Abstract
Fifty-seven dogs were subjected to hemorrhagic hypotension by a variety of protocols. Histologic pulmonary changes were studied using the light microscope. Of these 57 dogs, 21 had no demonstrable lesions, 8 had minimal changes, and 28 had moderate or severe lesions, all of a focal nature. No correlation was found between the presence of lesions and mean systemic arterial pressure during shock, the udration of the hemorrhagic period, the fate of the animal, preoperative hematocrits and blood volumes, mean postreinfusion arterial pressure, whether the animals were mongrels or purebred beagles, whether they were awake or sedated, whether they breathed spontaneously or were artifically ventilated, whether they had undergone previous splenectomy or not, whether hilar stripping was performed or not, and finally, whether blood was reinfused after hemorrhage or not. Thus we conclude that multiple factors may exert a harmful effect on the lung in hemorrhagic shock, and that shock probably makes the lungs more vulnerable to other injurious agents rather than there being one single pathogenetic mechanism for the pulmonary damage. The term "adult respiratory distress syndrome" rather than "shock lung" is best used for the human clinical entity since it implies a complex ettiology rather than a discrete pulmonary lesion produced by a single pathogenetic mechanism.
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Selected References
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- Ashbaugh D. G., Bigelow D. B., Petty T. L., Levine B. E. Acute respiratory distress in adults. Lancet. 1967 Aug 12;2(7511):319–323. doi: 10.1016/s0140-6736(67)90168-7. [DOI] [PubMed] [Google Scholar]
- Ashbaugh D. G., Petty T. L. The use of corticosteroids in the treatment of respiratory failure associated with massive fat embolism. Surg Gynecol Obstet. 1966 Sep;123(3):493–500. [PubMed] [Google Scholar]
- Barkett V. M., Coalson J. J., Greenfield L. J. Early effects of hemorrhagic shock on surface tension properties and ultrastructure of canine lungs. Johns Hopkins Med J. 1969 Feb;124(2):86–94. [PubMed] [Google Scholar]
- Bredenberg C. E., James P. M., Collins J., Anderson R. W., Martin A. M., Jr, Hardaway R. M., 3rd Respiratory failure in shock. Ann Surg. 1969 Mar;169(3):392–403. doi: 10.1097/00000658-196903000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brewer L. A., Burbank B., Samson P. C., Schiff C. A. The "Wet Lung" in War Casualties. Ann Surg. 1946 Mar;123(3):343–362. [PMC free article] [PubMed] [Google Scholar]
- Bryant L. R., Trinkle J. K., Dubilier L. Acute respiratory pathophysiology after hemorrhagic shock. Surgery. 1970 Sep;68(3):512–519. [PubMed] [Google Scholar]
- Buckberg G. D., Lipman C. A., Hahn J. A., Smith M. J., Hennessen J. A. Pulmonary changes following hemorrhagic shock and resuscitation in baboons. J Thorac Cardiovasc Surg. 1970 Mar;59(3):450–460. [PubMed] [Google Scholar]
- Chien S., Dellenback R. J., Usami S., Burton D. A., Gustavson P. F., Magazinovic V. Blood volume, hemodynamic, and metabolic changes in hemorrhagic shock in normal and splenectomized dogs. Am J Physiol. 1973 Oct;225(4):866–879. doi: 10.1152/ajplegacy.1973.225.4.866. [DOI] [PubMed] [Google Scholar]
- Clowes G. H., Jr, Zuschneid W., Turner M., Blackburn G., Rubin J., Toala P., Green G. Observations on the pathogenesis of the pneumonitis associated with severe infections in other parts of the body. Ann Surg. 1968 May;167(5):630–650. doi: 10.1097/00000658-196805000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cook W. A., Webb W. R. Pulmonary changes in hemorrhagic shock. Surgery. 1968 Jul;64(1):85–94. [PubMed] [Google Scholar]
- EINHEBER A., CERILLI G. J. Hemorrhagic shock in the monkey. Am J Physiol. 1962 Jun;202:1183–1187. doi: 10.1152/ajplegacy.1962.202.6.1183. [DOI] [PubMed] [Google Scholar]
- Gomez A. C. Pulmonary insufficiency in nonthoracic trauma. J Trauma. 1968 Sep;8(5):656–686. doi: 10.1097/00005373-196809000-00005. [DOI] [PubMed] [Google Scholar]
