TY  - CHAP
M1  - Book, Section
TI  - Cardiovascular Failure
A1  - Bradley, Nori L.
A1  - Cotton, Bryan A.
A2  - Feliciano, David V.
A2  - Mattox, Kenneth L.
A2  - Moore, Ernest E.
PY  - 2020
T2  - Trauma, 9e
AB  - KEY  POINTSCardiac  output  (heart  rate  ×  stroke  volume)  is  determined  by  rate,  preload,  afterload,  and  contractility.Ventricular  filling  determines  left  ventricular  end-diastolic  volume,  which  in  turn  determines  the  force  of  ventricular  contraction.Hemodynamic  transesophageal  echocardiography  (TEE)  is  performed  with  a  miniaturized  two-dimensional  monoplane  disposable  TEE  probe  that  can  be  left  in  place  for  up  to  72  hours.Right  heart  failure  is  characterized  by  increased  right  ventricular  (RV)  afterload  (increased  pulmonary  resistance),  which  decreases  the  ability  of  the  RV  to  pump  blood  forward  to  the  left  heart,  thus  decreasing  left  ventricular  preload.In  valvular  aortic  stenosis,  symptoms  of  left  heart  failure  include  dyspnea  on  exertion,  angina,  lightheadedness,  and  syncope.Management  of  myocardial  dysfunction  includes  vasopressors  (eg,  norepinephrine,  vasopressin,  phenylephrine),  inotropes  (eg,  epinephrine,  dobutamine,  milrinone,  dopamine,  digoxin),  and  intra-aortic  balloon  pump  counterpulsation.A  low  mixed  venous  oxygen  saturation  occurs  with  decreased  oxygen  delivery  (decreased  hemoglobin,  oxygen  saturation,  or  flow)  or  increased  oxygen  demand  (hyperthermia,  pain,  seizure,  or  shivering).In  the  management  of  acute  heart  failure,  nitroprusside  reduces  afterload  by  acting  on  arteriolar  smooth  muscle  and  has  a  rapid  onset  of  action,  and  its  effects  cease  within  minutes  of  stopping  the  infusion.In  diastolic  dysfunction,  β-adrenergic  blockade  or  calcium  channel  blockade  reduces  heart  rate  and  increases  left  ventricular  filling,  which  reduce  mortality.Cardiac  death  or  a  myocardial  infarction  occurs  in  1%  to  5%  of  unselected  patients  undergoing  noncardiac  surgery,  and  this  concern  is  the  most  common  indication  for  a  preoperative  cardiac  evaluation.  
SN  - 
PB  - McGraw Hill
CY  - New York, NY
Y2  - 2024/04/16
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1175136598
ER  -