TREATMENT OF SHOCK IN A CANINE MODEL OF PULMONARY-EMBOLISM

Publisher Website
Google Scholar
Abstract
Despite the high mortality (greater than 30%) associated with hypotension complicating pulmonary embolism, previous studies have not systematically investigated how best to treat shock resulting from pulmonary embolism. In 24 dogs, relevant hemodynamic parameters were measured before and after shock was produced by i.v., injected autologous blood clots. When systemic blood pressure fell to 70 mm Hg, dogs were randomly divided into groups and treated blindly for 1 h. All control dogs and all dogs treated with volume and isoproterenol died. In contrast, all dogs treated with [norepinephrine] were resuscitated and remained hemodynamically stable for 1 h. This effect of noradrenaline was significant (P < 0.01, Fisher''s exact test). Noradrenaline improved right ventricular performance by increasing blood pressure and improving right ventricular perfusion and/or by a direct increase in contractility. In a canine model of pulmonary embolism and shock, norepinephrine may be the drug of choice for acute resuscitation.