Applied Cardiac Physiology

Both the severity and duration of intraoperative arterial hypotension correlate directly with surgical mortality. Particularly in elderly patients, delayed or inadequate correction of hypotension comprises nearly 40% of substandard intraoperative care and is closely associated with postoperative myocardial ischemia and infarction. Prompt correction of hypotension with restoration of normal blood pressure markedly reduces subsequent morbidity. Consequently, the practicing anesthesiologist needs an efficient and effective approach for diagnosing the cause of intraoperative hypotension and providing appropriate management. This chapter examines the basic cardiovascular physiological principles that regulate blood pressure using the algorithm depicted in Figure 1 (Supplemental Digital Content 1, http://links.lww.com/ASA/A212).