Mikel Rothenberg says:


I'm sure you've heard of the Houston study where
they claimed it didn't make a difference....NOT a "clean" study -- very
specific patients in one system, and the "no fluid" patients actually got ~
2000 cc of fluid, by my reading of the article.  What Pepe and colleagues
HAVE nicely done is to open our minds to our goals -- do we just want a BP of
90 or greater, or do we want optimal tissue perfusion.  I know of no
evidence, animal or human, that proves that a BP of 90 mm HG assures ideal
tissue perfusion.  Maybe we can do this with lower/higher pressures -- maybe
a lower pressure will work, and reduce active bleeding -- some of the animal
data suggests that a mean BP of 40 mm Hg is better for survival than 90 mm
Hg....And that's not all -- the critical care literature for years has
suggested that there is absolutely no correlation between BP, tissue oxygen
delivery, etc......