Importance of Venous Return, Venous Resistance, and Mean Circulatory Pressure in the Physiology and Management of Shock

      A reasonable, unifying definition of shock at the cellular level is inadequate oxygen consumption by the cell for its metabolic needs. The negative consequence is the accumulation of an oxygen debt with eventual cellular dysfunction and death.
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      REFERENCES

        • Guyton AC
        • Jones CE
        • Coleman TG
        Circulatory physiology: cardiac output and its regulation. 2nd. W.B. Saunders, Philadelphia1973
        • Perkin RM
        • Levin DL
        Shock in the pediatric patient: Part II. Therapy.
        J Pediatr. 1982; 101: 319-332
        • Green JF
        Circulatory mechanics.
        Fundamental cardiovascular and pulmonary physiology. Lea & Febiger, Philadelphia1982: 101-110
        • Green JF
        Determinants of systemic blood flow.
        in: Guyton AC Young DB International review of physiology: cardiovascular physiology III. vol 18. University Park Press, Baltimore1979: 34-65
        • Weil MH
        • Shubin H
        Proposed reclassification of shock states with special reference to distributive defects.
        Adv Exp Med Biol. 1972; 23: 13-22
        • Holcroft JW
        Impairment of venous return in hemorrhagic shock.
        Surg Clin N Am. 1982; 62: 17-28
        • Hinshaw LB
        Release of vasoactive agents and the vascular effects of endotoxin.
        in: Kadis S Weinbaum G Ajl SJ Microbiol toxins. Academic Press, New York1971: 209-255
      1. Bressack MA, Morton NS, Hortop J. Group B streptococcal sepsis in the piglet: effects of fluid therapy on venous return, organ edema, and organ blood flow. Circ Res (in press)

        • Hinshaw LB
        • Shambour LL
        • Greenfield LJ
        • Coalson JJ
        Mechanism of decreased venous return.
        Arch Surg. 1970; 100: 600-606
        • Pollack MM
        • Fields AL
        • Ruttimann UE
        Sequential cardiopulmonary variables of infants and children in septic shock.
        Crit Care Med. 1984; 12: 554-559
        • Hinshaw LB
        Role of the heart in the pathogenesis of endotoxic shock.
        J Surg Res. 1974; 17: 134-145
        • Shoemaker WC
        • Hauser CH
        Critique of crystalloid versus colloid therapy in shock and shock lung.
        Crit Care Med. 1979; 7: 117-124
        • Lillehei RC
        • Longerbeam JK
        • Bloch JH
        • Manax WG
        The nature of irreversible shock: experimental and clinical observations.
        Ann Surg. 1964; 160: 682-708
        • Marino RJ
        • Romagnoli A
        • Keats AS
        Selective venoconstriction by dopamine in comparison with isoproterenol and phenylephrine.
        Anesthesiology. 1975; 43: 570-572
        • Rothe CF
        Venous system: physiology of the capacitance vessels.
        in: Shepherd JT Abboud FM Handbook of physiology: peripheral circulation and organ blood flow. Ed 2. American Physiology Society, Bethesda1983: 397-452
        • Holcroft JW
        • Link DP
        • Lantz BMT
        • Green JF
        Venous return and the pneumatic antishock garment in hypovolemic baboons.
        J Trauma. 1984; 24: 928-935
        • Lopes OU
        • Velasco IT
        • Guertzenstein PG
        • Silva MR
        • Pontieri V
        Hypertonic sodium chloride restores mean circulatory filling pressure in severely hypovolemic dogs.
        Hypertension. 1986; 8: I 195-I 199
        • Ogilvie R
        Comparative effects of vasodilator drugs on flow distribution and venous return.
        Can J Physiol Pharmacol. 1985; 63: 1345-1355
        • Ito H
        • Hirakawa S
        Effects of vasodilators on the systemic capacitance vessels, a study with the measurement of the mean circulatory pressure in dogs.
        Jap Circ J. 1984; 48: 388-404
        • Sylvester JT
        • Goldberg HS
        • Permutt S
        The role of the vasculature in the regulation of cardiac output.
        Clin Chest Med. 1983; 4: 111-128