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September 1967

Hemodynamic Patterns After Acute Anesthetized and Unanesthetized TraumaEvaluation of the Sequence of Changes in Cardiac Output and Derived Calculations

Author Affiliations

From the Department of Surgical Research, Division of Surgery, Hektoen Institute for Medical Research, Cook County Hospital, and the University of Illinois, Chicago.

Arch Surg. 1967;95(3):492-499. doi:10.1001/archsurg.1967.01330150168021

THE CARDIOVASCULAR derangements occurring with both hemorrhagic and traumatic shock were described over 20 years ago by Cournand, Richards and coworkers1,2 as decreased cardiac output and increased peripheral resistance. Since then there has been a tendency in some circles to assume that shock, irrespective of the precipitating events, is associated with low cardiac output and high resistance. More recently, however, other workers3-10 have described increased or no appreciable changes in cardiac output and decreased or no change in resistance in various types of clinical shock. The relatively small numbers of patients in the various reported series may account for these apparent discrepancies. An alternative explanation for these differences is that shock may represent a rather large waste basket of conditions, in which various factors play significant roles in producing one or more types of circulatory disturbances. Furthermore, it is entirely possible that patients who have sustained shock

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