J.Jpn. Surg. Soc.. 91(9): 1150-1153, 1990

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Report on the annual meeting

ACUTE MEDICINE AND THE PROGRESS IN SHOCK RESEARCH

Two themes are essential for acute medicine : one is aggressologia, a branch of medicine dealing with host response to acute stress though it may be trauma or not, and the other is critical care medicine dealing with severe emergent patients. Shock, therefore, has been one of the main subjects of our annual meetings.
During the past fifty years, studies on shock in surgery have greatly changed. In the 1950s, during the Korean War, most shock patients were severely wounded soldiers and traffic accident victims. Rapid decrease of blood volume was attributed to the primary problem in shock. The treatment mainly involved blood transfusion and the administration of fluids. In contrast, now in the 1980s, we can see shock in the patients following major operative procedures, patients in ICU or CCU, and especially patients suffering from severe infections. Numerous investigations are focused on the chemical mediators and toxic humoral factors such as endotoxin, oxygen free radical (O₂^-), PAF, lysosomal enzymes, IL-1, and etc. Attention in the management of shock turns to the control of MOF after critical shock-state rather than resuscitative measures themselves.
We report here our recent understanding of 1) O₂^- ＆ the organ damage and 2) MOF ＆ DIC. Controversy over quantitative measurement of endotoxin is also briefly reviewed.

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