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Regional Blood Flow and Oxygen Consumption in Experimental Hemorrhagic Shock

Regional Blood Flow and Oxygen Consumption in Experimental Hemorrhagic Shock Abstract The fundamental element in the treatment of hemorrhagic shock is the correction of the deficit of blood volume before critical changes have occurred which render the shock irreversible. In the dog which has been subjected to severe hemorrhagic shock the reinfusion of shed blood almost invariably leads to a recovery of blood pressure and cardiac output. This recovery is short-lived in animals which have passed the point of reversibility, and it is a matter of the greatest difficulty to explain why one animal will go on to survive while another will die. During the period of hypotension the perfusion of tissues and the consumption of oxygen are both greatly reduced. The degree of depression of oxygen consumption during shock has been shown by Guyton and Crowell to bear a relationship to recovery.11 Immediately after reinfusion the oxygen consumption rises along with the blood pressure and cardiac output, but it References 1. Abel, F. L., and Murphy, Q. R.: Mesenteric, Renal, and Iliac Vascular Resistance in Dogs After Hemorrhage , Amer J Physiol 202:978, 1962. 2. Andersen, M. N.; Hambraeus, G.; Alfano, G. A.; and Schenk, W. G., Jr.: Distribution of Splanchnic and Peripheral Blood Flow During Acute Reduction in Circulatory Rate , Ann Surg 153:477, 1961.Crossref 3. Ballinger, W. F., II, and Vollenweider, H.: The Effect of Acute Hemorrhage Upon Hepatic Blood Flow and Splanchnic Oxygen Consumption in Dogs , Surgery 48:758, 1960. 4. Blalock, A., and Mason, M. F.: Observations on the Blood Flow and Gaseous Metabolism of the Liver of Unanesthetized Dogs , Amer J Physiol 117: 328, 1936. 5. Bounous, G., and King, H.: Cross Clamping of the Descending Thoracic Aorta , AMA Arch Surg 78:519, 1959.Crossref 6. Bradley, S. E.; Marks, P. A.; Reynell, P. C.; and Meltzer, J.: The Circulating Splanchnic Blood Volume in Dog and Man , Trans Ass Amer Physicians 66:294, 1953. 7. Cull, T. E.; Scibetta, M. P.; and Selkurt, E. E.: Arterial Inflow Into Mesenteric and Hepatic Vascular Circuits During Hemorrhagic Shock , Amer J Physiol 185:365, 1956. 8. Frank, E. D.; Frank, H. A.; Jacob, S. W.; Fine, J.: Hepatic Blood Flow in Experimental Hemorrhagic Shock , Amer J Physiol 202:7, 1962. 