BIOCHEMICAL STUDIES ON SHOCK : II. THE ROLE OF THE PERIPHERAL TISSUES IN THE METABOLISM OF PROTEIN AND CARBOHYDRATE...

The changes in the blood levels of amino nitrogen, glucose, lactate, and pyruvate were compared in eviscerate (liverless) rats and eviscerate rats subjected to hemorrhage, in order to establish the rôle of the peripheral tissues in the blood changes during shock. It was found that:- 1. The blood amino acids accumulate at a more rapid rate in the bled liverless rats than in the control liverless animals. 2. The blood sugar falls more rapidly in the liverless rat after hemorrhage, both in animals with intact suprarenal glands and those with enucleated suprarenal medullae. 3. The blood lactate and pyruvate rise slowly in the liverless rat, but maintain a constant relation to each other except terminally when convulsions occur. In the bled liverless rat both lactate and pyruvate increase much more rapidly than in the control liverless rat, and the lactate/pyruvate ratio also increases. These data are interpreted to indicate that a decrease in liver function during hemorrhagic shock serves to make apparent a considerable increase in peripheral protein catabolism and accentuates the effects of an increased carbohydrate utilization by the periphery. The lactate and pyruvate changes are determined chiefly by anoxia of the peripheral tissue and probably indicate an increasing predominance of anaerobic over aerobic metabolism of carbohydrate in muscle. The liver plays a negligible rôle in the lactate and pyruvate changes in shock.