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Raper R F - - 1984
While some of the details of resuscitation of the bleeding patient remain contentious, the basic principles are clear. Adequate resuscitation implies the prompt restoration of tissue oxygenation by achievement and maintenance of airway patency, adequate ventilation, cardiac rhythm and intravascular volume. The choice of fluid for primary resuscitation is considerably ...
Ozier Y - - 1984
A 50-yr-old woman exhibiting streptococcal neck cellulitis developed severe septic shock with low cardiac output, which was reversed by infusion of dopamine plus dobutamine. Two-dimensional echocardiography performed at the bedside demonstrated severe myocardial failure. The patient's condition remained dependent on inotropic drug support for 2 days and ultimately improved. Two-dimensional ...
Vaney C - - 1984
To determine whether plasma renin activity in addition to catecholamines could be used as risk indicators, these parameters were measured in 19 patients with acute myocardial infarction. During the course of hospitalization, five patients developed ventricular fibrillation and three, cardiogenic shock. On admission, heart rate, plasma norepinephrine, epinephrine, and renin ...
Takano T - - 1984
The effects of intraaortic balloon pumping (IABP) were studied in 91 patients with acute myocardial infarction complicated with cardiogenic shock (75 pts), ventricular septal perforation (VSP) (12 pts), and/or mitral regurgitation (MR) (4 pts). Out of 44 pts with cardiogenic shock in whom IABP was performed, 14 pts could not ...
Raper R F - - 1984
A 43 year old female was admitted to hospital with severe pulmonary hypertension and cardiogenic shock. She had a two week history of dyspnea only. Resuscitative measures proved unsuccessful and she died ten hours after admission. Post mortem examination indicated that the pulmonary hypertension and right ventricular failure were due ...
Thijs L G - - 1984
A small review is presented on the problems encountered in the treatment of septic shock. The discussion is focussed on haemodynamic problems. At least three and possibly four haemodynamic mechanisms seem to be involved: peripheral pooling, increased vascular permeability, myocardial failure (right and/or left heart failure) and probably peripheral vascular ...
Ino T - - 1984
As a mechanical cardiac support, prolonged (over 5 hrs) Veno Arterial Bypass (VAB) with membrane oxygenator was indicated to 13 patients who was profound cardiogenic shock following open heart surgery, among 1700 cases of cardiac surgery (0.8%). In 12 of 13 cases, cardiopulmonary bypass could not be weaned after intracardiac ...
Ida T - - 1984
Of the patients treated in the CCU of Nippon Medical School for acute myocardial infarction in the past 5 years and 8 months, 44 with cardiogenic shock, 11 with severe heart failure, 7 with ventricular septal perforation and 2 with mitral regurgitation were treated by IABP. The peak effect of ...
Abraham E - - 1984
Sequential hemodynamic and oxygen transport monitoring was performed in 33 patients with septic shock to define physiologic patterns associated with outcome. Measurements taken over a 24-hour period prior to the hypotensive crisis, defined as the lowest initial mean arterial pressure (MAP) after a decrease of at least 30 mm Hg ...
Wagner D L - - 1984
Many factors may contribute to producing a shock state within the surgical environment. The classic causes of shock--hypovolemia, cardiac failure, and sepsis--occur commonly in the operating room. Additionally, concurrent surgery and anesthesia may contribute to produce clinical shock. Surgery may produce hypovolemia from "third space" loss and/or from blood loss. ...
Widimský P - - 1984
Five patients in cardiogenic shock due to acute myocardial infarction were examined by two-dimensional echocardiography. In one patient, cardiogenic shock developed only after rupture of the interventricular septum, four subjects had "primary" cardiogenic shock. In these four persons there were found extensive disturbances of left ventricular wall motion (the mean ...
Matangi M F - - 1983
Three cases of subacute cardiac rupture following acute myocardial infarction are described. All three patients experienced sudden collapse during convalescence and following cardiopulmonary resuscitation were in cardiogenic shock, the shock being due to haemopericardium causing cardiac tamponade. Two of the patients who had electrocardiographic monitoring at the time of their ...
