Effect of Slowly Absorbed Epinephrine in Experimental Shock. ∗

Abstract

The impression is prevalent that administration of adrenalin is harmful in clinical shock. 1 Furthermore, various investigators including Freeman 2 3 have reported that a condition which they claim is analogous to shock can be produced in experimental animals by continuous injection of large doses of adrenalin. However, other workers have been unable to produce shock by prolonged administration of this drug. 4 5 In a recent study of traumatic shock, 6 physiologic doses of adrenalin were shown to have a more pronounced pressor action in the course of shock than before trauma.

In view of the controversy concerning the rôle of epinephrine in shock, the effect of administration of slowly absorbed epinephrine in experimental shock was investigated. Shock was produced in anesthetized cats by exposure and manipulation of the small intestine for 30 minutes. The manipulation consisted of stripping the gut forcefully throughout its length. In the control experiments this procedure produced a marked momentary spasm of the segment of gut stripped. There was considerable oozing of sanguinous fluid and the bowel became purple in color. The visible fluid loss at the time of manipulation never exceeded 5 cc. In the animals receiving adrenalin, the identical procedure resulted in less spasm, no visible fluid loss, and less discoloration of the gut.

In 14 cats, anesthetized with chloralose, 80 mg/kilo, the bowel was manipulated without aseptic precautions, using bare hands, and blood pressure was recorded with a mercury manometer from a cannula in the carotid artery. In 6 control experiments, a fall in blood pressure to shock level (60 mm Hg) was produced in an average of one hour and 33 minutes after beginning intestinal trauma, with a range from 35 to 195 minutes. These animals survived an average of 3 hours with a range from 47 minutes to 4 hours and 23 minutes.