BLAIR 



reduced perfusion, the failure of the needed carrier mechanism. 

 The hypoglycemia observed during hypothermia is not in keeping 

 with the usual observations. Hyperglycemia is fairly characteristic 

 in normal animals cooled from 31° C to 25° C (Bickford and Mot- 

 tram, 1960; Blair, unpublished data) andinhumansat 30° C (Henne- 

 man et aI,,I958),Theelevatedbloodsugar has been attributed to re- 

 duced metabolism and impaired absorption (Henneman et al., 19 58; 

 Wynn, 19 54), Endotoxins have been demonstrated to produce hypo- 

 glycemia after an initial hyperglycemia (Berry et al., 1959), Hypo- 

 glycemia was not observed in only those patients under hypothermia 

 in this study. One likely explanation may be that shivering caused 

 this, but since all survivors shivered at one time or another, other 

 causes must have existed. 



While there is little doubt of the efficacious role of hypothermia 

 in bacteremia shock, the evidence thereto is essentially imperical. 

 The continued administration of antibiotics, corticosteroids, and 

 other drugs may well have obscured the precise effect of hypo- 

 thermia itself. In order to assess the effect of cooling per se, an 

 experimental study was undertaken. 



EXPERIMENTAL STUDY 



Methods 



Randomized chlorolosed mongrel dogs of both sexes weighing be- 

 tween 10-15 kg were induced into septic shockby peritoneal instilla- 

 tion of 1 to 1.5 gms of feces, suspended in saline. Ventilation was 

 unsupported. Three groups of dogs were studied: normal (B), septic 

 shock (S.S.), and septic shock plus hypothermia of 32° C (S.S. + H.). 

 Arterial blood pressure (ABPm) was monitored, as were heart and 

 ventilatory rates (HR and Vj^, Arterial and mixed venous samples 

 and expired air were withdrawn for baseline controls during septic 

 shock and after hypothermia was induced. Oxygen content was de- 

 termined by Van Slyke-Neil method, while oxygen uptake (V02) was 

 determined by Scholander; and from these cardiac output (Q) was 



428 



