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May 2, 1977

Monitoring Resuscitation of the Injured Patient

Author Affiliations

University of Pennsylvania Philadelphia

JAMA. 1977;237(18):1929. doi:10.1001/jama.1977.03270450018007

To the Editor.—  The article by Drs Hartong and Dixon (237:242, 1977) contains deficiencies in methodology and data presentation that limit the generalization of the "Summary" statements.I expected that an article entitled "Monitoring Resuscitation of the Injured Patient" would say something about injured humans. The only mention of the authors' experience with humans is the unsupported statement at the end of the text about the US Army Trauma Center. In a study comparing the usefulness of various physiological measurements, I would have expected the measurements to be obtained with comparable precision. In this study, the pulmonary artery pressure (PAP) was measured with an electronic transducer, but the central venous pressure (CVP) was monitored with a water manometer. Were the authors prejudging their results? The deficiencies of the water manometer have been reported,1 and I find that during surgery, it provides much less information about CVP than an electronic