VanVleet J F - - 1983
In 14 dogs, a newly designed automatic defibrillator electrode catheter with paired ventricular and superior vena caval electrodes was implanted transvenously into the right ventricular (RV) apex for 26 weeks. Twelve dogs were given multiple (mean total = 21.3) near-threshold (mean delivered energy = 17.6 joules) shocks via the lead ...
Esteban A - - 1983
A 54-year-old man had had an acute anterior myocardial infarction nine years prior to this hospital admission. Since that time he had been asymptomatic with the exception of occasional episodes of precordial chest pain. The patient died from septic shock on the tenth day after the present admission. On autopsy ...
Resnekov L - - 1983
The definition, pathophysiology, and diagnosis of cardiogenic shock are presented. Its management is detailed, including specific forms of therapy for the various subgroups of patients in whom cardiogenic shock is an integral part. The choice of patients for and results of circulatory support using the intra-aortic balloon pump followed by ...
Madsen E B - - 1983
For predicting the 3 endpoints death, cardiac arrest, and cardiogenic shock within 44 days after admission for acute myocardial infarction (MI), a competing risk variant of the Cox multivariate model was developed. The population consisted of 1,140 patients with definite MI admitted within 24 hours of onset of symptoms. Prognostic ...
Katzberg R W - - 1983
Investigations into the nature of severe and fatal reactions to contrast media have been severely limited by their unpredictable occurrence in the clinical setting and the absence of suitable laboratory models. The authors report their experience with a canine dehydration model. Intravenous administration of 2 ml/kg of 76% sodium methylglucamine ...
Orlando R R - - 1983
Intra-aortic balloon counterpulsation (IABC) is a widely used form of mechanical circulatory assistance. We have successfully employed IABC in three patients with refractory cardiogenic shock secondary to cardiac contusion. All patients had multiple blunt injuries with cardiac contusion documented electrocardiographically, by CPK isoenzyme determinations, and clinically. IABC was instituted for ...
Grande P - - 1983
The relationship between estimated infarct size and cardiogenic shock was investigated in 317 consecutively admitted patients with acute myocardial infarction (AMI). Infarct size was estimated in vivo by serum CK-MB in all patients, and at heart autopsy by histological and histochemical techniques in 23 patients who died in hospital. Although ...
Ditchey R V - - 1983
Although direct-current (DC) electrical shocks do not significantly alter left ventricular systolic performance, their effects on ventricular diastolic properties and the role of sympathetic stimulation in maintaining postshock contractility are unknown. Accordingly, we studied both diastolic and systolic left ventricular performance in seven open-chest dogs before and after three consecutive ...
Barker-Voelz M A - - 1983
In ten beagles ranging in weight from 7.4 to 13.0 kg, a defibrillating shock of 10 A (three dogs), 20 A (four dogs), or 30 A (three dogs) intensity was applied through a chronically implanted right ventricular catheter electrode. Ten-lead ECG, right ventricular electrogram, and right ventricular impedance were recorded ...
Niebauer M J - - 1983
The effect of suprathreshold defibrillator shocks on cardiac function was compared in 8 isolated, perfused, contracting canine hearts using 4 durations of rectangular electrical waveforms. Defibrillation threshold was first determined for each duration; then overdose shocks of 3, 4.5, 6, and 9 times threshold current density were delivered. Left ventricular ...
Shumakov V I - - 1983
Intra-aortic counterpulsation with a balloon pump (IABP) was used in 63 patients with cardiogenic shock, heart failure after surgery with artificial circulation, internal lacerations of the myocardium, or unstable angina. It was found that the IABP was most efficient in conditions related to myocardial ischemia. Use of arteriovenous perfusion (in ...
Rubányi G - - 1983
The aim of the present study was to test the hypothesis that endogenous nickel release may play a role in myocardial depression in the acute phase of burn shock in rats. Serum nickel concentration (Se-Ni) measured by atomic absorption spectrophotometry, the sensitivity of isolated perfused hearts to exogenous nickel chloride ...
Legrand V - - 1983
Out of 178 consecutive patients with acute inferior wall myocardial infarction submitted to technetium-99 m pyrophosphate scintigraphy, 49 (27.5%) were found to have concomitant right ventricular infarction. Gated blood pool scans showed right ventricular abnormalities in 21 out of 26 patients who were submitted to this investigation (right ventricular asynergy: ...
