J.Jpn. Surg. Soc.. 80(12): 1566-1569, 1979

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Report on the annual meeting

SOME CARDIOPULMONARY ASPECTS IN SHOCK

Cardio-and pulmonary systems must be analyzed simultaneously to interprete the severity of shock. Reduced VO₂ was frequently observed with onset of shock and is an early warning of impeding disaster. The fall in VO₂ indicates diminished peripheral tissue perfusion. VO₂ was measured using replenishment method. Oxygen is mixed with the patient's exhaled air until the mixture has the same oxygen concentration as the inspired air. Once a stedy state is reached, the oxygen replenishment rate is a continuos measure of the patient's mean VO₂.
Venous admixture is increased in shock, and increased capillary permeability and microthrobmbi might cause interstitial lung edema and pulmonary shunt. Experimentally it was demonstrated that shock state contributed to establish DIC-like state in dogs to which thromboplastin was infused and the increase of the pulmonary arterial pressure was noted. In normal dogs the dose of this thromboplatin had no influence to cause DIC-like state.
Supporting data were presented as for the significance of the toxic factors in shock such as MDF. Changes in the oxyhemoglobin dissociation characteristics of the blood will have a profound effect on the amount of available oxygen. Oxygen transport, oxygen releasing capacity was compared in hemorrhagic and septic shock. Also significance of correction of acidosis was discussed upon improvement of oxygen transport and its release.

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