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Open AccessReview

A Physiologic Approach to Hemodynamic Monitoring and Optimizing Oxygen Delivery in Shock Resuscitation

1
Division of Pulmonary, Critical Care, Hyperbaric, Allergy, and Sleep Medicine, Loma Linda University, Loma Linda, CA 92354, USA
2
Department of Emergency Medicine, Loma Linda University, Loma Linda, CA 92354, USA
3
Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI 48202, USA
4
Surgical Critical Care, Henry Ford Hospital, Detroit, MI 48202, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(7), 2052; https://doi.org/10.3390/jcm9072052
Received: 25 May 2020 / Revised: 18 June 2020 / Accepted: 27 June 2020 / Published: 30 June 2020
The approach to shock resuscitation focuses on all components of oxygen delivery, including preload, afterload, contractility, hemoglobin, and oxygen saturation. Resuscitation focused solely on preload and fluid responsiveness minimizes other key elements, resulting in suboptimal patient care. This review will provide a physiologic and practical approach for the optimization of oxygen delivery utilizing available hemodynamic monitoring technologies. Venous oxygen saturation (SvO2) and lactate will be discussed as indicators of shock states and endpoints of resuscitation within the framework of resolving oxygen deficit and oxygen debt. View Full-Text
Keywords: shock; resuscitation; hemodynamic monitoring; fluid responsiveness; stroke volume; venous oxygen saturation; lactate; oxygen delivery shock; resuscitation; hemodynamic monitoring; fluid responsiveness; stroke volume; venous oxygen saturation; lactate; oxygen delivery
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MDPI and ACS Style

Russell, A.; Rivers, E.P.; Giri, P.C.; Jaehne, A.K.; Nguyen, H.B. A Physiologic Approach to Hemodynamic Monitoring and Optimizing Oxygen Delivery in Shock Resuscitation. J. Clin. Med. 2020, 9, 2052.

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