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Experimental Cardiogenic Shock: Effect of Low Molecular Weight Dextran

Experimental Cardiogenic Shock: Effect of Low Molecular Weight Dextran Abstract IN BROAD terms, shock may be defined as a state in which cardiac output is insufficient to meet the normal nutritional needs of tissues. The shock syndrome may have a variety of initiating causes, but shock becomes progressive, not necessarily because the initial cause is becoming more severe, but because intrinsic changes in the animal deprived of adequate tissue blood supply tend to perpetuate circulatory deterioration. One of these intrinsic changes is associated with alterations in the rheologic properties of the blood. Cardiogenic shock, a syndrome of progressive circulatory deterioration initiated by myocardial damage, is the most common clinical etiological factor associated with shock, and has a mortality approaching 80%.1 In common with other forms of shock, reduced venous return, low cardiac output, high peripheral resistance, and microcirculatory insufficiency are self-propagating. It is commonly held that there is something "different" about cardiogenic shock that removes it from other forms References 1. Kindly supplied as Rheomacrodex by Pharmacia, Uppsala, Sweden. 2. Kindly supplied and sized by Mr. Ivan Grotenhius, Minnesota Mining and Manufacturing Company, St. Paul. 3. Binder, M., et al: Evaluation of Therapy in Shock Following Acute Myocardial Infarction , Amer J Med 18:622, 1955.Crossref 4. Lillehei, R. C., et al: Nature of Irreversible Shock: Experimental and Clinical Observations , Ann Surg 160:682, 1964.Crossref 5. Agress, C. M., et al: Protracted Shock in Closed Chest Dog Following Coronary Embolization With Graded Microspheres , Amer J Physiol 170:536, 1952. 6. Bloch, J. H.; Pierce, C. H.; and Lillehei, R. C.: Experimental Cardiogenic Shock Produced by Microsphere Embolization: Improved Standardized Model in Dog, to be published. 7. Bloch, J. H.; Pierce, C. H.; and Lillehei, R. C.: Treatment of Experimental Cardiogenic Shock, Surgery, to be published. 8. Conference on Evaluation of Low Molecular Weight Dextran in Shock: Pharmacology and Pertinent Rheology , Washington, DC: National Academy of Science, National Research Council, 1963. 9. Gronwall, A.: Dextran and Its Use in Colloidal Infusion Solutions , New York: Academic Press, 1957. 10. Gelin, L. E.; Solvell, L.; and Zederfeldt, B.: Plasma Volume Expanding Effect of Low Viscous Dextran and Macrodex , Acta Chir Scand 122:309, 1961. 11. Ingelman, B.: Chemistry of Dextran and Properties of Low Molecular Weight Dextran and Other Dextran Preparations , Conference on Evaluation of Low Molecular Weight Dextran in Shock: Pharmacology and Pertinent Rheology , Washington, DC: National Academy of Science, National Research Council, 1963, p 2. 12. Long, D. M., Jr., et al: Use of Low Molecular Weight Dextran and Serum Albumin as Plasma Expanders in Extracorporeal Circulation , Surgery 50:12, 1961. 13. Bernstein, E. F.: Methods of Measurement of Red Blood Aggregation , Conference on Evaluation of Low Molecular Weight Dextran in Shock: Pharmacology and Pertinent Rheology . Washington, DC: National Academy of Science National Research Council, 1963, p 2. 14. Gelin, L. E.: Studies in Anemia of Injury , Acta Chir Scand , (suppl 210) , 1956. 15. Gelin, L. E.: Method for Studies of Aggregation of Blood Cells, Erythrostasis, and Plasma Skimming in Branching Capillary Tubes , Biorheology 1:119, 1963. 16. Bernstein, E. F., et al: Effect of Low Molecular Weight Dextran on Red Blood Cell Charge During Clinical Extracorporeal Circulation , Circulation 27:816, 1963.Crossref 17. Bloom, W. L., et al: Coating of Vascular Surfaces and Cells; New Concept in Prevention of Intravascular Thrombosis , Proc Soc Exp Biol Med 113:384, 1964.Crossref 18. Finsterbusch, W., et al: Renal Arteriography During Extracorporeal Circulation in Dogs With Preliminary Report Upon Effects of Low Molecular Weight Dextran , J Thor Surg 41:252, 1961. 19. Manax, W. G., et al: Organ. Perfusion Before Transplantation With Particular Reference to Kidney, Surgery, to be published. 20. Langsjoen, P. H., et al: Observations in Treatment of Acute Myocardial Infarction With Low Molecular Dextran , Angiology 14:465, 1963.Crossref 21. Linden, L.: Myocardial Infarction Treated With Low Molecular Weight Dextran , Lancet 2:759, 1964.Crossref 22. Susuki, F., and Shoemaker, W. C.: Effect of Low Viscosity Dextran on Red Cell Circulation in Hemorrhagic Shock , Surgery 55:304, 1964. 23. Longerbeam, J. K., et al: Treatment of Irreversible Shock, Brochure prepared for Exhibit, American College of Surgeons, Oct 28, 1963. 24. Lillehei, R. C., et al: Nature of Experimental Irreversible Shock With Its Clinical Application , Int Anesth Clinics 2:139, 1964.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Experimental Cardiogenic Shock: Effect of Low Molecular Weight Dextran

