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October 1966

A Bioassay of Treatment of Hemorrhagic ShockI. The Roles of Blood, Ringer's Solution With Lactate, and Macromolecules (Dextran and Hydroxyethyl Starch) in the Treatment of Hemorrhagic Shock in the Anesthetized Dog

Arch Surg. 1966;93(4):537-555. doi:10.1001/archsurg.1966.01330040001001

SHOCK has been variously defined. The simplest definition, "a rude unhinging of life," aptly fits the depth of our state of ignorance about it. Its origins and manifestations vary, but the outcome is, nevertheless, the same: death, or recovery.

Looking at the problem philosophically, the outcome in any particular case is unpredictable, and it must be so, as long as we are incapable of determining the biologic significance of each of the physiologic changes that accompany the genesis of shock. Is the fall of oxygen consumption that follows a large hemorrhage and accompanies shock regulatory (positive and good), nonregulatory (negative and bad), or positive at one time during the course of shock and negative at another? Is the acceleration of the secretions of the adrenal medulla and cortex positive and good, or negative and bad? Is the production of vasopressor proteoses and amines good or bad? Is the hyperpotassemia of

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