9. Friedman, J. J.: Mesenteric Circulation in Hemorrhagic Shock , Circ Res 9:561, 1961.Crossref 10. Gregg, D. E.: in Shock: Pathogenesis and Therapy; An International Symposium , edited by K. D. Bock, Berlin: Springer-Verlag, 1962. 11. Guyton, A. C., and Crowell, Z. W.: Dynamics of the Heart in Shock , Fed Proc 20:51, 1961. 12. Hamrick, L. W., Jr., and Myers, J. D.: Effect of Hemorrhage on Hepatic Blood Flow and Splanchnic Oxygen Consumption of Dog , Circ Res 3:65, 1955.Crossref 13. Hinshaw, D. B.; Peterson, M.; Huse, W. M.; Stafford, C. E.; and Joergenson, E. J.: Regional Blood Flow in Hemorrhagic Shock , Amer J Surg 102:224, 1961.Crossref 14. Johnson, P. C., and Selkurt, E. E.: Intestinal Weight Changes in Hemorrhagic Shock , Amer J Physiol 193:135, 1958. 15. Lillehei, R. C.: The Intestinal Factor in Irreversible Hemorrhagic Shock , Surgery 42:1043, 1957. 16. Longerbeam, J. K.; Lillehei, R. C.; and Scott, W. R.: The Nature of Irreversible Shock: A Hemodynamic Study , Surg Forum 13:1, 1962. 17. Osten, W.: Behavior of the Splanchnic Area and of the Total Organism in Hemorrhagic Shock in Animal Experiment , Z Ges Exp Med 131:30, 1959.Crossref 18. Pontius, R. G.; Brockman, H.; Hardy, E. G.; Cooley, D. A.; and DeBakey, M. F.: The Use of Hypothermia in the Prevention of Paraplegia Following Temporary Aortic Occlusion: Experimental Observations , Surgery 36:33, 1954. 19. Powers, L. H., and Schloerb, P. R.: Intestinal Factor in Irreversible Hemorrhagic Shock , Surg Forum 9:40, 1958. 20. Reynell, P. C.; Marks, P. A.; Chidsey, C.; and Bradley, S. E.: Changes in Splanchnic Blood Volume and Splanchnic Blood Flow in Dogs After Haemorrhage , Clin Sci 14:407, 1955. 21. Selkurt, E. E., and Brecher, G. A.: Splanchnic Hemodynamics and Oxygen Utilization During Hemorrhagic Shock in the Dog , Circ Res 4:693, 1956.Crossref 22. Thompson, B. G.; Hampson, L. G.; and Gurd, F. N.: The Relationship of Oxygen Consumption, Oxygen Debt, and Cardiac Output to Survival of Dogs in Hemorrhagic Shock, in preparation. 23. Werner, A. Y.; MacCanon, D. M.; and Horvath, S. M.: Fractional Distribution of Total Blood Flow to and Oxygen Consumption of the Liver as Influenced by Mild Hemorrhage , Amer J Physiol 170:624, 1952. 24. Zanetti, M. E.: Significance of Elevated Portal Vein Pressure in Etiology of Hemorrhagic Shock , Amer J Physiol 171:538, 1952. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Regional Blood Flow and Oxygen Consumption in Experimental Hemorrhagic Shock

