Comparative Evaluation of Sympathomimetic Amines in Clinical Shock

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Abstract
Comparative hemodynamic measurements were obtained in a series of 17 shock patients before and during infusion of 4 sympatho-mimettc amines. Cardiac output increased significantly only during isoproterenol infusion. Cardiac work and mean arterial pressure were increased during administration of all 4 agents. Increased central venous pressure, central blood volume, total peripheral resistance and stroke volume was observed during norepinephrine and mataraminol infusion. Methoxamine increased central venous pressure and peripheral resistance in these patients. Individual patients responses were analyzed in terms of their response to methoxamine. Hemodynamic changes characteristic of ventricular failure were observed in 4 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.

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