Cutaneous and skeletal muscle vascular responses to hemorrhage and irreversible shock

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Abstract
Studies were carried out in skeletal muscle and cutaneous vascular beds of 10 innervated and 8 denervated hindlimbs to determine if there is a peripheral vascular failure in the "irreversible" state of hemorrhagic shock. Venous outflow from each bed was recorded with a cannulation-type square-wave electromagnetic flowmeter during local graded reduction in the perfusion pressure and during stepwise reduction of systemic pressure by hemorrhage. These data were compared to those obtained during the irreversible shock which developed during the phase of prolonged hypotension produced by hemorrhage and persisted until death following reinfusion of blood. It is concluded that sympathetic nerves and hormonal substances both play a role in the vasocontriction that occurs in skeletal muscle during hemorrhage, hormonal constrictors play the dominant role in inducing vasoconstriction in skin, and an important feature in irreversible shock is a progressive increase in skeletal muscle vascular conductance which is related to an accumulative metabolic deficit and is able to overpower the neurogenically induced vasoconstriction.