ABSTRACT
Optimum cardiovascular management of critically ill trauma patients often requires accepting hemodynamic indices that are reasonable rather than normal. When clinicians insist upon pushing the patient’s hemodynamic system toward normal or even supranormal targets, iatrogenic complications can occur (1)
This chapterprovides the trauma intensivistwithareview of reasonable hemodynamic goals in hypertensive patients by surveying the normal cardiovascular indices during health, and explaining how these parameters are altered by trauma andcritical illness (1-4).This chapter also reviews thevasoactive drugs commonly used in trauma and critical care. A complete review of cardiovascular physiology is presented in Volume 2, Chapter 3 and cardiovascular monitoring in Chapter 9. Accordingly, these topics are only briefly reviewed here. The optimum management for both hypotension and significant hypertension is summarized for the most common etiologies. Optimum hemodynamic management is based upon (i ) the immediate cause of hypotension or hypertension, (ii ) the presence of concomitant injuries, and (iii ) the baseline medical conditions affecting the patient.
