Goal-Directed Therapy for Cardiac Surgery.

Kevin W Lobdell, Subhasis Chatterjee, Michael Sander

Journal: Critical care clinics 2021;36(4):653-662

PMID: 32892819

Full Text on Elsevier Science View on PubMed

Abstract

Goal-directed therapy couples therapeutic interventions with physiologic and metabolic targets to mitigate a patient's modifiable risks for death and complications. Goal-directed therapy attempts to improve quality-of-care metrics, including length of stay, rate of readmission, and cost per case. Debate persists around specific parameters and goals, the risk profiles that may benefit, and associated therapeutic strategies. Goal-directed therapy has demonstrated reduced complication rates and lengths of stay in noncardiac surgery studies. Establishing goal-directed therapy's early promise and role in cardiac surgery-namely, producing fewer complications and deaths-will require larger studies, including those with greater focus on high-risk patients.

Address: Atrium Health Cardiothoracic Surgery, Atrium Health's Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA. Electronic address: [email protected].; Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM 390, Houston, TX 77030, USA; Division of Cardiovascular Surgery, Texas Heart Institute, Houston, TX, USA. Electronic address: https://twitter.com/SXC71.; Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Giessen, Justus-Liebig University Giessen, Rudolf-Buchheim-Strasse 7, Giessen 35392, Germany; Charity Medical University, Berlin, Germany. Electronic address: https://twitter.com/Mich_San_d.

DOI: 10.1016/j.ccc.2020.06.004

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MeSH Terms: Cardiac Surgical Procedures, Goals, Humans, Length of Stay, Postoperative Complications