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April 1971

internal at large medicine

Arch Intern Med. 1971;127(4):541-552. doi:10.1001/archinte.1971.00310160019002

Cardiogenic shock  Intra-aortic counterpulsation appears to be the method of choice for treating patients in cardiogenic shock, according to a comparative study at St. Vincent's Hospital and Medical Center, New York.Hiltrud Mueller, MD, chief of the hospital's Shock Unit, and her colleagues studied the effects of intraaortic counterpulsation (IACP), L-norepinephrine and isoproteronol in 22 patients treated over a six-month period.The team's conclusions, as reported to the American College of Cardiology meeting at Washington:

  • Isoproteronol therapy in six patients led to increased cardiac output and coronary blood flow. At the same time, the myocardial metabolism of the patients deteriorated, apparently because the increased work load of the heart with its attendant demands for oxygen exceeded the increases of perfusion and oxygenation given by the drug.

  • The effects of L-norepinephrine were studied in eight patients. This agent resulted in an increase of coronary blood flow, myocardial metabolism and myocardial work,

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