Title:The Hemodynamics of Septic Shock: A Historical Perspective
Volume: 11
Issue: 2
Author(s): Francois Feihl, Bernard Waeber and Lucas Liaudet
Affiliation:
Keywords:
History, shock, sepsis, hemodynamics, blood pressure, cardiac output, venous return
Abstract: In the late 19th century, it was already known that severe infections could be associated with cardiovascular collapse,
a fact essentially attributed to cardiac failure. A major experimental work in the rabbit, published by Romberg and
Pässler in 1899, shifted attention to disturbed peripheral vascular tone as the mechanism of hypotension in these conditions.
In the first half of the 20th century, great progresses were made in the pathophysiologic understanding of hemorrhagic
and traumatic shocks, while researchers devoted relatively little attention to septic shock. Progress in the hemodynamic
understanding of septic shock resumed with the advent of critical care units. The hyperdynamic state was recognized
in the late fifties and early sixties. The present short review ends with landmark studies by Max Harry Weil, demonstrating
the importance of venous pooling, and John H. Siegel, which introduced the concept of deficient peripheral utilization
of oxygen, inspiring later work on the microvascular disturbances of septic shock.
