Ischemic Compression Shock, With an Analysis of Local Fluid Loss

Green, Harold D.; Dworkin, Robert M.; Antos, Robert J.; Bergeron, Georges

doi:10.1152/ajplegacy.1944.142.4.494

Cited by 10 publications

(3 citation statements)

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“…Although poor correlation has been reported (27,16) we obtained fairly constant changes in relation to magnitude of edema. Hematocrit levels rose sharply during the first 15 minutes following release of tourniquet, corresponding to the period of greatest fluid loss, less rapidly during the next 15 minutes, and leveled off somewhat abruptly thereafter.…”

Section: Resultscontrasting

confidence: 56%

“…This procedure fails to include edema fluid which collects in soft tissues, especially pelvis and flank, without causing expansion and hence gives values lower than those obtained with bisection. A comparison of the 2 methods in dogs by Green and associates (16) showed that the gain in volume measured by immersion ranged from 63 to 88 per cent of the difference in weight of the 2 extremities. Nickerson (17) The rats in this study showed reactive hyperemia of the constricted leg almost immediately after renewal of blood flow.…”

Section: Resultsmentioning

confidence: 99%

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Fluid Loss in Rats With Tourniquet Shock 1

Koletsky

Gustafson²

1946

J. Clin. Invest.

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Release of a high unilateral tourniquet producing complete interruption of blood flow to a hind limb of the rat for about 5 hours almost invariably results in fatal shock. The development of shock is accompanied by progressive edema of the limb. The main object of the following experiments was to determine the magnitude and the rapidity of the fluid loss in the injured extremity. METHODSAdult white male rats weighing about 150 to 300 grams were used. These were anesthetized with sodium pentobarbital, given intraperitoneally in dosage of 25 to 35 mgm. per kgm. of body weight (0.3 to 0.4 ml. of a 2 per cent solution). Circulation in the left lower extremity was then entirely occluded by 2 tightly wound rubber band tourniquets. The first was placed around the knee in order to obtain extension of the leg. This facilitated the application of the second tourniquet, which was placed as high as possible in the groin, anchorage being obtained over a redundant segment of skin drawn down beneath the rubber band.Constriction was maintained for 5 hours and 10 minutes, at the end of which time the rats were alert and showed complete outward recovery from the anesthesia. The animals were then sacrificed by decapitation, either without release of tourniquet, or at fixed time intervals after release, i.e., 15 minutes, 30 minutes, and 1, 2 and 3 hours. The experiments were performed with small groups of rats sacrificed at different periods by random selection, until there was a total of 20 rats for each time interval.In each group there were 1 or more control rats which developed shock after removal of tourniquet and went on to death. Since these yielded only little blood at the time of death, an additional group of 11 rats was sacrificed at 5 to 6 hours following removal of constriction, in order to obtain sufficiEnt blood for chemical determinations. In 18 rats sacrificed by ether at various intervals after tourniquet release, the figures for fluid loss were of the same order as those obtained from decapitated animals.There were a few deaths apparently due to anesthesia. In addition, several rats which chewed their leg before or after removal of tourniquet were discarded. Food and water were withheld for a period of about 10 hours be-1 Aided by a grant from the Elisabeth Severance Prentiss Foundation.fore anesthesia was given, and also during the course ot the experiments. The latter were performed at room temperature during the summer and autumn seasons.The amount of fluid lost in the leg following removal of tourniquet was determined by the method of bisection (1, 2). An anterior midline incision was made from sternum to symphysis pubis and follow.ed by evisceration. A similar posterior midline incision extended down across the base of the tail. The spine was then transected at about the level of the first or second lumbar vertebra, and the lower extremities separated by bilateral paravertebral incisions passing through the hip joints.The difference in weight between the normal and the edematous extremity gave the gain in wei...

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Section: Resultscontrasting

confidence: 56%

Section: Resultsmentioning

confidence: 99%

Fluid Loss in Rats With Tourniquet Shock 1

Koletsky

Gustafson²

1946

J. Clin. Invest.

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“…It has been found (14) that the blood volume lost into the extremities in tourniquet shock was much less than that required to produce a corresponding severity of shock in dogs subjected to hemorrhage. These investigators confirm our observation (1) that the dog is in a precarious state even while the blood pressure is at a relatively satisfactory level.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Shock. Xii. Hemodynamic Effects of Alterations of Blood Viscosity in Normal Dogs and in Dogs in Shock 1

Seligman

Frank²,

Fine³

1946

J. Clin. Invest.

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Striking differences have been noted between dogs in hemorrhagic and in tourniquet shock (1). In both types, there is a reduction in blood volume, but the hematocrit and blood viscosity, which remain substantially unchanged in hemorrhagic shock, increase in tourniquet shock. At a blood pressure level of 80 to 100 mm. Hg, the dog in hemorrhagic shock is only mildly depressed and is still responsive to ordinary stimuli; whereas, in tourniquet shock he is already severely depressed, unresponsive to strong stimulation, much more sensitive to further slight blood loss, and is in a state of rapid deterioration. When the pressure falls below 70 to 80 mm. Hg in tourniquet shock, the collapse is precipitous; whereas, the unanesthetized dog in hemorrhagic shock can tolerate a blood pressure of 50 mm. Hg for many hours. These differences have been explained on the basis of a toxin from devitalized tissue (2, 3) or bacteria (4) in the tourniqueted extremity. The successful treatment of tourniquet shock in the unanesthetized dog by plasma infusion alone (1) constitutes evidence against the "toxin" hypothesis.Since the increase in blood viscosity in tourniquet shock is one of the outspoken differences between tourniquet and hemorrhagic shock, the effect of increased blood viscosity on blood flow in the intact and shocked animal was investigated to see how far it might explain the sharp disparity between these two types of shock. METHODAccording to Poiseuille's equation (5) that the formula can be used to relate viscosity to blood flow through the perfused isolated hind limb of the dog.In the intact animal, therefore, blood flow (or cardiac output) may be considered to be determined by the mean arterial pressure, a constant, and the total peripheral resistance (TPR). The TPR is the product of blood viscosity (v) and the peripheral resistance (R) which is dependent upon the number, length, and diameter of the blood vessels. The data obtained in the following experiments represent an effort to quantitate all the factors in Poiseuille's equation. The cardiac output, the mean arterial pressure and the blood viscosity (X) were measured, while the constant and peripheral resistance (R) were determined indirectly. With such data the effect of blood viscosity on total blood flow can be evaluated.(a) Determination of peripheral resistance (R)Total peripheral resistance (TP R) in the animal as a whole is ordinarily calculated from the formula TP R = Pressure

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Some Experimental Shock Models: Traumatic Shock, Catecholamine Shock, Burn Shock and Other Shock Forms

Schmidt¹

1975

Experimental Production of Diseases: Heart and Circulation

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Ischemic Compression Shock, With an Analysis of Local Fluid Loss

Cited by 10 publications

References 0 publications

Fluid Loss in Rats With Tourniquet Shock 1

Fluid Loss in Rats With Tourniquet Shock 1

Traumatic Shock. Xii. Hemodynamic Effects of Alterations of Blood Viscosity in Normal Dogs and in Dogs in Shock 1

Some Experimental Shock Models: Traumatic Shock, Catecholamine Shock, Burn Shock and Other Shock Forms

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