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March 20, 1948

Current Comment

JAMA. 1948;136(12):832. doi:10.1001/jama.1948.02890290022010

ELECTROLYTES AND WATER IN SHOCK  "Shock is a syndrome resulting from the depression of many functions, but in which reduction of the effective circulating volume and blood pressure are of basic importance and in which impairment of the circulation steadily progresses until it eventuates in a state of irreversible circulatory failure."1 Extended discussion on the nature of the initiating factors in shock has appeared during the past quarter of a century with varying emphasis on their relative importance; however, the ultimate result is diminution of fluid within the blood vessels and the accompanying deleterious hemodynamic effects. Circulatory collapse is the.outstanding clinical feature of shock from trauma or burns; in both circumstances it has not been possible to account satisfactorily for the loss of circulatory fluid by the accumulation of water in the tissues or the loss from the surface. A recent report2 describes experiments designed to trace this

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