Prediction of survival or death of patients in a state of severe shock.

In previously normal patients in a state of severe shock, a prolongation of partial thromboplastin time above 100 seconds due to shock, an elevation of lactic dehydrogenase above 500 units per milligram, an elevation of serum glutamicoxalacetic transaminase above 125 units per milliliter, an elevation of serum glutamic-pyruvate transaminase above 60 units per milliliter, an elevation of lactate above 52 milligrams per milliliter are grave signs and predict a probable mortality. This does not apply to patients in a state of acute traumatic and hemorrhagic shock in extreme vasoconstriction or treated with vasoconstrictors. An arterial pO2-alveolar pO2 ratio of below 15 per cent indicates a probable mortality, above 30 per cent, a probable recovery. Cardiac index, arterial pH, arterial pO2, blood volume and systemic blood pressure have little correlation with survival. Monitoring coagulation and the intensity of its activity seem to be an effective index of mortality in severe shock in previously normal patients.