scholarly journals TRAUMATIC SHOCK. X. THE TREATMENT OF HEMORRHAGIC SHOCK IRREVERSIBLE TO REPLACEMENT OF BLOOD VOLUME DEFICIENCY 1

1945 ◽  
Vol 24 (4) ◽  
pp. 435-444 ◽  
Author(s):  
Howard A. Frank ◽  
Arnold M. Seligman ◽  
Jacob Fine
Keyword(s):  
Hemorrhagic Shock ◽  
Blood Volume ◽  
Traumatic Shock

scholarly journals EVIDENCE FOR A LETHAL ENDOTOXEMIA AS THE FUNDAMENTAL FEATURE OF IRREVERSIBILITY IN THREE TYPES OF TRAUMATIC SHOCK

1960 ◽  
Vol 112 (5) ◽  
pp. 793-800 ◽  
Author(s):  
F. B. Schweinburg ◽  
J. Fine
Keyword(s):  
Hemorrhagic Shock ◽  
Blood Volume ◽  
Hypovolemic Shock ◽  
Traumatic Shock ◽  
Bacterial Activity ◽  
Pathophysiological Mechanism ◽  
Volume Therapy ◽  
Progressive Decline ◽  
Fundamental Feature

The data here reported (Table I) show that a toxin is present in the blood of animals with two types of irreversible hypovolemic shock. These data also show that although blood volume therapy does not correct the hypovolemia because of continuing loss of plasma at the site of injury, the major factor in the progressive decline and death is the endotoxemia rather than the hypovolemia. This is also true of severe and prolonged hemorrhagic shock that is irreversible to transfusion. The data also show that even when there is bacterial activity at the site of injury, the pool of endotoxin in the intestine is the chief source of the circulating endotoxin. In all three types of shock, the endotoxemia develops because persisting hypovolemic shock renders the RE system unable to destroy the endotoxin. The demonstration of an endotoxemia as the cause of irreversibility and death in three types of traumatic shock caused by three different agents suggests that a single pathophysiological mechanism accounts for the phenomenon of irreversibility in all types of traumatic shock.

Different Effects of Volatile and Nonvolatile Anesthetic Agents on Long-Term Survival in an Experimental Model of Hemorrhagic Shock

2020 ◽  
Vol 25 (4) ◽  
pp. 346-353
Author(s):  
Wangde Dai ◽  
Jianru Shi ◽  
Juan Carreno ◽  
Robert A. Kloner
Keyword(s):  
Blood Pressure ◽  
Survival Rate ◽  
Hemorrhagic Shock ◽  
Blood Volume ◽  
Brain Infarction ◽  
Anesthetic Agent ◽  
Term Survival ◽  
Long Term Survival ◽  
Isoflurane Group

Background: We investigated whether the cardioprotective, volatile gas anesthetic agent, isoflurane, could improve survival and organ function from hemorrhagic shock in an experimental rat model, compared to standard nonvolatile anesthetic agent ketamine/xylazine. Methods: Sprague Dawley rats (both genders) were randomized to receive either intraperitoneal ketamine/xylazine (K/X, 90 and 10 mg/kg; n = 12) or isoflurane (5% isoflurane induction and 2% maintenance in room air; n = 12) for anesthesia. Blood was withdrawn to maintain mean arterial blood pressure at 30 mm Hg for 1 hour, followed by 30 minutes of resuscitation with shed blood. Rats were allowed to recover and survive for 6 weeks. Results: During the shock phase, the total withdrawn blood volume (expressed as % of estimated total blood volume) to maintain a level of hypotension of 30 mm Hg was significantly higher in the isoflurane group (51.0% ± 1.5%) than in the K/X group (45.3% ± 1.8%; P = .023). Recovery of blood pressure during the resuscitation phase was significantly improved in the isoflurane group compared to the K/X group. The survival rate at 6 weeks was 1 (8.3%) of 12 in rats receiving K/X and 10 (83.3%) of 12 in rats receiving isoflurane ( P < .001). Histology performed at 6 weeks demonstrated brain infarction in the 1 surviving rat receiving K/X; no brain infarction occurred in the 10 surviving rats that received isoflurane. No infarction was detected in heart, lung, liver, or kidneys among the surviving rats. Conclusions: Isoflurane improved blood pressure response to resuscitation and resulted in significantly higher long-term survival rate.

Pulmonary blood volume in hemorrhagic shock in the dog and primate

1967 ◽  
Vol 213 (5) ◽  
pp. 1072-1078 ◽  
Author(s):  
FL Abel ◽  
JA Waldhausen ◽  
WJ Daly ◽  
WL Pearce
Keyword(s):  
Hemorrhagic Shock ◽  
Blood Volume ◽  
Pulmonary Blood Volume

scholarly journals The first domestic devices for intraosseous infusion - is the great advance of military medicine in pre-hospital stage enhancement

2018 ◽  
Vol 20 (4) ◽  
pp. 106-112
Author(s):  
I M Samokhvalov ◽  
K P Golovko ◽  
A V Denisov ◽  
S Yu Telitsky ◽  
N A Zhirnova ◽  
...  
Keyword(s):  
Blood Volume ◽  
Medical Devices ◽  
Limited Liability ◽  
Traumatic Shock ◽  
Infusion Therapy ◽  
Volume Resuscitation ◽  
Limited Liability Company ◽  
Circulating Blood Volume ◽  
Medical Evacuation ◽  
Intraosseous Infusion