Gunnar R M - - 1983
In the past 25 years the treatment of shock in myocardial infarction has evolved into a physiologic approach based on on-line measurements of hemodynamic variables. This has aided in the development of new pressor agents so that a family of pharmacologic agents is now available. Appropriate use of vasodilators and ...
Roberts R - - 1983
Right ventricular (RV) infarction, once considered rare, is now recognized as common in patients with inferior infarction. It usually involves the posterior wall of the right ventricle and seldom the anterior right ventricle. There is concomitant transmural injury to the posterior wall of the left ventricle and interventricular septum. Severe ...
Zheng Z S - - 1983
A new SECP was developed and is currently successfully used in more than 120 clinics in China. This sequenced counterpulsation device has the effect of milking more blood as pressure is applied on the extremities in succession (first distally then proximally) and in decreasing values (265 to 200 mm Hg). ...
Patton M L - - 1983
Endogenous opioid substances are activated in and may contribute to the cardiovascular depression of hemorrhagic shock. In order to determine the importance of the adrenal gland in the beneficial effects of the opiate antagonist naloxone in shock we studied 23 adrenalectomized dogs subjected to hemorrhagic shock. Adrenalectomy abolished the salubrious ...
Piazza M - - 1983
The main study methods used in situations of cardiogenic shock were applied to the hearts of patients who died of noncardiogenic shock, namely, the macroscopic nitro-BT test and histological examination for waves, contraction bands and coagulation necrosis. The hearts studied were obtained at autopsy from 20 patients who had died ...
Rude R E - - 1983
Cardiogenic shock is a relatively specific clinical syndrome characterized by decreased cardiac output, elevated left ventricular filling pressure, and arterial hypotension with vital organ hypoperfusion. It most commonly occurs as the consequence of extensive left ventricular damage due to myocardial infarction. The prognosis of patients with cardiogenic shock is very ...
Jacob H S - - 1983
The complement (C) system evolved as a beneficial antimicrobial system. However, when activated during extracorporeal perfusion as with haemodialysis or cardiopulmonary bypass modest pulmonary dysfunction associated with granulocyte aggregation and embolization can occur. When C activation is massive and prolonged, as with severe sepsis, trauma, or acute pancreatitis, severe pulmonary ...
Alivizatos P A - - 1982
Cardiogenic shock after myocardial infarction still carries a high mortality despite use of intraaortic counterpulsation and early surgical revascularization. An experimental canine model of left ventricular exclusion and circulation support was developed by closing the mitral valve and by interposing "in series" a cardiac allograft between pulmonary and systemic circulations. ...
Lefer A M - - 1982
Myocardial Depressant Factor (MDF) is a small peptide circulating in the blood of all mammalian species tested in a variety of shock states including endotoxic, hemorrhagic, cardiogenic, bowel ischemic, acute pancreatitis, burn, and traumatic shock. MDF is produced by the action of proteolytic enzymes released by the ischemic pancreas. MDF ...
Durrer J D - - 1982
We gave sodium nitroprusside by intravenous infusion to 163 randomly selected patients during the first 24 hours after hospitalization for typical acute myocardial infarction, and we studied its effects on mortality at one week, on the incidence of cardiogenic shock, on clinical signs of left ventricular failure, and on peak ...
Snow N - - 1982
Two patients who sustained cardiac contusions secondary to blunt chest trauma developed refractory cardiogenic shock. Use of intra-aortic balloon counterpulsation improved circulatory dynamics in each case and one patient survived. Requirements for inotropic agents were diminished or eliminated, cardiac output was increased, acidosis was reversed, and the electrocardiogram reverted to ...
Zipes D P - - 1982
The purpose of this study was to test the efficacy, safety, and patient tolerance of transvenous cardioversion and defibrillation in patients who had recurrent ventricular tachyarrhythmias. In five of seven patients, a truncated exponential shock of 0.025 to 2.0 joules synchronized to the QRS complex terminated 47 episodes of recurrent ...
Mihara M - - 1982
Pigeons received 30 pairings of a light stimulus (CS) and a brief electric foot shock (US) or random presentations of 30 CSs and 30 USs monocularly. The birds that received the paired presentations showed a clear increase of heart rate during CS presentation periods and maintained the conditioned cardiac response ...
