Early Goal-Directed Invasive and Noninvasive Monitoring of High Risk Postoperative and Septic Surgical Patients Improves Outcome

  • W. C. Shoemaker
Conference paper


Diagnosis of shock at the very earliest time may be difficult because shock is routinely recognized by imprecise signs and subjective symptoms that are observer-dependant. By contrast, shock is easy to recognize in the late stages when therapy may be ineffective. If shock could be recognized earlier and treated more vigorously to physiologic endpoints, improved outcome might be anticipated. A major problem is that shock is routinely recognized by unstable vital signs such as falling blood pressure and tachycardia plus altered mental status, cold clammy skin, weak thready pulse, and other subjective signs and symptoms. However, it is not until after the patient reaches the ICU that haemodynamic measurements are made.


Septic Shock Septic Shock Patient Invasive Monitoring High Risk Surgical Patient Oxygen Debt 
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Copyright information

© Springer-Verlag Italia 1999

Authors and Affiliations

  • W. C. Shoemaker
    • 1
  1. 1.Dept. of Anaesthesiology and SurgeryUniversity of Southern California School of MedicineLos AngelesUSA

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