Review Article

The History of Goal-Directed Therapy and Relevance to Cardiopulmonary Bypass

Address correspondence to: Joseph J. Sistino, PhD, CCP, Division of Cardiovascular Perfusion, College of Health Professions, Medical University of South Carolina, 151B Rutledge Avenue, MSC 962, Charleston, SC 29425. E-mail: sistinoj@musc.edu

Received: 2 December 2014
Accepted: 17 May 2015

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 goal-directed 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.