J.Jpn. Surg. Soc.. 53(4): 256-264, 1952
Original article
STUDIES ON SHOCK
PART I PHYSIOLOGICAL STUDIES ON PERIPHERAL CIRCULATION IN EXPERIMENTAL SHOCK
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II. Surgical Department, Tokyo University Medical School (Director, Prof. T. Fukuda) Naoya MIYAO |
(1) In order to judge the shock stadium easilly, blood pressure, venous pressure (femoral, inferior caval and portal vein), and circulation time (from the femoral vein to the carotid sinuses) were measured at the same time.
In the preshock stadium, each value was various, but in the shock studium the decrease of every venous pressure and the prolongation of circulation time were parallel to decrease of blood pressure.
In burn shock, however, venous pressure usualy remained not so low till the terminal stadium come. Then prolongation of circulation time proved to be the most reliable method of judging the shock stadium in every kind of shock.
(2) The cause of the decrease of shock tolerance in visceral approaches after laparotomies was investigated in the respect of circulating blood volume.
Circulating blood volume decreases almost without exception in visceral approaches after laparotomies.
The fact that the decrease of circulating blood volume had an evident influence upon shock tolerance was revealed by experiment of hemorrhagic and operation shock, which showed that grades of the decrease of ciraulatimg blood volume brought about distinct differenees in surviving time inspite of the same following stresses.
(3) Regarding the changes of thiocyanate fluid volume, no opinion has been settled.
The results shows that the extracellar fluid volume incresed always after every kind of stress.
In case of hemorrhagic shock, the extracellar fluid volume began to decrease at the biginning stage of the severe shock stadium, and in a very few cases the value of the volume came back to that of the preshock stage or less than that. But in most cases the extracellar fluid volume still remained more increasing than before hemorrhage.
The same tendency was observed in the operation shock but almost every terminal value remained more increasing than the preoperative value.
In burn shock and traumatic shock, most cases showed extraordinay increase (more than 50% of body weight), but the fact seems to have been the result of invasion of thiocyanate salt into cells with extracellar fluid, and the author imagines the extracellar fluid volume decreases in the severe Shock.
(author's abstract)
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