The history of goal-directed therapy and relevance to cardiopulmonary bypass

Abstract

Goal-directed therapy is a patient care strategy that has been implemented to improve patient outcomes. The strategy includes aggressive patient management and monitoring during a period of critical care. Goal-directed therapy has been adapted to perfusion and has been designated goal-directed perfusion (GDP). Since this is a new concept in perfusion, the purpose of this study is to review goal-directed therapy research in other areas of critical care management and compare that process to improving patient outcomes following cardiopulmonary bypass. Various areas of goaldirected therapy literature were reviewed, including fluid administration, neurologic injury, tissue perfusion, oxygenation, and inflammatory response. Data from these studies was compiled to document improvements in patient outcomes. Goal-directed therapy has been demonstrated to improve patient outcomes when performed within the optimal time frame resulting in decreased complications, reduction in hospital stay, and a decrease in morbidity. Based on the successes in other critical care areas, GDP during cardiopulmonary bypass would be expected to improve outcomes following cardiac surgery.