There can be little doubt that the ideal treatment of hemorrhagic shock is blood transfusion given early, in sufficient quantity, and at a rapid rate of flow. However, prompt replacement of whole blood may of necessity be delayed under certain circumstances with a resultant failure to achieve a favorable response. Prolonged periods of hypotension may result in failure of the patient to survive, due to persistence of the shock state and to the consequence of visceral injury. Indeed, specific protection of vital organs pending full recovery from the shock state may be considered a more pressing requirement than simple elevation of the blood pressure. It is thus not surprising that adjunctive pharmacological agents have come under study in circumstances which appear to represent a failure of blood volume replacement alone.
Three such agents, hydralazine (and other adrenergic blocking drugs), hydrocortisone* and levarterenol(l-norepinephrine), have received considerable attention in recent
HAKSTIAN RW, HAMPSON LG, GURD FN. Pharmacological Agents in Experimental Hemorrhagic Shock: A Controlled Comparison of Treatment with Hydralazine, Hydrocortisone, and Levarterenol (l-Norepinephrine). Arch Surg. 1961;83(3):335–347. doi:10.1001/archsurg.1961.01300150009002
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