FLUID REPLETION IN CIRCULATORY SHOCK: CENTRAL VENOUS PRESSURE AND OTHER PRACTICAL GUIDES.
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Biomedical subjects
Publications and source records attributed to M H WEIL.
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"Excess lactate," an indicator of oxygen debt, has been studied as a metabolic index of severity of the shock state in human patients. The levels of excess lactate correspond to severity of circulatory failure, and an excess of more than 4 millimoles per liter prognosticates a fatal outcome. The validity of this index was confirmed by studies on experimental hemorrhagic shock in dogs. It provides a parameter for measurement of "reversibility" and serves as an objective clinical guide.
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Alpha-methyldopa in amounts of 750 mg twice daily is an effective antihypertensive agent, intermediate in potency between reserpine-thiazide combinations and ganglionic-sympathetic blocking drugs. Because it produces few undesirable side effects, it is well accepted by patients.It is useful for patients with moderate or severe hypertension not controlled by reserpine-thiazide combinations. Its favorable action on cardiac output and renal blood flow provides special advantages for patients with advanced hypertension aggravated by cardiac or renal combinations.
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