For many years various methods to decrease venous return to the heart have been effectively used in acute congestive failure or pulmonary edema. These include phlebotomy, Fowler's position, tourniquets, digitalis therapy, and many others. In basic research programs Sarnoff,1 Hilden,2 Kelley,3 and others4 have used ganglionic blocking agents with success in the treatment of pulmonary edema. These, however, were not recommended for clinical use; in fact, Tage Hilden claimed it was not safe after trying it in seven cases. It is our purpose to discuss the place of this method in clinical medicine and establish it as a useful therapeutic concept.
It has been shown that, when acute congestive failure develops, certain pathophysiological conditions usually occur. These are (1) reflex increase in peripheral resistance with resultant increase in systemic blood pressure; (2) increased venous pressure, filling pressure of the right side of the heart, pulmonary
Ellestad MH, Olson WH. USE OF INTRAVENOUSLY GIVEN GANGLIONIC BLOCKING AGENTS FOR ACUTE PULMONARY EDEMAPRELIMINARY REPORT. JAMA. 1956;161(1):49–53. doi:10.1001/jama.1956.62970010001015
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