FACTORS CONCERNED IN THE CIRCULATORY FAILURE OF ADRENAL INSUFFICIENCY

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Abstract
In 12 expts. on 8 dogs, plasma vols. measured by the dye method in the crisis of adrenal insufficiency were about 30% below normal on the avg., while the total blood vol. calculated from the plasma vol. was only about 17% below normal. fluid vols. measured by the sulfocyanate method in crisis were always reduced, but relatively much less than the plasma vols., viz., about 5% on the avg. with much variation. The decrease in plasma vol. may be attributed to at least 2 factors: (a) loss of total extracellular fluid as a result of loss of Na and retention of K, (b) reduction in plasma proteins and consequent loss of plasma to the extravascular spaces. Cardiac failure as evidenced by a high incidence of bradycardia is a more important factor in crisis than is usually recognized. It may be responsible, together with decreased capillary tone, for the severe circulatory failure associated with the apparently moderate decrease in blood vol. In those expts. in which crisis after deprivation of cortin was delayed by a high salt diet, there was evidence suggesting inability of the kidneys to produce urine of high salt content.