Resuscitation of a polytraumatized patient with large volume crystalloid-colloid infusions--correlation between global and regional hemodynamics: case report

Aggressive large volume resuscitation is obligatory to achieve necessary tissue oxygenation. An adequate venous preload normalizes global hemodynamics and avoids multiorgan failure (MOF) and death in patients with multiple injuries. Large volume resuscitation is associated with complications in minimally monitored patients. A properly guided resuscitation procedure will finally prevent MOF and patient death. Transpulmonary thermodilution technique and gastric tonometry are used in venous preload monitoring, calculating volumetric hemodynamic variables and estimating splanchnic perfusion as well. We present a 24-year-old man with multiple injuries resuscitated with large volume infusions and monitored by transpulmonary thermodilution technique and gastric tonometry. It is very important to monitor regional hemodynamics that enables clinician to maintain the required relations between global and regional hemodynamics. It prevents the development of MOF and patient death.