Affiliation:
1. From the Shock Research Unit and the Department of Medicine, University of Southern California School of Medicine, the Los Angeles County/USC Medical Center, and the Center for the Critically Ill, Hollywood Presbyterian Medical Center, Los Angeles, California.
Abstract
Blood volume was measured following onset of shock in 19 patients who had sustained acute myocardial infarction. The plasma volume was measured by dilution technique utilizing R
125
ISA and the red cell mass by (
51
Cr) red cell tag, at the time of admission.
The plasma volume in six survivors was 41.1 ± 3.3 ml/kg; in 13 fatal cases it was 44.7 ± 4.0 ml/kg; this difference was not significant. The red cell mass in four survivors was 27.2 ± 1.75 ml/kg and in four fatal cases, 24.7 ± 1.60 ml/kg. Since these measurements are within normal ranges, we excluded absolute hypovolemia as a significant factor in accounting for the circulatory failure. Infusion of fluids in amounts which maintained a positive fluid balance selectively increased the plasma volume (57.1 ± 4.4 ml/kg), cardiac index, stroke volume and central blood volume in survivors, and reversed arterial vasoconstriction and lactic acidosis. However, the plasma volume was unaffected in the fatal cases (44.4 ± 4.0 ml/kg) and this was associated with progressive hemodynamic and metabolic deterioration.
These observations support the hypothesis that recovery from shock is associated with expansion of plasma volume. To the contrary, during fatal progression of shock, plasma volume expansion does not occur despite volume loading.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Reference38 articles.
1. Quantification of myocardial damage in cardiogenic shock;Circulation,1971
2. Myocardial Changes Associated with Cardiogenic Shock
3. Hemodynamic and metabolic observations during the course of shock complicating myocardial infarction;Circulation,1967
4. Transfusion Treatment of Shock Due to Myocardial Infarction
5. Plasma and blood infusion following myocardial infarction
Cited by
25 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献