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February 10, 1962

Capillary Circulation: Characteristics During Treatment of Shock by Means of Artificial Heart-Lung Procedures in the Dog

Author Affiliations

Atlanta, Ga.

JAMA. 1962;179(6):417-420. doi:10.1001/jama.1962.03050060027005

ACCORDING to prevailing opinion, shock is an absolute or relative decrease in blood volume combined with reduced cardiac output, leading to insufficient blood flow to the tissues. It has been demonstrated that arterial blood pressure of patients and experimental animals on complete or partial cardiopulmonary bypass can be maintained at physiological levels by circulating an appropriate amount of blood per minute. It appears from the above statements that application of pump oxygenators to treatment of shock would correct the basic hemodynamic mechanism of this ailment, provided that it also maintains a normal capillary circulation. The experience gained from open-heart operations indicates that procedures conducted with high perfusion rates are followed by more favorable clinical results. Therefore, one can assume that subjects perfused with higher output maintain a more efficient capillary circulation compared to subjects operated with low perfusion rates.

However, the extent to which increased blood volume and the rise