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"Some hypotensive patients may require a larger than normal volume to produce a cardiac filling pressure adequate to maintain a normal cardiac output," Jay N. Cohn, MD, of Georgetown University School of Medicine, told the Hahnemann Medical College Symposium on Shock and Hypotension, March 18-21 in Philadelphia. These patients may have no history of blood loss and may register normal measured blood volumes, Cohn said, yet, "expansion of blood volume in these patients produces striking hemodynamic improvement."
Cohn, an instructor in medicine and pharmacology, studied the hemodynamic patterns of 32 patients with hypotension or shock who exhibited inadequate venous return despite a normal total blood volume. Most of the patients were elderly and had diseases often involving multiple systems with a high incidence of complicating infections, he said. Patients with evidence of significant blood loss were not studied, and, frequently, no cause of the hypotensive episode was apparent.
Higher Than Normal Blood Volume Tried in Shock. JAMA. 1964;188(1):A33. doi:10.1001/jama.1964.03060270117051