BLAIR 



■re 



40 



38 

 36 

 34 

 32 



30- 

 160 

 I40 



120' 

 100- 

 80 

 60' 

 40 

 20 



BlX»0D CULTURE 



WBC IN THOUSANDS 

 7 5 7 10 25 21 



HEMATOCRIT 

 26 35 35 



TRANSFUSION 



31 20 25 33 



i- - 









? io Iz 13 M is i 26* ii ' 67*' 61 



DAYS 01 234 5678 



12 3 4 5 6 



HYPOTHERMIA 



Figure 6. Case of bacteroldes septic shock managed with hypothermia. 



and coma believed due to brain abscess, necessitated further 

 cooling. Within 24 hours the patient was again awake. The pa- 

 tient complained of the cold and was shivering actively. Re- 

 warming was started again on the eighth day and was followed 

 by an elevated temperature of 38° C, Since the patient's hemo- 

 dynamics and neurologic status remained normal, no further cooling 

 was attempted. Figure 7 shows the blood picture, Durir^ the ini- 

 tial period of the bacteremia, there was a leucopenia. The white 

 blood cell count was 5,000 with only 30 per cent mature gran- 

 ulocytes and 50 per cent immature cells. Just prior to cooling, 

 the white count increased and continued to be elevated during 

 hypothermia. Mature polymorphonuclear leucocytes appeared in 

 the high ratio normally expected in severe sepsis. The alter- 

 ations in hematocrit coincided with the whole blood deficits, and 

 returned to normal with blood replacement. 



426 



