TY - CHAP M1 - Book, Section TI - Cardiovascular Failure A1 - Baldea, Anthony J. A1 - Posluszny Jr, Joseph A. A1 - Luchette, Fred A. A2 - Moore, Ernest E. A2 - Feliciano, David V. A2 - Mattox, Kenneth L. Y1 - 2017 N1 - T2 - Trauma, 8e AB - Cardiovascular failure is deterioration of cardiac function or vascular tone that results in impairment in end-organ perfusion. Collapse of the cardiovascular system can be either the end result of multisystem organ failure (MOF) or a manifestation of impaired cardiac function. In the acute phase of trauma, most shock is due to hemorrhage. Hemorrhagic shock leads to decreased preload or decreased right heart filling volumes, which is compensated by tachycardia and then may progress to hypotension and end-organ hypoperfusion. Cardiogenic shock alone stems from impaired myocardial contractility resulting in impairment of end organ perfusion with elevated cardiac filling pressures and low cardiac output.1 Unlike hemorrhagic shock, cardiogenic shock often does not respond simply to volume/blood product resuscitation and control of hemorrhage.2,3 Cardiogenic shock solely from impaired contractility is most often due to an acute myocardial infarction or acute on chronic heart failure.4 Therapy to support the failing cardiovascular system is directed at the etiology of the shock state and includes fluid resuscitation (preload) as well as pharmacologic modulation of vascular tone (afterload), contractility (with inotropes), and heart rate (with chronotropes). This chapter will explain the physiologic components of cardiovascular failure, assessment of patients with cardiovascular failure, treatment and monitoring (Fig. 56-1).5 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=1147420551 ER -