RT Journal
A1 Buchman TG
T1 Shock: Blalock and cannon
JF Archives of Surgery
JO Archives of Surgery
YR 2010
FD April 1
VO 145
IS 4
SP 393
OP 394
DO 10.1001/archsurg.2010.34
UL http://dx.doi.org/10.1001/archsurg.2010.34
AB Archives of SurgeryShock: Further Studies With Particular Reference to the Effects of HemorrhageAlfred Blalock, MDThis paper reports on a continuation of experiments in dogs to determine the effects of hemorrhage on physiologic measurements of pulse rate and blood pressure along with the weight of vital organs by comparing normal controls to animals exposed to either sodium barbital anesthesia or ether anesthesia. Hemorrhage was caused by removal of blood in small increments (large blood vessel hemorrhage) or trauma (small vessel hemorrhage due to capillary congestion and loss of red blood cells and plasma into locally traumatized area). Changes found in the tissues were related to the length of time that the blood pressure remained low. In these experiments, shock, which is associated with an increased concentration of red blood cells, capillary congestion, and hemorrhage into the tissues, can be produced by hemorrhage alone. Treatment of shock due to loss of blood due to a large vessel injury that has been repaired with the transfusion blood results in the blood staying in the bloodstream and alleviates the shock. Whereas that is not true when the blood loss is due to trauma and the blood and fluid loss is from many small vessels that allow sequestration to occur in the tissues. If low blood pressure remains for several hours in either type of injury, fluid will not be retained intravascularly as then the capillaries become damaged.