Monday, Nov. 18, 1946

The Quick v. the Dead

An average man has about eleven pints of blood. Loss of more than a third usually causes profound shock, from which the body can seldom be revived even by transfusion. But at the Cleveland Clinic, two top-rank U.S. scientists have succeeded in reversing "irreversible" shock in revolutionary blood experiments on dogs.

Heart Specialist Irvine H. Page and Biophysicist Otto Glasser drained more than half of the dogs' blood, kept them in profound shock for two to three hours. Then, in place of the usual transfusion into a vein, they pumped blood into an artery, under pressure. In 70% of the cases, the dogs survived. In one experiment, dogs were bled to the point of death. Twenty out of 23 were revived after they had been clinically "dead" (no heartbeat or breathing) for five minutes.*

The secret of the Page-Glasser method is the speed of transfusion. Intravenous transfusion, which restores blood to the arteries by the roundabout course of veins and lungs, is necessarily slow. But by pumping blood rapidly into the main thigh artery, Page & Glasser completed a massive transfusion in one minute.

Dr. Page has been working quietly on his experiments for six years, has tried arterial transfusions on 20 human patients, with "very encouraging" results. Some of his patients survived, he says, when "intravenous transfusion would not have done a particle of good." Advantages of arterial transfusion. P: It brings the body out of shock quickly. In prolonged shock, said Dr. Page, death is due in large part to failure of the kidneys to secrete urine.

P: It automatically avoids dangerous overtransfusion. The blood is forced in from a bottle under controlled pressure; transfusion stops automatically when the blood pressure reaches normal. P: It requires less blood (some dogs regained normal blood pressure after 20% of their drained blood was returned). P: It gives a quick check on internal hemorrhage: if arterial pressure continues to drop after transfusion starts, the doctor knows that the patient is bleeding somewhere, and that he must operate immediately to tie off the bleeding vessels.

* Russian scientists, in similar dog-reviving experiments, have used a more elaborate method--arterial and intravenous transfusion, artificial respiration, adrenalin injections.

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