Irreversible hemorrhagic shock in dogs: problem of onset of irreversibility

Abstract

Various time course studies were conducted in dogs subjected to a modified Wiggers procedure in an effort to ascertain whether the first reinfusion demand (the earliest overt sign of cardiovascular instability) could be associated with any other measurable biological change. The biphasic blood glucose pattern characteristic of irreversible hemorrhagic shock was thus shown generally to reach its hyperglycemic peak shortly before or at the time of first reinfusion, typically preceded by or coinciding with the earliest morphological changes in liver mitochondria (phase contrast, electron micrographs) and followed by progressive lengthening of the prothrombin time. The declining phase in blood glucose concentration was apparently not associated with any critical liver glycogen level or with any unusual rises in blood lactate, etc. The suggestion is therefore made that the sugar is used metabolically because of a liver shutdown induced by some extrahepatic agent(s) and that these events may, in turn, elicit malfunction elsewhere, e.g. the heart.