Serum protein concentration during hemorrhagic shock

Abstract

Early changes in serum protein concentration during hemorrhagic shock were evaluated in a series of 20 dogs, following massive bleeding. The serum protein concentration fell faster than did the hematocrit value, with significant changes becoming apparent 15 minutes after hemorrhage, p less than 0.05. After this initial fall, a less marked descent occurred. The most remarkable changes were in the serum albumin fraction. Changes of the globulin levels were less evident. These findings of an early albumin loss, occurring within 15 minutes following acute massive hemorrhage in the dog, probably are due to a leakage of albumin into the interstitial space, secondary to increased capillary membrane permeability. Larger molecules, such as the globulin fraction, did not consistently decrease during the first 45 minutes following shock, a possible indication that loss of this protein into the interstitial space did not occur in a consistent manner. The aforementioned findings support the early use of intravenous infusions containing macromolecules, larger than albumin, during hemorrhagic shock, to re-establish an oncotic gradient, which is diminished due to a loss of albumin from the circulation.