Hypovolemia in Shock Due to Acute Myocardial Infarction

Author:

LOEB HENRY S.1,PIETRAS RAYMOND J.1,TOBIN JOHN R.1,GUNNAR ROLF M.1

Affiliation:

1. From the Department of Adult Cardiology and the Hektoen Institute for Medical Research of the Cook County Hospital; the Section of Cardiology, Department of Medicine, University of Illinois College of Medicine, Chicago, Illinois; and the Department of Medicine of the Loyola University Stritch School of Medicine, Hines, Illinois.

Abstract

Twelve patients with the clinical features of shock following acute myocardial infarction were treated with low molecular weight dextran (LMWD) as a plasma volume expander. Two of the patients had elevated central venous pressures (CVP), and neither responded favorably to plasma volume expansion. The remaining 10 patients had CVPs under 7 mm Hg prior to dextran infusion; five survived. Each survivor responded favorably to dextran infusion manifested by an increase in arterial pressure and cardiac index. The average increase in CVP in these patients was 1.0 mm Hg per 100 ml of dextran infused. The other five patients died either without recovering from shock or in chronic cardiac failure. These patients failed to show a significant increase in arterial pressure or cardiac index after dextran infusion; CVP increased by an average of 1.9 mm Hg per 100 ml infused. Hypovolemia must be considered in all patients in whom clinical evidence of shock develops as a complication of acute myocardial infarction, and if the CVP is normal or low, plasma volume expansion should be undertaken with caution. Increase in arterial pressure and evidence of improved cardiac index with little rise in CVP indicate a good response to the infusion and excellent prognosis for survival.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

Cited by 47 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

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