Full Description
1. Renal failure following circulatory shock develops because of per- sistent vasoconstriction which is just sufficient to prevent glomerular filtration. Hypoxia of renal tissue has not been demonstrated in surviving cases. 2. During the low-pressure phase in circulatory shock the remaining blood flow through the medullary regions washes out the osmotic gradient built up by the countercurrent system of Henle's loops, so that a concentrated urine cannot be formed. 3. During recovery from circulatory failure the osmotic gradient of the medullary region can only be built up if sufficient fluid from the glomerular filtrate reaches the countercurrent system. The greater the GF, the faster the gradient is built up. References 1. BoYLAN, J. W. , and E. AssHAUER: Unpublished data. -2. DEETJEN, P. , and K. KRAMER: Pfliigers Arch. Physiol. (G. ) (in press). - 3. KRAMER, K. , and K. ULLRICH: Pfliigers Arch. Physiol. (G. ) 267,251 (1958). -4. KRA- MER, K. , K. THURAU and P. DEETJEN: Pfliigers Arch. Physiol. (G. ) 270, 251 (1960). - 5. KRAMER, K. , and P. DEETJEN: Pfliigers Arch. Physiol. (G. ) 271, 782 (1960). -6. KRAMER, K. , and P. DEETJEN: Unpublished data. - 7. KuHN, W. , and A.
RAMEL: Helv. chim. acta 42,628 (1959). - 8. LASSEN, N. A. , 0. MuNcK and J. H. THAYSEN: Acta physiol. Scand. IJ1, 371 (1961). - 9. MUNCK, 0. : Renal Circulation in Acute Renal Failure. Oxford 1958.
Contents
Definition and classification of various forms of shock.- Comparison of various forms of experimental shock.- Possible role of endotoxin in the perpetuation of shock.- Hemodynamic factors in shock.- Nervous adjustments of the vascular bed with special reference to patterns of vasoconstrictor fibre discharge.- Metabolic aspects of shock.- Microscopic observations of the mesenteric circulation in rabbits subjected to reversible and irreversible haemorrhagic shock.- The nature of irreversible shock: its relationship to intestinal changes.- Renal failure in shock.- Renal blood flow and renal clearances during hemorrhage and hemorrhagic shock.- The participation of the adrenal glands in endotoxin, shock.- Aldosterone and alterations in circulatory reactivity following endotoxins.- Reflex mechanisms and the central nervous system.- The effects of emotional stress on the circulation through voluntary muscles.- Hemorrhagic and post-hemorrhagic shock.- The effect of hypovolaemic stagnant and arterial hypoxia on the distribution of cardiac output in dogs and rats.- Observations on haemo-respiratory effects of acute haemorrhage.- Clinical aspects of traumatic shock.- Pathogenesis and therapy of shock due to infection: experimental and clinical studies.- Toxic factors in shock (with special reference to burns).- On the pathogenetic therapy of shock.- Myocardial shock.- Allergic shock.- Radiation shock.- Shock and extracorporeal circulation.- Humoral and myogenic factors in shock: evaluated by means of isolated arteriolar smooth muscle response.- Hypothermia in shock.- Fluid substitution in shock.- Further aspects of fluid substitution.- Drug therapy of shock.- Some aspects of treatment in shock.- Closing remarks.- List of authors.
