J.Jpn. Surg. Soc.. 60(11): 1846-1862, 1960

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EXPERIMENTAL STUDY ON EFFECT OF MASSIVE SALINE SOLUTION, BLOOD TRANSFUSION FOR MASSIVE HEMORRHAGE.

Hemorrhagic shock was produced in 47 mongrel doge by Lamson and Délormé's method. The experimental animals which have been exposed to severe hemorrhagic hypotention for a certain period of time failed to respond, with death ensued, to reinfusion of the total volume of the heparinized blood withdrown from the femoral artery. In these experiments the whole course in the development of shock was divided into two stadiums-the bleeding and the back-flow stadium. In the present report the effect of transfusion of massive saline solution and/or blood in each stadium was considered from the aspect of arterial pressure, inferior vena caval pressure, circulating blood valume, circulating serum volum , circulating time, hematocrit, plosma protein content and histological changes in important organs. The results are as follows:
1) Effect of saline and/or blood transfusion on the circulatory system was considerably slighter when it was carried out in the bleeding stadium than when in the back-flow stadium. All animals survived more than 24 hours with less histological changes in the liver, kidneys and adrenals.
2) In the bleeding stadium transfusion of saline solution affected more favorably on the circulatory system than blood transfusion did. Hemodilution was demonstrated in the former series, while tread of hemoconcentration was encountered in the latter series.
3) Although the histological changes were severer in dogs submitted to blood transfusion in the back-flow stadium, survival time was more prolonged as compared with dogs treated with saline transfusion in the same stadium.
4) From the results of hemodynamic tolerance, changes in hemocomponents and survival time, the bleeding stadium and the back-flow stadium were considered, respectively, to be compensatory and decompensatory stadiums in the development of shock.
5) Autonomic blocking due to venoculysis of Cocktail M₁ or Packatal prior to bleeding stabilized the circulatory system of animals. In these experiments the effect of massive saline transfusion on circulation, hemocomponents and histological pictures was remarkably slight with resultant prolongation of survival time over 24 hours.
(Author's abstract)

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