Experimental Cardiogenic Shock

Bloch, Jack H.; Pierce, Charles H.; Manax, William G.; Lyons, Gary W.; Lillehei, Richard C.

doi:10.1001/archsurg.1965.01320130079011

Cited by 15 publications

(7 citation statements)

References 8 publications

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“…Bloch et al [3] and Lillehei et al [10] have advocated the use of a-receptor blocking agents to establish an effective blood flow through the microcirculation by reducing the high vascular tone in the viscerocutaneous areas. This approach appears logical in patients with the clinical evidence of vasoreactive shock.…”

Section: Therapymentioning

confidence: 99%

Clinical Appraisal of Shock Following Acute Myocardial Infarction

Mir¹,

Rees²,

Yahya³

et al. 1974

Cardiology

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An attempt has been made to define clinically recognizable forms of cardiogenic shock. ‘Vasoreactive’ shock, characterized by a cold and sweaty skin, oliguria and moderate to gross mental dysfunction, was managed by reducing the vascular resistance with phenoxybenzamine. ‘Vasolytic’ shock, suggested by a grey or flushed facies, slightly reduced urinary output, and mild to moderate mental impairment, was treated with aramine. Patients with clinical features between these two extremes (‘intermediate’ group) were initially treated according to the most prominent clinical features. Further management was based on the assessment of easily measurable parameters such as central venous pressure, acid-base status, arterial pressure, temperature, etc. The mortality rate of the entire group of 31 patients was 42%.

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Section: Therapymentioning

confidence: 99%

Clinical Appraisal of Shock Following Acute Myocardial Infarction

Mir¹,

Rees²,

Yahya³

et al. 1974

Cardiology

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“…It is possible that in some forms of cardiogenic shock, for example, after cardiac surgery, it would be possible to buffer the patient with alpha blockers. 9 In myocardial infarction, however, it is not yet possible to recognize a preshock stage and alpha blockade cannot be recommended as prophylaxis. Studies with alphablocking drugs in cardiogenic shock are sparse, and at least one major group in this field considers acute myocardial infarction, which is perhaps the commonest cause of cardiogenic shock, an absolute contraindication to alpha blockers.…”

Section: Hemolysis Equipmentmentioning

confidence: 99%

“…2 In animal models, in which cardiogenic shock results from coronary artery microsphere embolization, favorable results have been reported with alpha blockers. 9 However, the pathology of microsphere embolization differs from coronary obstruction in man, since in the latter, in addition to the occluded arteries, there are numerous stenotic placques in other arteries which tend to lower perfusion pressure in the uninfarcted ischemic portions of the myocardium. In order to continue perfusion of these areas of uninfarcted myocardium, it is essential to maintain sufficiently high aortic diastolic pressures.…”

Section: Hemolysis Equipmentmentioning

confidence: 99%

Cardiogenic shock: A review

Perlroth

Harrison

1969

Clin Pharma and Therapeutics

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A great expansion of interest has occurred in the syndrome of circulatory shock. The measurement of hemodynamic and metabolic variables in human beings and experimental animals now allows an orderly and integrated approach to the ill patient. In cardiogenic shock the minute output of the acutely iniured heart abruptly decreases with attendant fall in arterial blood pressure, tissue perfusion, and pH. Effective venous return to the right and left heart may be monitored by central venous pressure and pulmonary artery diastolic pressure. If low, infusion of volume expanders alone may be sufficient to reverse the shock syndrome. If drugs are required, a variety of catecholamines with alpha and beta stimulating properties are available, as well as inotropic agents such as digitalis and glucagon. Principles for their selection are discussed. The potential roles and hazards of alpha-and beta-adrenergic blocking agents and steroids are also considered. When limits of pharmacologic resuscitation have been reached, mechanical aid and surgical assistance to the cardiovascular system are available. The latter promises to pe of greater importance in the future.

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“…These findings are confirmed by observations of Hinshaw et al (1960), Hunt et al (1967), Korolkov & Koziner (1967a, b), Schmidt & Bokenkamp (1967) and Whitmore (1967). Certainly more data are needed, especially regarding regional differences (Race, Cooper & Rosenbaum, 1968 (Lepley et al, 1963;Johnston, Pearson & Murphy, 1964;McPherson & Haller, 1964;Schenk et al, 1964;Greenfield & Blalock, 1964;Schumer, 1967;Takaori & Safar, 1967), endotoxic (Lillehei et al, 1964;O'Neill & Foster, 1964;Wiznitzer & Rozin, 1965), exotoxic (Atik et al, 1967) and cardiogenic (Bloch et al, 1965); and clinical (Bergentz et al, 1961;Baker et al, 1964;Carey et al, 1965a, b;Cohn & Luria, 1965;Gunnar et al, 1967;.…”

Section: Effect On the Rheological Properties Of Bloodmentioning

confidence: 99%

Volume expansion and flow promotion in shock

Gruber

1969

Postgraduate Medical Journal

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Summary Volume replacement is the most important step in treating hypovolaemic shock. Blood is needed when the oxygen carrying capacity threatens to fall below a critical level, but has the disadvantage of transmitting virus hepatitis. Anicteric hepatitis is about four times more frequent than the icteric form. Pasteurized plasma protein solution and albumin are free from the risk of transmitting hepatitis virus, and are good volume restorers. Dextran 70 represents the best artificial colloid with additional anti-thrombotic properties. Dextran 40 is indicated in special situations to promote flow. There is no proof that large amounts of Ringer solution are superior for treating hypovolaemic shock in man compared with colloids and electrolytes.

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Experimental Cardiogenic Shock

Cited by 15 publications

References 8 publications

Clinical Appraisal of Shock Following Acute Myocardial Infarction

Clinical Appraisal of Shock Following Acute Myocardial Infarction

Cardiogenic shock: A review

Volume expansion and flow promotion in shock

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