Cardiac and peripheral failure in hemorrhagic shock treated with massive transfusions

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Abstract
Hemorrhagic hypotension of variable duration was induced in 18 dogs. Cardiac output, right and left ventricular end-diastolic pressures, and 17 other variables were followed. The shed blood was reinfused and then extra blood and plasma totaling up to 160 ml/kg body weight was transfused to maintain the central venous pressure at the control value. The data support a hypothesis of multifactor failure in shock. Massive, continuing losses of fluid, associated with progressive increases in hematocrit and plasma protein concentration occurred in 7 of the 12 dogs which died. The fluid loss was only partly attributable to intestinal hemorrhage. Cessation of respiration occurred in 4 of the 12, with mean arterial pressures above 80 mm Hg. Cardiac weakening was present in many experiments, but frank cardiac failure occurred in only 1 of the 12. A control series of experiments showed that the technique used and reinfusion of homologous blood after only 5 min of hypotension did not markedly affect the cardiovascular system.

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