Surgery
Volume 27, Issue 11 , Pages 486-491, November 2009

Management of the circulation on ICU

Wolfgang O Bauer FRCA is a Specialist Registrar in Intensive Care Medicine at the Department of General Intensive Care, St George's Hospital, London, UK

Gianpaola Monti MD is a Consultant in Intensive Care Medicine at the Department of General Intensive Care, St George's Hospital, London, UK

Maurizio Cecconi MD is a Consultant in Intensive Care Medicine at the Department of General Intensive Care, St George's Hospital, London, UK

Andrew Rhodes FRCA FRCP is a Consultant and Honorary Senior Lecturer in Anaesthesia and Intensive Care Medicine at St George's Hospital, London, UK

Abstract 

The management of the circulation of the critically ill surgical patient is a major challenge and is becoming increasingly complex. Prompt recognition and treatment of acute circulatory failure, or shock, is crucial to improve the poor prognosis that most shock states carry. While critical care specialists may be involved in the later stages of the treatment process, the recognition, diagnosis and initial management of the shocked patient will often be the responsibility of the surgical team. This article aims to describe the different types of shock, the principles of diagnosis and basic and advanced haemodynamic monitoring, and finally it provides a basic strategy for the management of circulatory failure in the critically ill.

Keywords: acute circulatory failure, haemodynamic assessment, haemodynamic monitoring, shock, shock management

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PII: S0263-9319(09)00192-6

doi:10.1016/j.mpsur.2009.09.004

Surgery
Volume 27, Issue 11 , Pages 486-491, November 2009