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Monitoring Modalities, Assessment of Volume Status, and Endpoints of Resuscitation2015

Type: Update Practice Management Guideline (PMG)
Existing PMG/EBR: Resuscitation Endpoints
Category: Surgical Critical Care
Committee Liaison: Vicki J Bennett, RN, MSN


This Practice Management Guideline has been accepted for publication by the Journal of Trauma and Acute Care Surgery - January 2018 Issue. J Trauma. 84(1):37-49, January 2018

Team leader(s)

Since the 2004 EAST Practice Management Guideline for Endpoints of Resuscitation(1) were posted, there have been ongoing investigations of shock resuscitation to include non-invasive monitoring. We propose an update to this PMG. We will review the expanding definition of clinically useful endpoints, the monitoring of resuscitation from shock and the various determinants of volume status. While lactate, base deficit and gastric tonometry were considered most relevant (level II) in the 2004 PMG, measures of tissue oxygenation (PtO2/PtCO2 and NIRS) were evolving as a monitoring tool (level III) and hemodynamic ultrasound was not specifically assessed. Our population will be defined as trauma patients in shock having had the source of hemorrhage surgically controlled. With the benefit of investigations performed since the first PMG, we will compare the various methods of monitoring resuscitative progress with the outcome being the usefulness to predict mortality or organ dysfunction. (1)Tisherman SA, Barie P, Bokhari F, et al. Clinical practice guideline: endpoints of resuscitation. J Trauma. 2004; 57 (4): 898-912

Guidelines Volunteers
Vicki Bennett, RN, MSN
Rachael Callcut, MD, MSPH
William C. Chiu, MD
Philipp Dahm, MD, MHSc
Samuel M. Galvagno, DO, PhD
Mark E. Hamill, MD
Lydia Lam, MD
Clinton Kakazu, MD
Uzer Khan, MD, MBBS
Dennis Kim, MD
Ali S. Raja, MD, MBA, MPH
Samuel A. Tisherman, MD
Jeremy Ward, MD

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