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Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1965.01320130079011
Publisher site
See Article on Publisher Site

Abstract

Abstract IN BROAD terms, shock may be defined as a state in which cardiac output is insufficient to meet the normal nutritional needs of tissues. The shock syndrome may have a variety of initiating causes, but shock becomes progressive, not necessarily because the initial cause is becoming more severe, but because intrinsic changes in the animal deprived of adequate tissue blood supply tend to perpetuate circulatory deterioration. One of these intrinsic changes is associated with alterations in the rheologic properties of the blood. Cardiogenic shock, a syndrome of progressive circulatory deterioration initiated by myocardial damage, is the most common clinical etiological factor associated with shock, and has a mortality approaching 80%.1 In common with other forms of shock, reduced venous return, low cardiac output, high peripheral resistance, and microcirculatory insufficiency are self-propagating. It is commonly held that there is something "different" about cardiogenic shock that removes it from other forms References 1. Kindly supplied as Rheomacrodex by Pharmacia, Uppsala, Sweden. 2. Kindly supplied and sized by Mr. Ivan Grotenhius, Minnesota Mining and Manufacturing Company, St. Paul. 3. Binder, M., et al: Evaluation of Therapy in Shock Following Acute Myocardial Infarction , Amer J Med 18:622, 1955.Crossref 4. Lillehei, R. C., et al: Nature of Irreversible Shock: Experimental and Clinical Observations , Ann Surg 160:682, 1964.Crossref 5. Agress, C. M., et al: Protracted Shock in Closed Chest Dog Following Coronary Embolization With Graded Microspheres , Amer J Physiol 170:536, 1952. 6. Bloch, J. H.; Pierce, C. H.; and Lillehei, R. C.: Experimental Cardiogenic Shock Produced by Microsphere Embolization: Improved Standardized Model in Dog, to be published. 7. Bloch, J. H.; Pierce, C. H.; and Lillehei, R. C.: Treatment of Experimental Cardiogenic Shock, Surgery, to be published. 8. Conference on Evaluation of Low Molecular Weight Dextran in Shock: Pharmacology and Pertinent Rheology , Washington, DC: National Academy of Science, National Research Council, 1963. 9. Gronwall, A.: Dextran and Its Use in Colloidal Infusion Solutions , New York: Academic Press, 1957. 10. Gelin, L. E.; Solvell, L.; and Zederfeldt, B.: Plasma Volume Expanding Effect of Low Viscous Dextran and Macrodex , Acta Chir Scand 122:309, 1961. 11. Ingelman, B.: Chemistry of Dextran and Properties of Low Molecular Weight Dextran and Other Dextran Preparations , Conference on Evaluation of Low Molecular Weight Dextran in Shock: Pharmacology and Pertinent Rheology , Washington, DC: National Academy of Science, National Research Council, 1963, p 2. 12. Long, D. M., Jr., et al: Use of Low Molecular Weight Dextran and Serum Albumin as Plasma Expanders in Extracorporeal Circulation , Surgery 50:12, 1961. 13. Bernstein, E. F.: Methods of Measurement of Red Blood Aggregation , Conference on Evaluation of Low Molecular Weight Dextran in Shock: Pharmacology and Pertinent Rheology . Washington, DC: National Academy of Science National Research Council, 1963, p 2. 14. Gelin, L. E.: Studies in Anemia of Injury , Acta Chir Scand , (suppl 210) , 1956. 15. Gelin, L. E.: Method for Studies of Aggregation of Blood Cells, Erythrostasis, and Plasma Skimming in Branching Capillary Tubes , Biorheology 1:119, 1963. 16. Bernstein, E. F., et al: Effect of Low Molecular Weight Dextran on Red Blood Cell Charge During Clinical Extracorporeal Circulation , Circulation 27:816, 1963.Crossref 17. Bloom, W. L., et al: Coating of Vascular Surfaces and Cells; New Concept in Prevention of Intravascular Thrombosis , Proc Soc Exp Biol Med 113:384, 1964.Crossref 18. Finsterbusch, W., et al: Renal Arteriography During Extracorporeal Circulation in Dogs With Preliminary Report Upon Effects of Low Molecular Weight Dextran , J Thor Surg 41:252, 1961. 19. Manax, W. G., et al: Organ. Perfusion Before Transplantation With Particular Reference to Kidney, Surgery, to be published. 20. Langsjoen, P. H., et al: Observations in Treatment of Acute Myocardial Infarction With Low Molecular Dextran , Angiology 14:465, 1963.Crossref 21. Linden, L.: Myocardial Infarction Treated With Low Molecular Weight Dextran , Lancet 2:759, 1964.Crossref 22. Susuki, F., and Shoemaker, W. C.: Effect of Low Viscosity Dextran on Red Cell Circulation in Hemorrhagic Shock , Surgery 55:304, 1964. 23. Longerbeam, J. K., et al: Treatment of Irreversible Shock, Brochure prepared for Exhibit, American College of Surgeons, Oct 28, 1963. 24. Lillehei, R. C., et al: Nature of Experimental Irreversible Shock With Its Clinical Application , Int Anesth Clinics 2:139, 1964.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jul 1, 1965

References