Jeffrey S. Sanders, MD; David W. Ferguson, MD
Tachycardia, increased sympathetic activity, and peripheral vasoconstriction have been described as the principal reflex adjustments to hypovolemic shock. However, experiments in animals suggest that bradycardia and sympathoinhibition can occur during severe hemorrhagic hypotension (1-5). In addition, recent observations indicate that a paradoxical bradycardia can occur during hypotensive hemorrhage in humans (6-8). The mechanisms of this response are not appreciated by most practicing physicians because hypovolemic shock is often promptly treated with volume expansion and because the acute manifestations of rapid, severe hypovolemia are rarely observed. Our observations in a normal, human subject help to delineate the autonomic responses to acute
Sanders JS, Ferguson DW. Profound Sympathoinhibition Complicating Hypovolemia in Humans. Ann Intern Med. 1989;111:439–441. doi: 10.7326/0003-4819-111-5-439
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Published: Ann Intern Med. 1989;111(5):439-441.
Cardiology, Hospital Medicine.
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