THE CIRCULATORY FAILURE ASSOCIATED WITH GUANIDINE INTOXICATION

¹ Department of Pediatrics, Vanderbilt University Medical School, Nashville, Tennessee

We have demonstrated that in the later stages of experimental guanidine intoxication there is usually serious circulatory collapse. The failure of the circulation is characterized by an inadequate return of blood to the heart rather than by a primary inefficiency of the heart itself. An important factor in the development of this shock is the loss of plasma fluid and protein from the blood stream through generally damaged capillaries. The fact that the cardiac output and plasma volume decrease significantly before the blood pressure falls indicates that loss of plasma volume rather than vasodilatation is the primary cause of peripheral circulatory failure. Later, however, vasodilatation is probably a contributory factor.

In such clinical conditions as are accompanied by an increase of guanidine in the blood it seems probable that circulatory impairment may at times result from such a retention.

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