Pharmacologic support of the failing heart.
Cardiovascular failure in critically ill patients carries a high mortality. Identification and treatment of the underlying etiology simultaneously with prompt therapy are indicated to avoid the consequences of prolonged shock. Physicians should assess patients using all available clinical, radiologic, and laboratory data to avoid the pitfalls associated with use of single measures of regional or global perfusion. Continued evidence of inadequate perfusion despite fluid resuscitation warrants consideration of placement of a pulmonary artery catheter or pharmacologic support of the cardiovascular system. Finally, the dynamic nature of physiology in critically ill patients requires constant patient reassessment and flexibility in treatment to tailor therapy individually as the pathologic state evolves.
London
Jason A
JA
Department of Surgery, Division of Trauma and Emergency Surgery, University of California, Davis Medical Center, 2315 Stockton Boulevard, Suite 4209, Sacramento, CA 95817, USA. jason.london@ucdmc.ucdavis.edu
Sena
Matthew J
MJ
D000465:Algorithms; D001808:Blood Vessels / Q000294:innervation; D002407:Catheterization, Swan-Ganz; D005938:Glucocorticoids / Q000627:therapeutic use; D006321:Heart / Q000294:innervation; D006329:Heart Conduction System / Q000503:physiopathology; D006331:Heart Diseases / Q000188:drug therapy*; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy; D010101:Oxygen Consumption; D012770:Shock, Cardiogenic / Q000188:drug therapy; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use; D014667:Vasopressins / Q000627:therapeutic use
D005938:Glucocorticoids; D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents; D014667:Vasopressins