PubMed1976
To elucidate the mechanism of development of renal, pulmonary and liver insufficiency after serious shock, retrospective analysis was performed in 85 patients with traumatic shock. Among them, 14 patients died of renal, pulmonary or liver insufficiency after the resuscitation of shock, where kidney and lung were damaged concomitantly in most patients. There was a close correlation between the death related to both insufficiency and the duration of the shockp when the shock was treated completely within 10 hours, there was almost no death related to shock organ, but when the shock persisted more than 10 hours, the death rate was increased as the shock persisted longer. On the contrary, no relation was revealed between death caused by liver insufficiency and the duration of the shock. Renal and pulmonary functions were also correlated with the duration of the shock. It was revealed that the lower PaO2/PAO2 ratio was, the higher urea-N was in these patients, when shock persisted more than 10 hours. On the other hand, no relation was found between the change in liver function and the duration of shock. It can be concluded that the kidney and lung have the same nature as a shock organ. In general both functions were impaired concomitantly, where 10 hours of persistence could be regarded as the critical border to develop the shock organ. The liver seemed to be independent of the others as the shock organ, so that it should be discussed separately.