1. Treat the underlying disease process.
3. Begin basic resuscitation (airway, breathing, circulation) and then proceed to more complex manipulation of the cardiovascular system and intravascular volume:
a. maintain adequate oxygenation of the lungs;
b. establish venous access;
c. rapidily infuse colloid, crystalloid, and/or blood (if hemoglobin is less than 10 g/dl);
d. use central venous pressure or pulmonary artery pressure manometry;
e. use pulse oximetry;
f. once adequate filling has been achieved, consider the use of vasoactive drugs to achieve a specific therapeutic aim. Chapter References
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Consensus Conference (1988). Perioperative red blood cell transfusion. Journal of the American Medical Association, 260, 2700-3.
Czer, L.S.C. and Shoemaker, W.C. (1978). Optimal hematocrit value in critically ill postoperative patients. Surgery, Gynecology and Obstetrics, 147, 363-8.
Lindner, A. (1983). Synergism of dopamine and furosemide in diuretic-resistant, oliguric acute renal failure. Nephron, 33, 121-8.
Malmberg, P.O. and Woodson, R D. (1979). Effect of anemia on oxygen transport in hemorrhagic shock. Journal of Applied Physiology, 47, 882-8.
Shoemaker, W.C., Appel, P.L., Kram, H.B., Waxman, K., and Lee, T.-S. (1988). Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients. Chest, 94,
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