Principles of management

The aim is to maintain an adequate oxygen supply-demand balance within both the myocardium and the body as a whole. A decrease in cardiac output relative to the body's oxygen requirements is manifest as symptoms of poor forward flow, for example weakness, fatigue, oligoanuria, confusion, drowsiness, and tachypnea secondary to metabolic acidosis. Thus therapy should be aimed at both increasing supply and decreasing demand ( Table 1).

Table 1 Achieving an adequate oxygen supply-demand balance

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