COLD THERAPY IN BACTEREMIC SHOCK 



the dog are hypotension, hyperpnea, tachycardia, and increased 

 A-"C^Q2. In the human they are hypotension, tachycardia, and a 

 reduced and irregular ventilation, and widened A-Vo2» 



L eucopenia . The leucopenia is reported due to endotoxic effect 

 and the hyperpyrexia due to pyrogens from granulocytes. The 

 mechanism is obscure, but may be in part caused by depression 

 of bone marrow activity. The breakdown of host resistance (Zwei- 

 tach et al,, 1957) lies in part to depression of the reticuloendo- 

 thelial system. Direct endotoxin effect or reduced perfusion or 

 both may contribute to the RES breakdown. Granulocytes were 

 affected primarily in this study. However, counts were made 

 on whole blood, and the increased hematocrit in this type of 

 shock may introduce an error in the cell counts. 



The persistence of positive blood cultures under hypothermia 

 indicated no significant effect on the bacteria at the temperature 

 used. Lower temperatures are required for possible influence on 

 growth (Balch et al., 1955). 



Hypothermia presumably does not alter the blood's ability 

 to clear bacteria (Fedor et al., 1956; Frank et al,, 1956), Pre- 

 vious experiences on the effect of hypothermia in experimental 

 infections have produced conflicting reports. Increased mor- 

 tality rate was observed in rabbits with pneumococcal infection 

 after cooling to 31° C (Sanders et al., 19 57). A similar study 

 at 21° C yielded an increased survival rate (Wotykins et al., 

 19 58). Death rates in rats from gram negative septicemia were 

 improved with cooling to 25° C (Balch et al., 19 55). The vari- 

 ations in results may well be due to species differences, depth 

 of cooling and virulence of the bacteria used. 



SUMMARY 



Bacteremia shock is usually of gram negative coliform origi"h. 

 The mortality persists at 65 to 70 per cent despite appropriate 



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