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Research Article| Volume 10, ISSUE 4, P289-296, May 1979

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The nature and therapy of refractory shock

DOI:https://doi.org/10.1016/0020-1383(79)90046-9
The nature and therapy of refractory shock
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      Abstract

      A standard experimental shock model was used to investigate the nature and treatment of refractory shock. Peripheral vasodilatation secondary to hypoxia appeared to be the primary problem in pathogenesis, such factors as myocardial or reticuloendothelial depression being of a secondary nature.
      Protease inhibition using aprotinin (Trasylol) was ineffective in therapy, but glucocorticoids in pharmacological dosage produced a significant improvement in cardiodynamic and oxygen metabolic factors, provided that the agent was administered early.
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      References

        • Back N.
        • Wilkens H.
        • Munson A.E.
        • et al.
        Trasylol in experimental shock states.
        in: Report of an International Symposium in Grobeleder, 23–30 March 1965. 1965: 170-175
        • Blattberg B.
        • Levy M.N.
        Mechanism of depression of reticulo-endothelial system in shock.
        Am. J. Physiol. 1962; 203: 111
        • Coleman B.
        • Kallal J.E.
        • Feigen L.P.
        • et al.
        Myocardial performance during haemorrhagic shock in the pancreatectomised dog.
        Am. J. Physiol. 1975; 228: 1462
        • Connolly J.E.
        • Bruns D.L.
        • Stoffer R.C.
        The use of intravenous hydrocortisone in haemorrhagic shock.
        in: Surg. Forum. 9. 1959: 17
        • Daniels C.
        • Stein A.A.
        • Moss G.
        The shock lung syndrome: anaemia as a predisposing factor.
        in: Surg. Forum. 24. 1973: 1
        • Dietzman R.H.
        • Castaneda A.R.
        • Lillehei C.W.
        • et al.
        Corticosteroids as effective vasodilators in the treatment of low output syndrome.
        Chest. 1970; 57: 440
        • Fine J.
        Host resistance to bacterial infection in traumatic shock.
        Br. J. Anaesth. 1958; 30: 485
        • Fisher W.D.
        • Heimbach D.W.
        • McArdle C.S.
        • et al.
        A circulating depressant effect following canine haemorrhagic shock.
        Br. J. Surg. 1973; 60: 392
        • Frey E.K.
        • Kraut H.
        • Werle E.
        Kallikrein (Puduntein). F. Enke, Stuttgart1950
        • Glenn T.M.
        • Herlihy B.L.
        • Lefer A.M.
        Protective action of a protease inhibitor in haemorrhagic shock.
        Arch. Int. Pharmacodyn. Ther. 1973; 203: 292
        • Hardaway R.M.
        The role of intravascular clotting in the aetiology of shock.
        Ann. Surg. 1962; 155: 325
        • Hume D.M.
        • Nelson D.H.
        Adrenal cortical function in surgical shock.
        in: Surg. Forum. 5. 1955: 568
        • Janoff A.
        • Weissmann G.
        • Zweifach B.W.
        • et al.
        Pathogenesis of experimental shock: IV studies on lysosomes in normal and tolerant animals subjected to lethal trauma and endotoxaemia.
        J. Exp. Med. 1962; 116: 451
        • Kim S.I.
        • Desai J.M.
        • Shoemaker W.C.
        Sequential respiratory changes in an experimental hemorrhagic shock preparation designed to simulate clinical shock.
        Ann. Surg. 1969; 170 (Part II): 166
        • Kim S.I.
        • Desai J.M.
        • Shoemaker W.C.
        Sequence of cardiorespiratory alterations after gradual prolonged hemorrhage in conscious dogs.
        Am. J. Physiol. 1969; 216: 1044
        • Knapp R.W.
        • Howard J.M.
        Studies on the effect of hydrocortisone on irreversible haemorrhagic shock in the dog.
        Surgery. 1957; 42: 919
        • Kusajima K.
        • Wax S.D.
        • Webb W.R.
        Effects of methyl prednisolone on pulmonary microcirculation.
        Surg. Gynecol. Obstet. 1974; 139: 1
        • Ledingham I.McA.
        Septic shock.
        Br. J. Surg. 1975; 62: 777
        • Ledingham I.McA.
        • Fisher W.D.
        • McArdle C.S.
        • et al.
        The incidence of the shock syndrome in a general hospital.
        Postgrad. Med. J. 1974; 50: 420
        • Ledingham I.McA.
        • Heimbach D.M.
        • Hutton I.
        • et al.
        Cardiac function in haemorrhagic shock.
        Br. J. Surg. 1971; 58: 868
        • Lefer A.M.
        • Martin J.
        Mechanism of the protective effect of corticosteroids in haemorrhagic shock.
        Am. J. Physiol. 1969; 216: 314
        • Lefer A.M.
        • Martin J.
        Origin of myocardial depressant factor in shock.
        Am. J. Physiol. 1970; 218: 1423
        • Lister G.D.
        Is there a place for proteinase inhibition? Review of the literature.
        Postgrad. Med. J. 1969; 45: 571
        • Ludwig H.
        • Tauber P.
        Proteinase inhibition in experimental shock.
        New Aspects of Trasylol Therapy. 1969; 4: 137
        • McConn Rita
        • Del Guercio L.R.M.
        Respiratory function of blood in the acutely ill patient and the effect of steroids.
        Ann. Surg. 1971; 174: 436
        • Marston A.
        The bowel in shock: the role of mesenteric arterial disease as a cause of death in the elderly.
        Lancet. 1962; 2: 365
        • Matheson N.A.
        The microcirculation in shock.
        Postgrad. Med. J. 1969; 45: 530

