We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Acid-Base Disturbances in Hemorrhagic Shock In 66 Severely Wounded Patients Prior to Treatment

Charles T. Cloutier, MC, USN; Brian D. Lowery, MC, USNR; Larry C. Carey, MD
Arch Surg. 1969;98(5):551-557. doi:10.1001/archsurg.1969.01340110043001.
Text Size: A A A
Published online


Evidence obtained in animal and man in shock indicates that the initial acid-base disturbance in hemorrhagic shock is metabolic acidosis.1 This acidosis results from the production of acid metabolites by cells forced into anaerobic metabolism by hypoxia. The hypoxia may be due to failure of the perfusion pump (heart), increased vascular resistance, loss of the perfusate (blood), or a failure to oxygenate the perfusate. In hemorrhagic shock without pulmonary injury, the first three are the most important. The opportunity to study previously healthy humans with severe hemorrhagic traumatic shock before treatment might cast light on the nature of the acid-base disturbance of shock in man.

The following study was designed to answer the following questions: (1) What is the initial acid-base profile in humans, in shock, from trauma and blood loss. (2) Can the degree of acid-base derangement be predicted from the magnitude of injury and blood loss, or


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.