Quantitative Indicies of the Shock Syndrome
Annual progress rept. 1 Jul 1970-1 May 1971
CALIFORNIA UNIV SAN DIEGO LA JOLLA
Pagination or Media Count:
The present studies demonstrate the usefulness of routine measurements of plasma colloid osmotic pressure c. o. p. both as a prognostic index of the course of the shock syndrome and as a guide for the effectiveness of other therapeutic measures. Severe and protracted hemorrhagic shock is associated with a failure of hemodilution mechanisms and a trend for plasma c. o. p. and blood hematocrit to become dissociated. Endotoxin has a clear-cut action on neurogenic readjustment mechanisms which is masked in anesthetized animals. Survivors of an LD50 dose of endotoxin, show a blunting of compensatory constrictor responses and thereby permit peripheral blood flow to be maintained more effectively as cardiac output and central pressure fall. Measurements of pressure within the microcirculation reveal that fatal shock is associated with an inability to maintain capillary pressure Pc and a progressive narrowing of the pressure differential or hydraulic driving force across the capillary bed. Fluid exchange at the capillary level is disrupted when capillary pressure Pc and plasma c. o. p. are no longer in balance and lead to extensive venular stasis during shock. Electrolyte therapy in hemorrhagic shock becomes less effective as the capillary barrier begins to show evidence of increased permeability filtration coefficients may increase 2 to 3 fold.
- Medicine and Medical Research