[Adaptive metabolic disorders in erythrocytes during shock]

In patients with shock the metabolic activity of the red blood cells was studied following separation according to cell-age by density layer centrifugation using Stractan II-Urografin solutions. Metabolic acidosis in patients with cardiogenic shock (n = 8) and with postoperative shock (n = 7) induced a pronounced fall in 2,3-diphosphoglycerate (2,3-DPG) levels and in adenosine triphosphate (ATP), in contrast to a raised lactate-pyruvate ratio. 2,3-DPG values were higher than normal in patients with hypoglycemic shock (n = 12), whereas further measured substrate levels were markedly decreased. The levels of these compounds of the red blood cells revealed a significant difference in the hemolysates derived from cells separated according to cell-age. The shock syndrome was also observed in patients suffering from severe congestive heart failure (n = 10) who received dopamine (300 mug/min) for its known action in improving hemodynamics and renal function. Following drug administration for 150 min a clinical improvement was associated with a change of extent and pattern of the red blood cell metabolic disorder.