Traumatic shock is considered to be the most common clinical form of a severe patient’s condition (63%). Timely and adequate blood volume resuscitation is one of the most important procedures in providing medical care to critically injured casualties and patients at the forward medical evacuation stage. The key to this problem, especially when the infusion therapy is needed at the pre-hospital stage, is the development of alternative (extravascular) techniques of plasma volume expander administration. The article presents the results of testing of the first domestic medical devices for intraosseous infusion in critically injured casualties and patients. At present, on commission of the Russian Ministry of Defense and with the scientific support of Kirov Military Medical Academy, domestic enterprises developed test samples of medical devices to provide intraosseous infusions: a «Disposable device for intraosseous infusion of solutions if there is no intravenous access, which was designed on the basis of a spring drive» - the index «VKI-P», developed by limited liability company «Novoplast-М» and a set for intraosseous infusion using an electric drive - the index « VKI-E», developed by limited liability company «Research engineering company «Spetsproekt». Assessment of performance of test samples of the medical devices for intraosseous infusions «VKI-P» and «VKI-E» was carried out using pathophysiologic model of traumatic shock in 14 experimental animals (pigs) by creating artificial blood loss of medium severity, 25% of circulating blood volume (in average 440 ml), followed by its resuscitation with intraosseous infusion of 0,9% solution of NaCl. As a result of the performed tests it was found that the device «VKI-P» and the set «VKI-E» provide for NaCl infusion in major vessels (with an intraosseous infusion), 750 ml of volume during 45-50 min, and can be used as an alternative access to provide infusion as a part of anti-shock therapy, which solves the problem of volume resuscitation when giving care to severely injured casualties and patients at the forward medical evacuation stages. These samples may be recommended for inclusion into the medical service list of complete supplies and the Medical Corps supply support, the Armed Forces of the Russian Federation.

Splanchnic blood volume in traumatic shock

1961 ◽  
Vol 200 (3) ◽  
pp. 614-618 ◽  
Author(s):  
J. J. Friedman
Keyword(s):  
Red Blood Cells ◽  
Cell Volume ◽  
Blood Volume ◽  
Plasma Volume ◽  
Blood Cells ◽  
Traumatic Shock ◽  
Red Cell ◽  
Differential Distribution ◽  
Red Cell Volume ◽  
Tourniquet Shock

The distribution of radioiodinated plasma and radioiron-labeled red blood cells between the liver, intestine and spleen were determined during the induction and development of tourniquet shock in mice. The data obtained indicate that plasma and red blood cells are distributed differentially throughout the splanchnic vasculature such that plasma volume of liver, intestine and spleen remain depressed for the entire shock interval, as does splenic red cell volume. After an early decline, the red cell volume of liver and intestine become elevated to a level above control. This differential distribution of plasma and red cells in liver and intestine is attributed to alterations in peripherovascular tone and suggests that a venous component becomes prominent late in shock and may act to pool blood out of active circulation.

Transfusion of Red Blood Cells under Shock Conditions in the Rat Microvasculature.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2713-2713 ◽  
Author(s):  
Ian Chin-Yee ◽  
Leslie Statchuk ◽  
Stephanie Milkovich ◽  
Anargyros Xenocostas ◽  
Christopher Ellis
Keyword(s):  
Hemorrhagic Shock ◽  
Blood Volume ◽  
Ex Vivo ◽  
Fluorescein Isothiocyanate ◽  
Arterial Line ◽  
Sprague Dawley ◽  
Time Points ◽  
Significant Difference ◽  
Fresh Rbcs ◽  
The Impact

Abstract Background RBC transfusion is the mainstay of therapy for resuscitation of patients with hemorrhagic shock. Ex-vivo storage of RBCs for transfusions is associated with a storage lesion which decreases erythrocyte deformability and increases their adhesiveness to vascular endothelium. This may impair microcirculatory flow with deleterious effects on oxygen delivery post-transfusion. The objective of this study was to determine whether transfused stored rat blood impairs the microcirculation following resuscitation from hemorrhagic shock Methods Donor Sprague Dawley rat RBCs were collected and stored in CPDA-1 under standard blood bank conditions. RBCs were labelled with FITC (fluorescein isothiocyanate) 24 hours before the experiment. RBCs stored for less than 24 hours (fresh) RBCs (n=3) were compared to RBCs stored for 7 days (n=3). To induce shock, forty percent of blood volume was removed from male Sprague Dawley rats. Animals were then resuscitated by injecting 1.5mL of labelled packed RBCs and sufficient saline to restore blood volume via arterial line. The number of adherent labelled RBCs in the extensor digitorum longus muscle (EDL) was detected using intravital video microscopy (20X magnification). RBC velocity, capillary diameters, capillary Hct (hematocrit), arterial Hct, and lactate data was collected at three time points (baseline, shock and resuscitation). Results Lactate levels increased significantly during shock in both the fresh and stored groups. Arterial Hct decreased in shock and was restored to baseline levels with resuscitation. The stored group had an increased number of stopped cells in the microcirculation compared to their fresh counterparts (p=0.004). There was no statistical significant difference in capillary diameters between groups or time points. Both groups showed an increase in RBC velocity from baseline to resuscitation (stored group doubled, fresh group tripled). Capillary Hct did not change in the fresh group but doubled in the old group from baseline to resuscitation. Conclusion In our shock model, transfusion of stored RBCs resulted in an increased number of stopped cells and lower RBC velocity in capillaries as compared to fresh RBCs. Stored RBCs also had an increased capillary Hct from baseline to resuscitation and a diminished hyperemic response as compared to fresh RBCs. We conclude that stored RBCs following transfusion behave differently than native or fresh transfused cells in the microcirculation. Further studies are needed to determine the impact of these microcirculatory changes on oxygen availability in transfusion.

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