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Publisher
American Medical Association
Copyright
Copyright © 1963 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1963.01310140148023
Publisher site
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Abstract

Abstract The fundamental element in the treatment of hemorrhagic shock is the correction of the deficit of blood volume before critical changes have occurred which render the shock irreversible. In the dog which has been subjected to severe hemorrhagic shock the reinfusion of shed blood almost invariably leads to a recovery of blood pressure and cardiac output. This recovery is short-lived in animals which have passed the point of reversibility, and it is a matter of the greatest difficulty to explain why one animal will go on to survive while another will die. During the period of hypotension the perfusion of tissues and the consumption of oxygen are both greatly reduced. The degree of depression of oxygen consumption during shock has been shown by Guyton and Crowell to bear a relationship to recovery.11 Immediately after reinfusion the oxygen consumption rises along with the blood pressure and cardiac output, but it References 1. Abel, F. L., and Murphy, Q. R.: Mesenteric, Renal, and Iliac Vascular Resistance in Dogs After Hemorrhage , Amer J Physiol 202:978, 1962. 2. Andersen, M. N.; Hambraeus, G.; Alfano, G. A.; and Schenk, W. G., Jr.: Distribution of Splanchnic and Peripheral Blood Flow During Acute Reduction in Circulatory Rate , Ann Surg 153:477, 1961.Crossref 3. Ballinger, W. F., II, and Vollenweider, H.: The Effect of Acute Hemorrhage Upon Hepatic Blood Flow and Splanchnic Oxygen Consumption in Dogs , Surgery 48:758, 1960. 4. Blalock, A., and Mason, M. F.: Observations on the Blood Flow and Gaseous Metabolism of the Liver of Unanesthetized Dogs , Amer J Physiol 117: 328, 1936. 5. Bounous, G., and King, H.: Cross Clamping of the Descending Thoracic Aorta , AMA Arch Surg 78:519, 1959.Crossref 6. Bradley, S. E.; Marks, P. A.; Reynell, P. C.; and Meltzer, J.: The Circulating Splanchnic Blood Volume in Dog and Man , Trans Ass Amer Physicians 66:294, 1953. 7. Cull, T. E.; Scibetta, M. P.; and Selkurt, E. E.: Arterial Inflow Into Mesenteric and Hepatic Vascular Circuits During Hemorrhagic Shock , Amer J Physiol 185:365, 1956. 8. Frank, E. D.; Frank, H. A.; Jacob, S. W.; Fine, J.: Hepatic Blood Flow in Experimental Hemorrhagic Shock , Amer J Physiol 202:7, 1962. 9. Friedman, J. J.: Mesenteric Circulation in Hemorrhagic Shock , Circ Res 9:561, 1961.Crossref 10. Gregg, D. E.: in Shock: Pathogenesis and Therapy; An International Symposium , edited by K. D. Bock, Berlin: Springer-Verlag, 1962. 11. Guyton, A. C., and Crowell, Z. W.: Dynamics of the Heart in Shock , Fed Proc 20:51, 1961. 12. Hamrick, L. W., Jr., and Myers, J. D.: Effect of Hemorrhage on Hepatic Blood Flow and Splanchnic Oxygen Consumption of Dog , Circ Res 3:65, 1955.Crossref 13. Hinshaw, D. B.; Peterson, M.; Huse, W. M.; Stafford, C. E.; and Joergenson, E. J.: Regional Blood Flow in Hemorrhagic Shock , Amer J Surg 102:224, 1961.Crossref 14. Johnson, P. C., and Selkurt, E. E.: Intestinal Weight Changes in Hemorrhagic Shock , Amer J Physiol 193:135, 1958. 15. Lillehei, R. C.: The Intestinal Factor in Irreversible Hemorrhagic Shock , Surgery 42:1043, 1957. 16. Longerbeam, J. K.; Lillehei, R. C.; and Scott, W. R.: The Nature of Irreversible Shock: A Hemodynamic Study , Surg Forum 13:1, 1962. 17. Osten, W.: Behavior of the Splanchnic Area and of the Total Organism in Hemorrhagic Shock in Animal Experiment , Z Ges Exp Med 131:30, 1959.Crossref 18. Pontius, R. G.; Brockman, H.; Hardy, E. G.; Cooley, D. A.; and DeBakey, M. F.: The Use of Hypothermia in the Prevention of Paraplegia Following Temporary Aortic Occlusion: Experimental Observations , Surgery 36:33, 1954. 19. Powers, L. H., and Schloerb, P. R.: Intestinal Factor in Irreversible Hemorrhagic Shock , Surg Forum 9:40, 1958. 20. Reynell, P. C.; Marks, P. A.; Chidsey, C.; and Bradley, S. E.: Changes in Splanchnic Blood Volume and Splanchnic Blood Flow in Dogs After Haemorrhage , Clin Sci 14:407, 1955. 21. Selkurt, E. E., and Brecher, G. A.: Splanchnic Hemodynamics and Oxygen Utilization During Hemorrhagic Shock in the Dog , Circ Res 4:693, 1956.Crossref 22. Thompson, B. G.; Hampson, L. G.; and Gurd, F. N.: The Relationship of Oxygen Consumption, Oxygen Debt, and Cardiac Output to Survival of Dogs in Hemorrhagic Shock, in preparation. 23. Werner, A. Y.; MacCanon, D. M.; and Horvath, S. M.: Fractional Distribution of Total Blood Flow to and Oxygen Consumption of the Liver as Influenced by Mild Hemorrhage , Amer J Physiol 170:624, 1952. 24. Zanetti, M. E.: Significance of Elevated Portal Vein Pressure in Etiology of Hemorrhagic Shock , Amer J Physiol 171:538, 1952.

Journal

Archives of SurgeryAmerican Medical Association

Published: Aug 1, 1963

References