The optimal endpoint of resuscitation in trauma patients

Although it has never been prospectively validated, the base excess (BE) is regarded as the standard end-point of resuscitation in trauma patients. In a rat hemorrhage model, in this edition of Critical Care, Totapally and colleagues demonstrate that the BE is an insensitive and slowly responsive indicator of changes in intravascular volume. This contrasts with changes in the esophageal-arterial carbon dioxide gap which more closely followed changes in blood volume. Esophageal or sublingual capnometry may prove to be a useful tool for monitoring the adequacy of resuscitation in trauma victims.