ONE of the most common acute physiologic insults occurring to man is hemorrhage. If sufficiently rapid and of adequate magnitude, hemorrhage per se is uniformly lethal. If of lesser magnitude or more prolonged, it may initiate a recognizable syndrome of body responses which have been termed "hypovolemic shock." Some clinical situations such as bleeding peptic ulcers, esophageal varices, or vascular tumors are examples of relatively pure hemorrhage. Unfortunately, however, most shocklike states are the result of a multiplicity of stresses; and also, unfortunately, shocklike states in which hemorrhage plays a part usually are associated with other factors such as tissue trauma, body exposure, or psychic turmoil. For example, the excited, frightened soldier has a shell fragment wound of the buttock which has severely damaged the muscle masses, perforated the rectum, and cut the hypogastric artery. He has lain in a cold rain for two hours before being carried into the
SWAN H. Experimental Acute Hemorrhage: The Relation of Blood Pressure Change to Plasma Dilution. Arch Surg. 1965;91(3):390–406. doi:10.1001/archsurg.1965.01320150020004
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