J.Jpn. Surg. Soc.. 56(12): 1693-1704, 1956

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EXPERIMENTAL STUDIES ON THE ACUTE HEMORRHAGE

I. I experimented and investigated on acute hemorrhage chiefly in the survey of arterial system, the movement of breathing, E.K.G. and E.E.G. Vital maximum volume of hemorrhage was average 51.1cc/kg and wa equal to 53.8% of average 93.9cc/kg of circulatory blood volume before operation. Vital volume of hemorrhage in acute hemorrhage is less than that in the case of subacute one, the sudden failure of arterial system and, at the same time, the failure in venous return takes part in it, and moreover insufficient compensation through tissure liquid and preserved blood has an influence upon it, too. Breathing accelerates in early stage, and prevents the valume of O₂ contained in artery from decreasing.
E.K.G. consists chiefly in the change of low voltage, S-T, and T, and shows nearly normal wave even in the time of breath stopping.
E.E.G. changes little in early stage, but after the time when baeathing becomes loose, increase of amplitude begins, and it shows that the cerebrum has fallen in the stage of anoxia, and the wave disappears about the time of breath stopping After disappearance of E.E.G., E.K.G. still shows nearly normal wave, and in the course of 15'~30' after the dissapearance, it falls in fibrillation or results in cardiac arrest.
II. I experimented and investigated that, in the process till death of acute hemorhage, the revival of life can be possible or not, by transfusion into artery or vein in various stages or time, and also studied on its process of revival or the cause of death.
In the case that, after hemorrhage, blood transufusion is used while one is still breathing, it is almost surely possible for one to escape from death. In this case, I observed the effect of intra-arterial or intra-venous blood transfusion in arterial blood pressure, breathing, the volume of O₂ contained in arterial blood, E.K.G., the recovering condition of E.E.G., but did not recognize superiority or inferiority particularly. Keeping alive degree is very low in the case of transfusing blood after hemorrhage and breathing stopped. Even in the case of death, for the most part, arterial blood pressure and E.K.G. seem to show an inclination to recovery, but breathing and E.E.G. don't recover, and soon blood pressure goes down to die. In this case, the lost cerebral faculty is thought to be a serious cause of death. Keeping alive degree is much more low in the case that blood transfusion is used after, with a head up and hemorrhage easily done, and the carotid arterial blood pressure gone down till OmmHg or below this, cerebral circulation completely stopped. In the case of keeping alive, the maximum time, from the time when carotid artery blood pressure went down OmmHg till blood transfusion was used, was 4'50". E.E.G has an important meaning in delivering one from hemorrhage. Under hibernating narcotism a great deel of hemorrhage can be endured. After hemorrhage, by keeping a head down, I observed the carotid arterial blood pressure and the wave on E.K.G. and recognized that such a change of attitude of body like this was efficient in the case of low blood pressure.
III. As a fundamental experimentation, I experimented cardiac puncture, intra-cardiac blood transfusion, so that, though temporary extra systole realized, and at the same time blood pressure descended, yet any special dangerous phenomenon could not be observed.
I thought, therefore, this method could be used for healing acute hemorrhage. Next, when I used it to dogs of middle acute hemorrhage, 21 cases done to right chamber showed death rate of 33% in 8 cases, and 10 cases done to left chamber showed 60%. Many of the death were due directly to stopping beating through cardiac puncture and blood transfusion, and a few of them fellen "Herz Tamponade" through the failure of punction and died.
(author's abstract)

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