THE RÔLE OF THE MESENTERIC CIRCULATION IN THE IRREVERSIBILITY OF HEMORRHAGIC SHOCK

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Abstract
The behavior of the mesenteric circulation suggests that mechanisms are operative which favor sequestration or pooling of blood in mesenteric vessels, contributing to the irreversibility which characterizes the standardized hemorrhagic shock procedure used here. These mechanisms are: elevated portal pressure; and reduced mesenteric vascular resistance. Pooling is then thought to occur typically when arterial inflow is adequate against increased portal resistance, as results when blood is re-infused following a period of hypotension. To test the hypothesis that increase in hepatic vascular resistance is the initiating factor in mesenteric pooling, portal pressure was experimentally elevated in animals not subjected to hemorrhage. This resulted in decreased mesenteric vascular resistance and variable decline in arterial pressure, and some of the animals went into circulatory collapse, revealing at autopsy the congested intestinal mucosa which characterizes the findings in hemorrhagic shock.