- Hardaway R. M., James P. M., Jr, Anderson R. W., Bredenberg C. E., West R. L. Intensive study and treatment of shock in man. JAMA. 1967 Mar 13;199(11):779–790. [PubMed] [Google Scholar]
- Henry J. N., McArdle A. H., Scott H. J., Gurd F. N. A study of the acute and chronic respiratory pathophysiology of hemorrhagic shock. J Thorac Cardiovasc Surg. 1967 Nov;54(5):666–681. [PubMed] [Google Scholar]
- JENKINS M. T., JONES R. F., WILSON B., MOYER C. A. Congestive atelectasia complication of the intravenous infusion of fluids. Ann Surg. 1950 Sep;132(3):327–347. doi: 10.1097/00000658-195009000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Keller C. A., Schramel R. J., Hyman A. L., Creech O., Jr The cause of acute congestive lesions of the lung. J Thorac Cardiovasc Surg. 1967 May;53(5):743–753. [PubMed] [Google Scholar]
- Largiadèr F., Illi E., Uhlschmid G. Lymphocyte typing in dogs. II. Production and storage of antisera. Eur Surg Res. 1973;5(1):1–10. doi: 10.1159/000127634. [DOI] [PubMed] [Google Scholar]
- Lewin I., Weil M. H., Shubin H., Sherwin R. Pulmonary failure associated with clinical shock states. J Trauma. 1971 Jan;11(1):22–35. doi: 10.1097/00005373-197101000-00002. [DOI] [PubMed] [Google Scholar]
- MOON V. H. The pathology of secondary shock. Am J Pathol. 1948 Mar;24(2):235–273. [PMC free article] [PubMed] [Google Scholar]
- Martin A. M., Jr, Simmons R. L., Heisterkamp C. A., 3rd Respiratory insufficiency in combat casualties. I. Pathologic changes in the lungs of patients dying of wounds. Ann Surg. 1969 Jul;170(1):30–38. doi: 10.1097/00000658-196907000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Meyers J. R., Meyer J. S., Baue A. E. Does hemorrhagic shock damage the lung? J Trauma. 1973 Jun;13(6):509–519. doi: 10.1097/00005373-197306000-00004. [DOI] [PubMed] [Google Scholar]
- Moss G. S., Das Gupta T. K., Newson B., Nyhus L. M. Morphologic changes in the primate lung after hemorrhagic shock. Surg Gynecol Obstet. 1972 Jan;134(1):3–9. [PubMed] [Google Scholar]
- Nash G., Blennerhassett J. B., Pontoppidan H. Pulmonary lesions associated with oxygen therapy and artifical ventilation. N Engl J Med. 1967 Feb 16;276(7):368–374. doi: 10.1056/NEJM196702162760702. [DOI] [PubMed] [Google Scholar]
- Nash G., Foley F. D., Langlinais P. C. Pulmonary interstitial edema and hyaline membranes in adult burn patients. Electron microscopic observations. Hum Pathol. 1974 Mar;5(2):149–160. doi: 10.1016/s0046-8177(74)80062-6. [DOI] [PubMed] [Google Scholar]
- OSBORN J. J., POPPER R. W., KERTH W. J., GERBODE F. Respiratory insufficiency following open heart surgery. Ann Surg. 1962 Oct;156:638–647. doi: 10.1097/00000658-196210000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
- PETERSDORF R. G., FUSCO J. J., HARTER D. H., ALBRINK W. S. Pulmonary infections complicating Asian influenza. AMA Arch Intern Med. 1959 Feb;103(2):262–272. doi: 10.1001/archinte.1959.00270020090010. [DOI] [PubMed] [Google Scholar]
- Sealy W. C., Ogino S., Lesage A. M., Young W. G., Jr Functional and structural changes in the lung in hemorrhagic shock. Surg Gynecol Obstet. 1966 Apr;122(4):754–760. [PubMed] [Google Scholar]
- Sugg W. L., Craver W. D., Webb W. R., Ecker R. R. Pressure changes in the dog lung secondary to hemorrhagic shock: protective effect of pulmonary reimplantation. Ann Surg. 1969 Apr;169(4):592–598. doi: 10.1097/00000658-196904000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Veith F. J., Hagstrom J. W., Panossian A., Nehlsen S. L., Wilson J. W. Pulmonary microcirculatory response to shock, transfusion, and pump-oxygenator procedures: a unified mechanism underlying pulmonary damage. Surgery. 1968 Jul;64(1):95–108. [PubMed] [Google Scholar]
- Veith F. J., Richards K. Improved technic for canine lung transplantation. Ann Surg. 1970 Apr;171(4):553–558. doi: 10.1097/00000658-197004000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Willwerth B. M., Crawford F. A., Young W. G., Jr, Sealy W. C. The role of functional demand on the development of pulmonary lesions during hemorrhagic shock. J Thorac Cardiovasc Surg. 1967 Nov;54(5):658–665. [PubMed] [Google Scholar]