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 2024/04/19
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.