RED CELL VOLUME, PLASMA ALBUMIN AND GLOBULIN IN FATAL SURGICAL SHOCK DUE TO REPEATED HEMORRHAGE

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Abstract
Fatal surgical shock followed repeated hemorrhage, each bleeding amounting to 10 ml./kg. of body wt. When the interval between bleedings was 1 or 2 hrs., but 30-40 ml. could be thus removed. When the interval was increased, relative survival was prolonged as shown by the fact that the amt. which could be removed before death increased in simple arithmetical progression. Study of red cell volume changes shows that at least 2 hrs. between bleedings are required for significant hemodilution and that when this interval is increased there is evidence of the addition of albumin to the diluting fluid, in contrast to globulin which was not restored in any of the expts. Artificial hemodilution by replacing the blood with physiological saline did not prolong life. These findings are described in support of the idea that acute hypoalbuminemia is an important cause of failure to compensate for the loss of blood.

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