Oxygen transport optimization

Increasing evidence indicates that in critically ill surgical patients, ear ly resuscitation using hemodynamic goals, such as oxygen delivery, has a fa vorable effect on the survival rate. The key issues include: a) prompt resu scitation when the tissues are still responsive to oxygen; b) early payment of oxygen debt; and c) prevention of multisystem organ failure. There is t he current dilemma of identifying early shock states since abnormalities of the traditional parameters (blood pressure, heart rate, and urine output) may be late signs. Identification of high-risk patients relies on our clini cal judgment based on the type of injury, underlying comorbidity (especiall y cardiopulmonary disease), patient's age, and the time elapsed from injury . One oxygen delivery value cannot suit all patients at each period of the pa tient's illness and recovery. Judicious augmentation of oxygen transport is a clinically useful and readily available tool. Early utilization of pulmo nary artery catheters and optimization of oxygen transport play important r oles in the acute resuscitation of severely injured patients.