TY  - CHAP
M1  - Book, Section
TI  - Chapter 22. Ventricular Dysfunction in Critical Illness
A1  - Walley, Keith R.
A2  - Hall, Jesse B.
A2  - Schmidt, Gregory A.
A2  - Wood, Lawrence D.H.
Y1  - 2005
N1  - 
T2  - Principles of Critical Care, 3e
AB  - Understanding  cardiovascular  dysfunction  in  a  critically  ill  patient  requires  consideration  of  cardiac  function  and  systemic  vascular  factors  controlling  venous  return.Compression  by  surrounding  structures  (cardiac  tamponade)  and  increased  afterload  must  be  considered  as  external  causes  or  contributors  to  cardiac  dysfunction.Decreased  ventricular  pump  function  may  be  due  to  decreased  systolic  contractility,  increased  diastolic  stiffness,  abnormal  heart  rate  and  rhythm,  or  valvular  dysfunction.Management  of  ventricular  dysfunction  aims  to  reverse  the  cause  by  optimizing  preload  and  afterload  and  correcting  abnormalities  in  heart  rhythm,  valve  function,  and  contractility.Acute  reversible  contributions  to  depressed  contractility  result  from  ischemia,  hypoxemia,  acidosis,  ionized  hypocalcemia  and  other  electrolyte  abnormalities,  myocardial  depressant  factors,  and  hypo-  and  hyperthermia.Management  of  acute-on-chronic  heart  failure  progressively  includes  oxygen;  optimizing  preload  with  diuretics,  morphine,  and  nitrates  or  fluid  infusion  for  hypovolemia;  afterload  reduction;  increasing  contractility  using  catecholamines  or  phosphodiesterase  inhibitors;  antiarrhythmic  drugs  and  resynchronization  using  biventricular  pacing;  intraaortic  balloon  counterpulsation;  and  cardiac  transplantation.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2023/10/01
UR  - accesssurgery.mhmedical.com/content.aspx?aid=2284545
ER  -