Assessing Adequacy of Resuscitation

  • Ram Nirula
  • Larry M. Gentilello


Resuscitation of the critically injured trauma patient has drastically changed with improved medical technology and a greater understanding of the pathophysiology of multiple organ system failure. Reliance upon urine output, heart rate and blood pressure as markers of inadequate tissue perfusion have been supplanted with thermodilution pulmonary artery catheters, gastric tonometers and near-infrared spectroscopy. These changes were fueled by recognition that, despite the return to “normal” blood pressure, heart rate and urine output, morbidity and mortality rates remained exceedingly high among critically injured. With this, the definition of shock no longer focused upon abnormal vital signs, but is now recognized as a state of inadequate tissue oxygenation. As a result, patients with compensated shock — having normal vital signs but evidence of inadequate tissue oxygenation - are now increasingly recognized.


Lactate Level Oxygen Delivery Pulmonary Artery Catheter Tissue Oxygen Tension Gastric Tonometry 
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Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Ram Nirula
  • Larry M. Gentilello

There are no affiliations available

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