Cardiovascular physiology for intensivists
Importance: The goal of the cardiovascular system is to maximize delivery of oxygen to organs and tissues to meet their metabolic demands. Disruption of this normal cardiac function is common in a variety of pediatric disease states that require management in an intensive care unit. These include shock, heart failure, arrhythmias, and congenital heart disease. A thorough understanding of cardiovascular physiology is essential in the successful management of these cardiovascular derangements. This chapter reviews the hemodynamic principles of circulatory flow, the processes that regulate the mechanical function of the heart, the determinants of cardiac output, the cardiopulmonary interactions of the heart, and the relationship between the right and left side of the heart. Observations: Our understanding of cardiovascular function and regulatory mechanisms as it relates to the management of pediatric patients in the intensive care unit has improved over recent years. The incorporation of these new physiologic principles into therapeutic and surgical interventions has been important in the management of pediatric cardiovascular disease by critical care providers. Conclusions and Relevance: An understanding of cardiovascular physiology is the foundation of medical and surgical management of pediatric patients in the intensive care unit.
