Bellamy R F, Pedersen D C, DeGuzman L R
Circ Shock. 1984;14(2):113-27.
We tested the hypothesis that death occurring shortly after massive hemorrhage can be attributed to the development of positive feedback loops arising from deficient blood flow to one or more vital organs such as the heart, brain, and respiratory muscles. The radiomicrosphere technique was used to measure organ blood flow in unmedicated, chronically instrumented swine subjected to removal of 41 ml/kg of blood in 15 min. Ten swine survived the experiments and five died, all within 2 hr after completion of hemorrhage. Cardiac output but not blood pressure was lower in nonsurvivors (mean +/- 1 SD). No difference was found in regard to blood flows to the heart, brain, and diaphragm (flow in ml/gm/min) between survivors and nonsurvivors. Although blood flow posthemorrhage to kidney, organs of the splanchnic bed, and the carcass tended to be greater in survivors compared to nonsurvivors, the difference reached statistical significance only in the small intestine. We conclude that in this model there is no evidence that death following massive hemorrhage results from positive feedback loops arising from deficient perfusion of the coronary or cerebral circulation. It is more likely that death results from abnormalities arising in the carcass and/or splanchnic bed.
大出血后不久发生的死亡可归因于一个或多个重要器官（如心脏、大脑和呼吸肌）血流不足所引发的正反馈回路的发展。使用放射性微球技术测量了未用药、长期植入仪器的猪在15分钟内失血41毫升/千克后的器官血流量。十头猪在实验中存活，五头死亡，均在出血完成后2小时内死亡。非存活猪的心输出量较低，但血压无差异（平均值±1标准差）。存活猪和非存活猪在心脏、大脑和膈肌的血流量（毫升/克/分钟）方面未发现差异。尽管与非存活猪相比，存活猪出血后肾脏、内脏床器官和躯体的血流量往往更大，但差异仅在小肠中达到统计学显著性。我们得出结论，在这个模型中，没有证据表明大出血后的死亡是由冠状动脉或脑循环灌注不足引起的正反馈回路导致的。死亡更有可能是由躯体和/或内脏床出现的异常所致。
