The Effect of Persisting Hypovolemic Shock on Pancreatic Output of Insulin

Study of the basic biological response of the body to an acute and prolonged deficiency of blood flow provides insight into the mechanisms of homeostasis and information necessary for rational therapy. Physiological changes define successive stages of homeostasis: compensation, equilibrium and deterioration. The relation of the biochemical changes, however, to the continued effectiveness of compensatory mechanisms is not clear. Initial metabolic responses reflect the combined effect of decreased peripheral perfusion and hormonal changes induced by acute circulatory insufficiency. In time the energy reserves of the body become depleted and homeostasis deteriorates. It is unlikely that any one change is critical but rather a series of complex interrelated events ultimately result in loss of compensation for a persisting reduction in peripheral blood flow. The problem for investigators today is to determine to what extent metabolic and endocrine alterations are involved in the loss of tolerance or compensation for shock (6).