OBJECTIVE EVALUATION OF TRANSFUSION THERAPY IN HEMORRHAGIC SHOCK

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Abstract
37 dogs were bled according to a standard method and when the animals had reached the "terminal stage" of hemorrhagic shock, whole blood or plasma was transfused in amt. sufficient to return the blood volume to approx. the control values. In 4 animals volume replacement was carried out with saline. During the control period, immediately before transfusion, and 4 hrs. after transfusion, the following detns. were made: plasma volume hematocrit value, plasma protein concn., arterial blood pH and O2 and CO2 content, whole blood lactate, plasma inorganic phosphate and amino N, urine volume and urinary phosphate concn., jugular venous O2 content, mean arterial blood pressure and heart rate. The degree of recovery, as judged by the return to control values of the various measurements, was more complete in the dogs which were permanently resuscitated by transfusion than in the animals which died in spite of volume replacement. This is shown especially in the increazed plasma bicarbonate concn., in the decreased arterial-jugular venous O2 difference and in the increased excretion of urine and urinary phosphate. The small extent and the transitory nature of the recovery after saline transfusion was striking. The dogs which died after transfusion were in a more serious condition immediately before volume replacement, as judged by the magnitude of the changes in the blood constituents studies, than were those in which transfusion brought about recovery. This finding suggests that when the insult produced by dimished blood volume is severe enough the return of blood volume to control the value does not result in permenent recovery. Differences between the effects of whole blood and plasma transfusions appear to be related to the decrease in viscosity which occurs when plasma is used.