      28. Mayo P. (1974) Personal communication.

        • Mela Leena
        • Becalzo jun., L.V.
        • Miller L.D.
        Defective oxidative metabolism of rat liver mitochondria in haemorrhagic and endotoxin shock.
        Am. J. Physiol. 1971; 220: 571
        • Motsay G.J.
        • Alho A.
        • Haeger T.
        • et al.
        Effects of methyl prednisolone, phenoxybenzamine and epinephrine tolerance in canine endotoxin shock: study of isogravimetric capillary in forelimb and intestine.
        Surgery. 1971; 70: 271
        • Norman J.N.
        • Napper A.J.
        • Davidson A.I.
        • et al.
        The possible use of total blood replacement in the management of liver failure.
        in: Proceedings of the 5th International Hyperbaric Conference. 2. 1973: 759

      32. Philip E. (1974) Personal communication.

        • Raflo G.T.
        • Jones R.C.W.
        • Wangensteen S.L.
        Inadequacy of steroids in the treatment of severe haemorrhagic shock.
        Am. J. Surg. 1975; 130: 321
        • Rothe C.F.
        • Selkurt E.E.
        Cardiac and peripheral failure in haemorrhagic shock in the dog.
        Am. J. Physiol. 1964; 207: 203
        • Schumer W.
        Dexamethasone in oligaemic shock: physiochemical effects in monkeys.
        Arch. Surg. 1969; 98: 259
        • Schumer W.
        Steroids in the treatment of clinical septic shock.
        Ann. Surg. 1976; 184: 333
        • Schumer W.
        • Nyhus L.M.
        Corticosteroid effect on biochemical parameters in human oligaemic shock.
        Arch. Surg. 1970; 100: 405
        • Schumer W.
        • Sperling R.
        Shock and its effect on the cell.
        JAMA. 1968; 205: 215
        • Smith J.A.R.
        • Norman J.N.
        Volume infusion in experimental refractory shock.
        Br. J. Surg. 1979; 66: 80
        • Smith J.A.R.
        • Norman J.N.
        • Smith G.
        Steroid and protease inhibition in refractory shock.
        Br. J. Surg. 1975; 62: 164
        • Smith L.L.
        • Moore F.D.
        Refractory hypotension in man—is this irreversible shock?.
        N. Engl. J. Med. 1962; 267: 733
        • Soares de Moura R.
        • Rodrigues H.
        • Sollero L.
        Hydrocortisone and vascular reactivity in dogs with haemorrhagic shock.
        Pharmacology. 1973; 9: 226
        • Spath J.A.
        • Lane D.L.
        • Lefer A.M.
        Protective action of methyl prednisolone on the myocardium during experimental myocardial ischaemia in the cat.
        Circ. Res. 1974; 35: 44
        • Stalker A.L.
        The microcirculation in shock.
        J. Clin. Pathol. 1970; 23: 10-15
        • Thomas C.S.
        • Brockman S.K.
        The role of adrenal corticosteroid therapy in escherichia coli endotoxin shock.
        Surg. Gynecol. Obstet. 1968; 126: 61
        • Trapnell J.E.
        • Rigby C.C.
        • Talbot C.H.
        • et al.
        A controlled trial of Trasylol in the treatment of acute pancreatitis.
        Br. J. Surg. 1974; 61: 177
        • Webster Marion E.
        • Clark W.R.
        Significance of the kallikrein-cellidinogen-cellidin system in shock.
        Am. J. Physiol. 1959; 197: 406
        • Weil M.H.
        The cardiovascular effects of corticosteroids.
        Circulation. 1962; 25: 718
        • Weil M.H.
        • Whigham H.
        Corticosteroids for reversal of haemorrhagic shock in rats.
        Am. J. Physiol. 1962; 209: 815
        • Wiggers C.J.
        The present status of the shock problem.
        Physiol. Rev. 1942; 22: 74
        • Wiggers C.J.
        The failure of transfusions in irreversible haemorrhagic shock.
        Am. J. Physiol. 1945; 144: 91
        • Wiggers H.C.
        • Ingraham R.C.
        Haemorrhagic shock definition and criteria for its diagnosis.
        J. Clin. Invest. 1946; 25: 30
        • Wiggers C.J.
        • Werle J.M.
        Cardiac and peripheral resistance factors as determinants of circulatory failure in haemorrhagic shock.
        Am. J. Physiol. 1942; 136: 421

      Article info

      Identification

      DOI: https://doi.org/10.1016/0020-1383(79)90046-9

      Copyright

      © 1979 Published by Elsevier Inc.

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