IN SEARCH OF THE OPTIMAL END-POINTS OF RESUSCITATION IN TRAUMA PATIENTS - A REVIEW

Complete resuscitation from shock is one of the primary concerns of th e surgeon taking care of injured patients, Traditionally, the return t o normalcy of blood pressure, heart rate, and urine output has been th e end point of resuscitation. Using these end points may leave a subst antial number of patients, up to 50 to 85% in some series, in ''compen sated'' shock, which if it persists may ultimately lead to the death o f the patient, Because of this potential other end points are being us ed and include supernormal values for oxygen transport variables (card iac index, oxygen delivery, and oxygen consumption), lactate, base def icit, and gastric intramucosal pH. We believe that the current data su pport the use of lactate, base deficit, and/or gastric intramucosal pH as the appropriate end points of resuscitation of trauma patients. Th e goal should be to correct one or all of three of these markers of ti ssue perfusion to normal within the initial 24 hours after injury.