Studies in Clinical Shock and Hypotension: The Value of Bedside Hemodynamic Observations

Hemodynamic studies have been performed at the bedsides of 50 patients with hypotension or clinical shock. Data important to the management of the patient were obtained quickly and with minimal discomfort. In a number of cases cited, hemodynamic and clinical improvement could be related to the employment of therapeutic approaches suggested by the studies but not considered on clinical grounds. Particularly important were observations of femoral-arterial pressure significantly higher than sphygmomanometer cuff pressures, recognition of heart failure, therapeutic application of blood volume expansion, and individualization of the choice of vasopressor drug. Proper management of the hemodynamic abnormality of hypotension and shock requires an assessment of the circulatory status of the individual patient.