The nature and therapy of refractory shock.

A standard experimental shock model was used to investigate the nature and treatment of refractory shock. Peripheral vasodilatation secondary to hypoxia appeared to be the primary problem in pathogenesis, such factors as myocardial or reticuloendothelial depression being of a secondary nature. Protease inhibition using aprotinin (Trasylol) was ineffective in therapy, but glucocorticoids in pharmacological dosage produced a significant improvement in cardiodynamic and oxygen metabolic factors, provided that the agent was administered early.