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Article
October 1966

A Bioassay of Treatment of Hemorrhagic ShockII. The Expansion of the Volume Distribution of Extracellular Ions During Hemorrhagic Hypotension and Its Possible Relationship to Change in the Physical-Chemical Properties of Extravascular-Extracellular Tissue

Arch Surg. 1966;93(4):556-561. doi:10.1001/archsurg.1966.01330040020002

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Abstract

Evidently something happens in the extracellular material lying between the exchange vessels and the cells causing more water molecules and sodium ions to be sorbed upon the macromolecules constituting and lying within the ground substance.

In man, the surface of extracellular collagen fibrils alone amounts to more than a million square meters (more than 160 acres or 0.25 sq mile). Collagen's sorption of water and sodium ions is altered remarkably by changes of pH, temperature, physical deformation, and the like.30 Consequently, with the increased concentration of lactic and pyruvic acids and lowered pH in the ground substance that occurs during hemorrhagic hypotension, the collagen could well adsorb more water molecules and salt ions and thereby reduce the amount of rapidly exchangeable sodium and water in the extravascular-extracellular tissue. The number of rapidly exchangeable sodium ions in the body is an important determinant of cell function.25

The proof that

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