From the classroom to the emergency room, O-R and beyond. You're joining trauma ICU rounds with your

host, Dr. Dennis Kim. For this talk, I was actually going through previous PowerPoints and

presentations to see what I could scavenge and incorporate into this one. And I realized that it's

been approximately five years to the month that I actually gave my first grand rounds at UCLA.

And so it's a real honor to be invited back to share with you a little bit in terms of what's

been happening kind of behind the scenes as well as on the scenes with regards to endpoints of resuscitation.

And whether you're a trauma surgeon, an anesthesia intensivist, or an emergency medicine,

physician, or healthcare professional, I think understanding the importance of determining which

endpoints we want to use in the resuscitation of our patients is critically

important. And so over the next 45 minutes or so, we're going to go over some of the state of

the art in terms of the various hemodynamic, metabolic, as well as regional endpoints of resuscitation.

And I have no disclosures. And in terms of the outline for this talk, we're

going to first talk about shock. And of course, this will be a general overview of what we mean by

shock, the classification of shock as well as stages of shock. And then the vast majority of this talk

is really going to focus in on endpoints of resuscitation.

And as I mentioned, there's three key endpoints.

And the vast majority of this discussion is going to focus on hemodynamics.

Because I think this is really where there's been a lot of progress made in terms of how we can

apply both static, but more importantly, dynamic measures of fluid

responsiveness in order to determine our endpoints of resuscitation and kind of find that balance

between where we want to start to throttle back in terms of our volume and crystalloid resuscitation and start to think about de-resuscitation,

which is becoming a more important topic these days. In the past, we used to say you have to swell to

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