RT Book, Section A1 Vincent, Jean-Louis A2 Longnecker, David E. A2 Mackey, Sean C. A2 Newman, Mark F. A2 Sandberg, Warren S. A2 Zapol, Warren M. SR Print(0) ID 1144135438 T1 Hemodynamic Support of the Critically Ill Patient T2 Anesthesiology, 3e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071848817 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1144135438 RD 2024/10/08 AB KEY POINTSEarly and adequate resuscitation of patients with acute circulatory failure is important to restore the balance between oxygen needs and delivery. Effective resuscitation can result in improved outcomes.Fluid resuscitation should be guided by repeated fluid challenges. Signs of fluid responsiveness can be explored in mechanically ventilated patients who are sedated. Passive leg raising is a relatively complex procedure.If fluid administration is insufficient to rapidly restore an adequate tissue perfusion pressure, vasopressors may be required even transiently; norepinephrine is currently considered the best first-line choice.Inotropes or vasodilator drugs may be needed to improve myocardial contractility and cardiac output. Dobutamine remains the inotropic agent of choice.Hemodynamic support should be titrated to the individual patient according to global parameters of hemodynamic and oxygenation status, supported by regional parameters when available.