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ARTICLE |

Effects of Levarterenol on Blood Flow in Inflammation

R. W. Hopkins, MD; R. P. Pauly, MD; T. E. Peters, MD; F. A. Simeone, MD
Arch Surg. 1968;97(6):1032-1038. doi:10.1001/archsurg.1968.01340060210025.
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PATIENTS who are in shock associated with infection continue to present difficult therapeutic problems. In addition to the multiple effects of bacterial toxins, patients in septic shock have invariably had associated problems which affect the hemodynamic and metabolic responses to shock, including hypovolemia from dehydration or hemorrhage, and diseases of the heart, lungs, kidneys, liver, or other organ systems.1

Clinical sepsis is often associated with extensive inflammation, which may impose hemodynamic burdens which the circulation is unable to support.2 Patients in septic shock are commonly found to have hypotension associated with a normal or high cardiac output, ie, "low-resistance," or "hyperdynamic" septic shock.3-6

Inadequate perfusion of tissues in these patients may result in part, at least, from arteriovenous shunting of blood in areas of inflammation,2,3,5,7 either through greatly dilated capillary beds or through arteriovenous communications, thereby creating a form of "high output cardiac failure."

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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