Pharmacological and surgical management

The Institute developed protocols for more general management of shock states including volume repletion by fluid challenge techniques, methods for minimizing the risk of shock during myocardial infarction, and implemented mechanical assist methods including balloon counter-pulsation. Pharmacological management and especially vasopressor drugs, antimicrobial drugs, and cortico-steroids were routinely used for managment of septic shock but with poor outcomes.At the Los Angeles General Hospital, there was a very high maternal mortality due to septic abortion which prompted our group to search for options to secure early rescue. We learned that for managment of septic shock associated with pregnancy, very early surgical interventions which would control of the infection by removal of the uterus with its contents improved outcomes. Accordingly, almost immediate referral to surgical management became the routine.