supranormais de IC, IDO2 e IVO2 em pacientes críticos, atribuiu um rigor metodológico e selecionou apenas sete artigos de 64 identificados e concluiu que existe uma tendência não estatisticamente significativa de diminuição da taxa de mortalidade, risco Assim, há a necessidade de constante atualização científica para esse assunto tão complexo e contraditório, motivando esta revisão sistemática e todas as outras que ainda virão, na tentativa de elucidar, baseada na melhor evidência possível, todas as questões pertinentes (Cook and Guyatt 1994).…”

Section: Total (95% Ci)unclassified

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Revisão sistemática dos marcadores de otiminização da perfusão tecidual em ensaios clínicos aleatórios de cirurgias de alto risco

Gurgel¹

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Endpoints of Resuscitation of Critically Injured Patients: Normal or Supranormal?

Cited by 192 publications

References 22 publications

Permissive Hypotension in Bleeding Trauma Patients: Helpful or Not and When?

Permissive Hypotension in Bleeding Trauma Patients: Helpful or Not and When?

Blood Tranfusion in Critically Ill Patients: State of the Art

Revisão sistemática dos marcadores de otiminização da perfusão tecidual em ensaios clínicos aleatórios de cirurgias de alto risco

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