Controlled Hypotension for Uncontrolled Hemorrhage

Robert W. Hopkins, MD; Richard B. Fratianne, MD; Jerome S. Abrams, MD; F. A. Simeone, MD
Arch Surg. 1967;95(3):517-530. doi:10.1001/archsurg.1967.01330150193024.
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HYPOTENSION induced and controlled by the administration of trimethaphan camsylate has been used as an adjunct to the therapy of patients with massive hemorrhage under circumstances in which bleeding was not readily controlled and did not spontaneously cease. The hypotensive agent was used to accomplish two principal objectives: (1) to lower the arterial pressure and thereby to reduce bleeding while restoring the blood volume to normal levels by transfusion, and (2) to prevent excessive vasoconstriction, the normal physiologic response to hypotention, with the consequent impairment of flow of blood through capillaries.

The findings in patients in whom deliberate hypotension was used in the management of severe bleeding have been reported previously.1 An additional 15 patients have been treated with controlled hypotension since that time.

Methods  Clinical observations have been made during 22 episodes of massive bleeding in 20 patients in whom hypotension was deliberately induced by the use of


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