Protocol medicine

Shoemaker, W C

doi:10.1097/00003246-197409000-00010

Cited by 17 publications

(6 citation statements)

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“…In the 1970s and 1980s, the development by Swan and Ganz of the flow-directed pulmonary artery catheter gave a clearer understanding of the impact of fluids and vasoactive agents on pulmonary artery pressure, cardiac filling pressures, cardiac output, and mixed venous oxygen saturation. [18][19][20][21] Having access to invasive hemodynamic variables provided clinicians with more meaningful and reliable targets than before. This led to the concept of a goal-directed approach to hemodynamic management through the optimization of cardiac output and oxygen delivery.…”

Section: Beginnings Of Intraoperative Hemodynamic Monitoring and Therapymentioning

confidence: 99%

Perioperative Fluid and Vasopressor Therapy in 2050: From Experimental Medicine to Personalization Through Automation

Coeckelenbergh,

Vincent,

Duranteau

et al. 2024

Anesthesia &Amp; Analgesia

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Intravenous (IV) fluids and vasopressor agents are key components of hemodynamic management. Since their introduction, their use in the perioperative setting has continued to evolve, and we are now on the brink of automated administration. IV fluid therapy was first described in Scotland during the 1832 cholera epidemic, when pioneers in medicine saved critically ill patients dying from hypovolemic shock. However, widespread use of IV fluids only began in the 20th century. Epinephrine was discovered and purified in the United States at the end of the 19th century, but its short half-life limited its implementation into patient care. Advances in venous access, including the introduction of the central venous catheter, and the ability to administer continuous infusions of fluids and vasopressors rather than just boluses, facilitated the use of fluids and adrenergic agents. With the advent of advanced hemodynamic monitoring, most notably the pulmonary artery catheter, the role of fluids and vasopressors in the maintenance of tissue oxygenation through adequate cardiac output and perfusion pressure became more clearly established, and hemodynamic goals could be established to better titrate fluid and vasopressor therapy. Less invasive hemodynamic monitoring techniques, using echography, pulse contour analysis, and heart-lung interactions, have facilitated hemodynamic monitoring at the bedside. Most recently, advances have been made in closed-loop fluid and vasopressor therapy, which apply computer assistance to interpret hemodynamic variables and therapy. Development and increased use of artificial intelligence will likely represent a major step toward fully automated hemodynamic management in the perioperative environment in the near future. In this narrative review, we discuss the key events in experimental medicine that have led to the current status of fluid and vasopressor therapies and describe the potential benefits that future automation has to offer.

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Section: Beginnings Of Intraoperative Hemodynamic Monitoring and Therapymentioning

confidence: 99%

Perioperative Fluid and Vasopressor Therapy in 2050: From Experimental Medicine to Personalization Through Automation

Coeckelenbergh,

Vincent,

Duranteau

et al. 2024

Anesthesia &Amp; Analgesia

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“…The ICU has undergone several revolutions over the years, and one of them was announced by Shoemaker in 1974 14 , when he predicted that critical care would be guided by protocols in the years to come. This prediction proved to be one of the most accurate, and in fact, protocols were largely responsible for reducing adverse events and improving patient care.…”

Section: Figurementioning

confidence: 99%

Intensive care medicine and the intensivist: from 1850 to 2021

Filho

Caraccio

2022

Medicina (Ribeirão Preto)

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“…Meade and Ely emphasized in 2002 that "the use of protocols has yielded some of the most important improvements in patient mortality and morbidity. 20 Now, in the third decade of the new millennium, advanced algorithms will be responsible for boosting intensive care, and medicine in a broader sense. Machine learning is already being used, amongst other features, to prognosticate patient outcomes, 21 to predict prolonged ventilation and tracheostomy, 21 acute kidney injury, 23 hypotension in perioperative patients, 24 pressure injury, 25 volume responsiveness, 26 and the need of critical care in prehospital emergency medical services.…”

Section: Improving Critical Care: From Protocols To Advanced Algorithmsmentioning

confidence: 99%

Artificial intelligence: what should an intensivist have in mind in the beginning of the new era?

Filho¹

2021

APIC

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A new era is coming for medicine, and for critical care in particular. The intensive care unit is at the edge of being completely changed by artificial intelligence, and many challenges are ahead of the intensive care physician. This article aims to address the benefits and difficulties that big data will bring to clinicians, and to provide an overview on the subject. Key words: Big Data; Artificial intelligence; ICU; Critical Care; Black box Citation: Filho LACB. Artificial intelligence: what should an intensivist have in mind in the beginning of the new era. Anaesth. Pain intensive care 2021;25(1):8-12. DOI: 10.35975/apic.v25i1.1428 Received: 10 December 2020, Reviewed: 3 January 2021, Accepted: 8 January 2021

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Protocol medicine

Cited by 17 publications

References 0 publications

Perioperative Fluid and Vasopressor Therapy in 2050: From Experimental Medicine to Personalization Through Automation

Perioperative Fluid and Vasopressor Therapy in 2050: From Experimental Medicine to Personalization Through Automation

Intensive care medicine and the intensivist: from 1850 to 2021

Artificial intelligence: what should an intensivist have in mind in the beginning of the new era?

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