THE CRITICAL CARE OF THE SEVERELY INJURED PATIENT .1. ASSESSING AND IMPROVING OXYGEN DELIVERY

The hallmark of critical care of the major trauma victim is ensuring a dequate cellular perfusion of oxygen and nutrients. Controversy exists as to the exact endpoint of therapeutic maneuvers aimed at achieving this objective. There should be general agreement, however, that there is a benefit to be gained from careful observation of clinical signs of perfusion status and bedside determinations of oxygen transport par ameters. This article discusses the pathophysiologic basis for the cli nical signs of hypoperfusion and the clinical application of the monit oring of oxygen transport parameters.