Little can be found in the literature at the present time, from either the experimental or the clinical standpoint, to indicate what effect massive hemorrhage followed by shock might have on hepatic function. Since the liver is important for the synthesis of certain blood proteins, including fibrinogen, and since severe hemorrhage can considerably deplete these proteins, impaired hepatic function produced by hemorrhage might result in inadequate restoration. It is possible that other functions of the liver also might be decreased as a result of hepatic cellular damage due to hemorrhage. Patients who die of severe postoperative shock caused by hemorrhage present clinical manifestations similar to those observed in so-called "liver death," which has been described in detail by Boyce and McFetridge1 and others. However, it is well established that most of the patients with manifestations of "liver death" have had definite impairment of hepatic function due to previous hepatic
IRENEUS C, PUESTOW CB. EFFECT OF MASSIVE EXPERIMENTAL HEMORRHAGE ON HEPATIC FUNCTION IN DOGS. Arch Surg. 1944;49(2):100–103. doi:10.1001/archsurg.1944.01230020105004
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