The intensity of organ support: Restrictive or aggressive therapy for critically ill patients

Hongxiang Li; Yuting Li; Yao Fu; Xinyu Zhang; Dong Zhang

doi:10.1016/j.jointm.2023.04.002

The intensity of organ support: Restrictive or aggressive therapy for critically ill patients

J Intensive Med. 2023 May 25;3(4):298-302. doi: 10.1016/j.jointm.2023.04.002. eCollection 2023 Oct 31.

Authors

Hongxiang Li¹, Yuting Li¹, Yao Fu¹, Xinyu Zhang¹, Dong Zhang¹

Affiliation

¹ Department of Intensive Care Medicine, The First Hospital of Jilin University, Changchun 130021, Jilin, China.

Abstract

The intensity of organ support has received attention in recent years. To make better clinical decisions, we should understand the mechanisms and benefits, and disadvantages of the different intensities of organ support in critically ill patients. Therapeutic strategies such as supplemental oxygen therapy, mechanical ventilation, respiratory stimulant, vasoactive agents, transfusion, albumin infusion, fluid management, renal placement, and nutrition support, if they are implemented in accordance with an aggressive strategy, could result in side effects and/or complications, resulting in iatrogenic harm in critically ill patients. It is found that the intensity of organ support is not a determining factor in prognosis. A normal rather than supernormal physiological target is recommended for support therapy.

Keywords: Aggressive therapy; Critically ill patients; Organ support; Prognosis; Restrictive therapy.

Publication types

Review