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December 2, 1961

The Use of Hypothermia in Septic Shock

JAMA. 1961;178(9):916-919. doi:10.1001/jama.1961.73040480005008b

BACTEREMIA producing shock has been observed following both gram-positive and gram-negative infections.1-4 The current therapeutic regimen in septicemia consists of the appropriate antibiotics, fluids and whole blood, and general supportive measures. This treatment appears to be effective until the arterial blood pressure falls to shock levels. The characteristic picture is that of a septicemic patient (usually elderly) who appears to be doing well when his temperature begins to fall, and he suddenly goes into an acute circulatory collapse. Vasopressors and corticoids are added to the regimen and the antibiotic administration is intensified. Despite all this the hypotension is resistant and the mortality rate from septic shock stands at an appalling 60% to 70%.

The clinical features observed in septic shock appear in Table 1. In our series the elderly debilitated patient with a neglected perforated viscus and subsequent coliform (Escherichia coli) septicemia are seen most often. Other experiences have