Elliott G T - - 1982
The treatment of various cardiovascular problems with intravenous nitroglycerin is widely practiced though unapproved. The uses of iv nitroglycerin include improvement of the hemodynamics of left ventricular failure and cardiogenic shock associated with infarction, control of hypertension during coronary artery surgery, and possibly, reduction of acute myocardial infarct size. The ...
Shatney C H - - 1982
Using closed chest coronary artery microsphere embolization, myocardial infarction and subsequent shock were produced in healthy adult mongrel dogs. Following infarction animals were distributed among the following groups: (1) control; (2) methylprednisolone sodium succinate (MPSS); (3) methylprednisolone sodium phosphate (MPSP); (4) sodium phosphate (SP); and (5) sodium succinate (SS). Drug ...
Archer L T - - 1982
We have documented that myocardial dysfunction occurs in canine endotoxin shock and have designed this study to determine the effect of lethal live E coli-induced shock on the myocardium. Small adult heart "donor" dogs (wt range 6-9 kg) were infused with LD100 E coli (N = 12) or saline (N ...
Liu M S - - 1982
The incorporation of 14C-palmitate into various classes of tissue lipids by isolated adult dog heart myocytes was studied in an attempt to understand the pathophysiology of myocardial dysfunction during endotoxic shock. The results showed that the incorporation of 14C-palmitate into phospholipids was increased by 85.3% and 108.8% at 0.5 hours ...
Roeske W R - - 1981
We documented the differences in clinical features between 86 autopsied and 54 nonautopsied subjects who died of myocardial infarction to ascertain any bias that might be present in use of postmortem data. More than 200 historical, clinical, noninvasive, and hemodynamic aspects were compared. Of noninvasive aspects examined in all subjects, ...
Mercer D - - 1981
Mortality in patients in septic shock remains high (50% to 80%) despite available treatment. In a 76-year-old women with hypodynamic septic shock intra-aortic balloon counterpulsation (IABC) successfully improved the hemodynamic status to the point at which the patient could maintain adequate cardiac output without assistance. The pertinent literature on experimental ...
Halon D A - - 1981
The use of a mobile gamma camera with thallium 201 myocardial imaging is described to exclude myocardial infarction in a patient admitted to the coronary care unit in shock and with clinical, enzyme, and ECG changes consistent with infarction. The patient suffered from acute aortic dissection associated with congenital coarctation ...
Radford M J - - 1981
Forty-one patients with postinfarction ventricular septal rupture were cared for in our hospital during 1971-1975. Cardiogenic shock developed after septal rupture in 55% of these patients. Shock was unrelated to site of infarction, extent of coronary artery disease, left ventricular ejection fraction, or pulmonary-to-systemic flow ratio, but mean pulmonary artery ...
Vincent J L - - 1981
The relative roles of bacterial infection, fluid loss and myocardial failure were investigated in 24 patients in whom circulatory shock appeared as a complication of purulent peritonitis. The 13 acute survivors, including 6 hospital survivors, had strikingly lower initial plasma volumes and total blood volumes than the 11 patients who ...
Matsui K - - 1981
Twenty-four patients underwent operation for ventricular septal rupture secondary to acute myocardial infarction. There were 14 hospital survivors (58%) and two late deaths (8%). There were eight hospital deaths (62%) of 13 patients referred in cardiogenic shock, but only two deaths (18%) of 11 patients not in shock at time ...
Iqbal M Z - - 1981
A patient had right ventricular infarction complicated by cardiogenic shock. Volume expansion along with high doses of dopamine hydrochloride successfully alleviated hypotension in this patient. However, he had persistent mental obtundation and low cardiac output, and adverse chronotropic responses to high doses of dopamine developed. Counterpulsation effectively maintained an adequate ...
Kerber R E - - 1981
Very high energy electrical countershocks can cause morphologic damage to the myocardium. In this study we searched for functional correlates of these shock-induced morphologic changes. We used ultrasonic sonomicrometers to measure myocardial contractility and radiolabeled microspheres to assess perfusion. Acute and chronic experiments were conducted in 45 dogs, assessing the ...
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