"Neither hypovolemia nor a reduction in cardiac output is an essential finding in patients with fatal septic shock," Robert W. Hopkins, MD, of Western Reserve University School of Medicine, Cleveland, told the AMA Annual Convention.
Hopkins' study of septic and hemorrhagic shock indicated differences between these conditions in man and endotoxic shock in experimental animals.
It has been assumed that similar hemodynamic changes occurred in both endotoxic shock in animals and septic shock in man—however, endotoxic shock has been characterized by a reduction in arterial pressure and in cardiac output, Hopkins reported.
A low cardiac output "undoubtedly contributed to the death of three patients" of the 23 studied, Hopkins continued, but "the findings in other patients suggest that a reduction in cardiac output is not always associated with fatal septic shock."
Although cardiac output was normal or elevated in many patients, excess lactate was found in the blood indicating that