Goal-Directed Therapy for Cardiac Surgery

Crit Care Clin. 2020 Oct;36(4):653-662. doi: 10.1016/j.ccc.2020.06.004. Epub 2020 Aug 12.

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.

Keywords: Acute kidney injury; Biomarkers; Cardiac surgery; Goal-directed therapy; Monitoring.

Publication types

  • Review

MeSH terms

  • Cardiac Surgical Procedures*
  • Goals*
  • Humans
  • Length of Stay
  • Postoperative Complications