Intra-arterial Infusion

Abstract

Recommendations continually appear for intra-arterial administration of infusion solutions in severe hemorrhagic shock [949, 1236, 1364, 1449, 1580]. In 1955 this problem was thoroughly clarified by Gurd [624]. He showed that the site of infusion is unimportant as long as sufficient volume can be supplied during a certain period of time (see also [640]). In these studies it can also be seen that too rapid infusion when normovolemia has almost been reached or overtransfusion worsens the prognosis. Furthermore intra-artierial infusions are seldom used clinically for shock therapy, since it is usually much more difficult and time-consuming to find a good approach to an artery than to one or more veins. On the other hand there is no objection to intra-arterial infusion if an artery has already been catheterized, perhaps intra- or postoperatively. One can assume that i. a. infusion has a better effect than i. v. infusion when the pressure in the aorta in terminal stages has already fallen so far that adequate perfusion of the coronaris is no longer possible. In all other situations there is no good evidence which would support the superiority of i. a. over i. v. infusion, so long as there is the possibility of infusing an equal volume in the same period of time.