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HYPERGLYCEMIA has been noted in man and animals during hemorrhagic shock. Studies in the dog demonstrated that this hyperglycemia is accompanied by elevated levels of serum immunoreactive insulin, suggesting increased insulin resistance.2 However, recent shock studies by Carey3 in man, and from our laboratory in the ba-boon6 have shown a different pattern. Insulin levels have been depressed despite hyperglycemia suggesting suppression of insulin release rather than increased insulin resistance.Most of these studies have relied on peripheral blood sampling for insulin assay. Since peripheral insulin levels represent an equilibrium expression between pancreatic release and peripheral uptake, it is not certain that peripheral insulin values correlate well with the level of insulin release from the pancreas. A more sensitive sampling site for assaying the insulin response to hemorrhagic shock should be the pancreatic venous outflow system-the portal vein. This study was therefore designed with the following objectives: 1) to determine the changes in portal vein insulin concentration during hemorrhagic shock 2) to determine how accurately peripheral insulin levels predict portal concentrations.

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