Contradictory results regarding the output of the heart in congestive failure have been obtained by various indirect methods. These results have led to two distinct ideas regarding the relationship of cardiac output to heart failure: 1. The signs and symptoms of cardiac failure are the result of diminished cardiac output—Mackenzie;1 Lewis;2 Meakins and Long;3 Means;4 Stewart and Cohn;5 Blumgart, Riseman, Davis and Berlin,6 and Henderson, Haggard and Dolley.7 2. There is no consistent relationship between cardiac output and heart failure— Harrison8 and Hamilton, Moore, Kinsman and Spurling.9
The results of indirect methods have been adversely criticized because different methods have given widely varying values. Even the original acetylene method of Grollman,10 which is generally considered the best of the indirect methods, has been modified by its originator when used for patients with congestive heart failure, as pulmonary congestion and sluggish blood flow greatly impair its reliability
McGUIRE J, HAUENSTEIN V, SHORE R. CARDIAC OUTPUT IN HEART DISEASE: DETERMINED BY THE DIRECT FICK METHOD, INCLUDING COMPARATIVE DETERMINATIONS BY THE ACETYLENE METHOD. Arch Intern Med (Chic). 1937;60(6):1034–1042. doi:10.1001/archinte.1937.00180060087009
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