THE ORIGIN AND UTILIZATION OF AMMONIA IN SHOCK.
Final technical rept. 1 Oct 55-30 Sep 62,
MARYLAND UNIV BALTIMORE SCHOOL OF MEDICINE
Pagination or Media Count:
Mechanism in various states of shock were studied hemorrhagic, septic, cardiogenic and strangulation obstruction. Metabolic acidosis was common to all. Ammonia increased early in the portal venous blood and peritoneal fluid and late in systemic circulation. Ammonia metabolic disruption prob ably is a consequence and not a contributory cause of irreversibility. The Fine preparation was too severe for therapeutic assay. An LD50 preparation was developed and is the standard University of Maryland model. Tissue hypoxia is a common denominator of pathophysiology re gardless of the shock type and may be the ulti mate responsible deficit for irreversibility. Therapeutic regimens explored included hypother mia, partial by-pass, balanced electrolyte solutions, mitochondria, infusion, aldosterone and hyperbaric oxygenation. On the basis of this experimental work, the following clinical applications evolved Hypothermia in cardiac surgery and septic shock ammonia in peritoneal fluid as useful test in the differential diag nosis of acute abdomen aldosterone in prefer ence to vasopressors in shock hyperbaric oxygen in hemorrhagic shock. Author