Corbett J L, Spalding J M, Harris P J
Br Med J. 1973 Aug 25;3(5877):423-8. doi: 10.1136/bmj.3.5877.423.
Three patients with severe tetanus had episodes of profound arterial hypotension lasting from minutes to hours. The blood pressure was recorded continuously for 13, 19, and six days respectively by an intra-arterial catheter, and other measurements included heart rate, central venous pressure, cardiac output, and blood gases.The hypotension was distinguished from that of "shock", for there was no clinical evidence of peripheral vasoconstriction and no tachycardia. It could not be attributed to disturbances of salt and water balance. During episodes of hypotension the blood pressure fell as low as 32/16 mm Hg, the heart rate fell from a mild tachycardia to normal values or a mild bradycardia, and the central venous pressure did not rise. The onset and the end of such episodes was often abrupt and the hypotension was often produced in response to a stimulus. In one patient extreme hypotension followed the aspiration of secretions from the trachea. These changes may represent another effect of tetanus on autonomic nervous activity, including impairment of baroreceptor reflexes.
三名重度破伤风患者出现了持续数分钟至数小时的严重动脉低血压发作。分别通过动脉内导管连续记录血压13天、19天和6天，其他测量指标包括心率、中心静脉压、心输出量和血气。这种低血压与“休克”所致低血压不同，因为没有外周血管收缩的临床证据，也没有心动过速。它不能归因于水盐平衡紊乱。在低血压发作期间，血压降至32/16 mmHg，心率从轻度心动过速降至正常或轻度心动过缓，中心静脉压未升高。这些发作的开始和结束通常很突然，低血压常因刺激而产生。在一名患者中，气管分泌物吸引后出现了极度低血压。这些变化可能代表破伤风对自主神经活动的另一种影响，包括压力感受器反射受损。
