The effects of PGE i on the pulmonary and systemic circulation were observed in critically ill surgical patients with evidence of circulatory impairment after maximal volume loading in a protocol for surgical patients prior to the development of ARDS. Traditionally, studies have evaluated physiologic effects of therapeutic agents given to patients in shock or other circulatory deficiencies; the physiologic effects are then compared with the biologic outcome, morbidity and mortality. This approach tacitly evaluates the agent tested as though its action were sufficient, in and of itself, to reverse an otherwise morbid course and thereby improve outcome.
The present study differs from this traditional approach in that it assumes that fluid therapy for shock states is the first important aspect of resuscitation of shock and shock-related circulatory deficiencies. Then, after maximally tolerated volume therapy has been given, additional therapy may be used to improve tissue perfusion from maldistribution of the systemic circulation produced by the secondary effects of hypovolemia or other effects of the shock state. buy yasmin online
In the present study, significantly increased Cl, Do2 and Vo2 were also observed after PGEi in the early postoperative period of surgical patients with circulatory deficiencies, but who did not at that time have ARDS.