III. Metaraminol and Capillary Flow in the Nonanesthetized and Anesthetized Pig

Olsen, William R.

doi:10.1001/archsurg.1969.01340170089021

Cited by 3 publications

(11 citation statements)

References 23 publications

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“…The duration of the shock period ranged from 15 minutes to 3.5 hours. Three studies did not report the duration of the shock period 19‐21 . In approximately half the studies, trauma was induced (44%), mainly by a midline laparotomy.…”

Section: Resultsmentioning

confidence: 99%

“…No meta-analysis was performed due to heterogeneity; therefore, no pooled effect is shown. For Olsen et al, 20 only results of the most clinically relevant model are shown, namely the conscious model an increase in blood flow following treatment, 25 whereas the other study reported no effect on blood flow. 28 Interestingly, the study that reported no effect of pentoxifylline used a more severe model of hemorrhagic shock compared to the study that reported an increase in blood flow, suggesting that the effectiveness of pentoxifylline is affected by the severity of hemorrhagic shock.…”

Section: F I G U R Ementioning

confidence: 98%

“…19,22,[56][57][58][59][60] The remaining two studies (10%) reported a decrease in blood flow, 61 or results varied markedly between organs. 20 Vasopressin showed contrasting results with a decrease in intestinal blood flow, 61 but no effect on dorsal blood flow. 57 This may be because measurements were performed in different organs and different concentrations were given, and high concentrations of vasopressin are known to have adverse effects on microcirculatory perfusion.…”

Section: Vasoactive Agents (N = 19)mentioning

confidence: 98%

“…Three studies did not report the duration of the shock period. [19][20][21] In approximately half the studies, trauma was induced (44%), mainly by a midline laparotomy.…”

Section: Experimental Protocolmentioning

confidence: 99%

“…One study reported the effect of vasoactive agent metaraminol on blood flow under conscious and unconscious conditions in nine different organs. 20 However, the reported results varied markedly and the experimental protocol is largely unclear which led to a high risk of bias. For this study, only the results of the clinically most relevant model, namely the conscious model, were shown in the forest plot.…”

Section: Vasoactive Agents (N = 19)mentioning

confidence: 99%

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Therapeutic interventions to restore microcirculatory perfusion following experimental hemorrhagic shock and fluid resuscitation: A systematic review

et al. 2020

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Section: Resultsmentioning

confidence: 99%

Section: F I G U R Ementioning

confidence: 98%

Section: Vasoactive Agents (N = 19)mentioning

confidence: 98%

“…Three studies did not report the duration of the shock period. [19][20][21] In approximately half the studies, trauma was induced (44%), mainly by a midline laparotomy.…”

Section: Experimental Protocolmentioning

confidence: 99%

Section: Vasoactive Agents (N = 19)mentioning

confidence: 99%

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Therapeutic interventions to restore microcirculatory perfusion following experimental hemorrhagic shock and fluid resuscitation: A systematic review

et al. 2020

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Progress in the treatment of acute gastroduodenal mucosal lesions (AGML)

Speranza¹,

Basso²

1977

World j. surg.

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This article presents an analysis of acute gastroduodenal mucosal lesions (AGML) based on a review of current literature and the personal experience of the authors. The pathology of AGML involes two distinct types of lesions, namely, superficial erosions confined to the acid-secreting gastric mucosa and presenting as erosive hemorrhagic gastritis, and acute ulcers that occur in the alkaline gastric mucosa and duodenum. The etiology of these two lesions is very likely different. Acut gastroduodenal ulcers, best known as stress ulcers, are probably "peptic" lesions, whereas erosive hemorrhagic gastritis appears to be due to pathologic back diffusion of hydrogen ions caused by a breakdown of the gastric mucosal barrier as a result of endogenous factors, such as gastric mucosal ischemia, and sometimes exogenous factors, such as alcohol, urea, and acetylsalicylic acid. Catecholamine hypersecretion resulting from severe stress, such as occurs in hypovolemia, sepsis, and hypercapnea, contributes to ischemia of the gastric mucosa by producing splanchnic vasoconstriction. The key to the diagnosis of AGML is early endoscopy in all cases of upper gastrointestinal bleeding. Therapy for AGML should begin with a trial of medical measures directed at restoring effective perfusion of tissues and removing hydrogen ions from the stomach by gastric washing. Medical therapy is effective in 80% of patients with erosive hemorrhagic gastritis, but surgical treatment is usually required in acute gastroduodenal ulcer. When surgery is necessary for either type of lesion, vagotomy with hemigastrectomy appears to be the most effective operation. The personal experience of the authors has involved 36 patients with AGML who were treated in three periods between 1968 and 1976. The mortality rate of patients with AGML has been reduced from 50% in the first 2 years to zero in the last 2 years by the use of emergency endoscopy for diagnosis, appropriate medical therapy, properly timed and executed surgery, and, most recently, selective angiography.

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