THE CARDIAC OUTPUT AND VASCULAR RESPONSE TO TRAUMA.
Progress rept. 1 Jun 66-30 May 67,
HARVARD UNIV BOSTON MASS MEDICAL SCHOOL
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Clinical and experimental observations were continued on the physiological role of the cardiovascular system in recovery from trauma, sepsis, and gangrene. Serial hemodynamic measurements including cardiac output were correlated with caloric energy expenditure, body water, respiratory function, and blood chemical alterations indicative of metabolic abnormalities. Excessive circulatory demand and reduction of the peripheral vascular resistance are in evidence. Explanations were sought for the mechanisms which interfere with the ability of the cardiovascular system to respond to this demand. Both the clinical observations and the experimental results employing a preparation with induced peritonitis suggest that myocardial failure, alterations of body water and electrolyte distribution, and a non-specific pulmonary inflammatory lesion accompanied by hypoxia all appear to be contributors to the low flow state. A method for studying the pulmonary hemodynamics and gas diffusion in intact animals was devised. Lung biopsies and cultures taken after the induction of peritonitis disclosed a monocytic infiltration of the septa, frequently in the absence of bacteria. Low flow states with high pulmonary vascular resistances were found to be associated with severe intracapillary red cell congestion. Author
- Medicine and Medical Research