Comparative Evaluation of Sympathomimetic Amines in Clinical Shock
Comparative hemodynamic measurements were obtained in a series of 17 shock patients before and during infusion of four sympathomimetic amines. Cardiac output increased significantly only during infusion of isoproterenol. Cardiac work and mean arterial pressure were increased during administration of all four agents. Increased central venous pressure, central blood volume, total peripheral resistance, and stroke volume were observed during norepinephrine and metaraminol infusion. Methoxamine increased central venous pressure and peripheral resistance in these patients.
Individual patient responses were analyzed in terms of their response to methoxamine. Hemodynamic changes characteristic of ventricular failure were observed in four patients who received methoxamine. Reversal of this pattern of ventricular failure was noted during infusion of agents with an inotropic effect. A hypothesis which explains these hemodynamic changes is discussed.
- © 1966 American Heart Association, Inc.