Treatment of Shock Based upon Physiological Principles and Impedence Method for Measuring Cardiac Output in Shock

摘要

Based on physiological observations, we have developed a 'unitarian'concept of shock. With the onset of a low-flow state, regardless of the cause, the sympathetic nervous system is stimulated - part of Canon's 'fight or flight' reflex. Initially this mechanism serves a protective function for the organism, and on a short-term basis the peripheral vasoconstriction and central and central tachycardia are beneficial. If, however, this sympathetic-induced peripheral vasconstriction persists, a state of 'decreasing return' develops; wherein tissue perfusion is reduced, anaerobic metabilism ensues, and cellular breakdown occurs. In addition to detelerious viscerocutaneous effects, peripheral vasconstriction places a heavy burden on the myocardium. As shock persists, cardiac function progressively deteriorates. This central pump failure further compounds the picture of stagbabt hypoxia peripherally, and a v icious cycle ensues which ulimately leads to the demise of the organism. Although the combination of volume and vasodilator therapy has lowered the mortality rate from shock, this after-the-fact treatment is not ideal. Studies in tolerant animals have revealed that it is possible to blunt the severe effects of shock and achieve close to 100% survival. It is hoped that in the future this form of preventive medicine for shock can be practiced in man. This report pertains to research on Endotoxic Shock, Hemorraghic Shock, and Cardiogenic Shock, Dogs are used as animal models.