The nervous factor in traumatic shock

Slome, David; O'Shaughnessy, Laurence

doi:10.1002/bjs.18002510017

Cited by 12 publications

(4 citation statements)

References 4 publications

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“…after the trauma, since after that time the natural development tends to arrest this condition without outside interference. This conclusion bears out the experience of Slome & O'Shaughnessy [1938] that 'the subject of severe trauma who does not show some sign of recovery under established modes of treatment within two or three hours of his injury is almost inevitably doomed'. The sealing up of the portals from the blood vessels to the tissues may be of mixed benefit, since it does not only stop the outflow of plasma into the tissue, but renders also the reflow into the reversed direction more difficult.…”

Section: Late Effectsmentioning

confidence: 67%

Capillary permeability in traumatic shock

Engel¹,

Forrai²

1943

The Journal of Physiology

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One of us [Engel, 1940] has recently worked out a method for determining directly the permeability of the capillaries in a given region. This method appeared suitable for reinvestigation of the problem of increased permeability of capillaries in 'traumatic shock'. We have therefore examined whether, after crushing a limb, there occurs an increase in the filtration through the capillaries either confined to the traumatized region and its immediate neighbourhood or generalized throughout the body.In traumatic shock a great quantity of plasma is assumed to escape from the blood vessels owing to their increased permeability. Evidence for this loss of plasma is of a twofold nature: the haemoconcentration found in man as well as in experimental animals during traumatic shock and the increase in weight of a traumatized limb. Both findings, however, are open to a different interpretation. Haemoconcentration may be due to escape of fluid constituents of blood, but it may also occur as a result of mobilization of blood corpuscles from the blood reservoirs, especially the spleen and the bone marrow. This possibility has not always been excluded as a cause of the haemoconcentration. The increase in weight of a traumatized limb, found by Blalock [1930] has been contested by some [Moon, 1938] but confirmed by others [Phemister, 1928;Harkins, 1941]. It results from loss into the crushed limb out of the vessels, of plasma as well as blood, in amounts sufficient to account for death. It is not possible to determine to what extent the increase in weight is due to escape of whole blood from broken or torn vessels or to escape of fluid through the capillary walls. Beard & Blalock [1931], by centrifuging crushed tissue in order to separate the extravascular fluid, attempted to show that the oedema fluid of a crushed limb has a similar composition as serum. This method, however, does not differentiate between the plasma of the extra-and intravascular blood in the tissue and the extravascular oedema fluid. Both will appear in the supernatant fluid on centrifugation. There is thus no direct evidence of an increased capillary permeability in shock.PH. CiI. 9

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Section: Late Effectsmentioning

confidence: 67%

Capillary permeability in traumatic shock

Engel¹,

Forrai²

1943

The Journal of Physiology

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“…The experiments of Slome and O'Shaughnessy (1938), as well as those of Lorber et al, emphasize the importance of the nervous factor in the development of traumatic shock. Either they severed the limb from its nervous connexions (nerve section, spinal section; spinal-cord destruction, spinal anaesthesia) or they severed the limb from everything except its peripheral nerves.…”

Section: Techniquementioning

confidence: 89%

Sympathetic Block for Traumatic Shock

Engel¹

1944

BMJ

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“…Cowell's (1919) "primary shock" may vary greatly in its prognostic significance, but is a clinical state that still happens and requires explanation. The stimulating hypothesis of Slome and O'Shaughnessy (1938) that the primary reaction was due to fluid loss and the secondary collapse had its nervous component, warrants renewed consideration at a higher level of complexity and in the light of further evidence from the human subject now that we can measure the degree of oligaemia.…”

Section: Shock: a Complex Of Reactionsmentioning

confidence: 99%

Recent Advances in Haemorrhage and Shock

Clarke¹

1957

BMJ

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The nervous factor in traumatic shock

Cited by 12 publications

References 4 publications

Capillary permeability in traumatic shock

Capillary permeability in traumatic shock

Sympathetic Block for Traumatic Shock

Recent Advances in Haemorrhage and Shock

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