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August 1964

Low Molecular Weight Dextran Therapy in Surgical ShockPart 1. Control Group and Shock Patients Resuscitated Prior to Low Molecular Weight Dextran Therapy

Arch Surg. 1964;89(2):373-379. doi:10.1001/archsurg.1964.01320020137020

Introduction  A wealth of information has accumulated over the past 30 years on the problems relating to shock, a great deal of which was derived from animal experimentation. Despite the tremendous value of such studies, it has long been recognized that the controlled shock of the laboratory is frequently a far cry from the clinical situation engendered by deep shock.Laboratory and clinical observations have sought to illuminate shock problems in two spheres, namely, pathophysiologic mechanisms, and, subsequently, appropriate, effective treatment. Unfortunately, mechanisms observed in the laboratory and at the bedside did not seem consistently to be identical, and, more often, treatment did not seem to have the same, or even similar, results.One obviously dissimilar feature between the experimental model and its human counterpart is the number of factors involved. The Wiggers preparation, encompassing controlled, graded hemorrhage and volumetric replacement in the dog, is not a clinical phenomenon. The