In 1920 J. C. Aub  and later A. Blalock  emphasized the decisive importance of volume loss (cf. also ). Before that, nervous factors and toxins were held responsible for the occurrence of shock (survey in  and Wiggers ). Extensive blood loss of more than 20% of the blood volume leads to regional vasoconstriction , decrease in central venous pressure  and in venous return , as well as to reduction of the cardiac output . The heart rate rises, the temperature in the periphery drops, and the skin is pale and moist. Obvious symptoms of increased sympathetic activity are present, but because of the volume deficit no hypertension occurs .
KeywordsPermeability Fatigue Starch Hydration Hydrocortisone
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