Resuscitation end points in severe sepsis: central venous pressure, mean arterial pressure, mixed venous oxygen saturation, and... intra-abdominal pressure.

摘要

Severe sepsis is widely recognized as a significant cause of morbidity and mortality in the critically ill. The appropriate treatment strategy has long been the subjectof controversy and has centered on the pros and cons of crystalloid vs. colloid, fluids vs. vasopressors, and steroids vs. no steroids. In recent years, however, an algorithmic evidence-based approach to the treatment of severe sepsis has been advocated by the Surviving Sepsis Campaign and broadly adopted worldwide (1). This strategy includes the use of goal-directed fluid and norepinephrine administration to restore systemic perfusion and oxygenation and ultimately improve patient survival. Resuscitation endpoints, such as central venous pressure, mean arterial pressure, and mixed venous oxygen saturation, are central to this approach.