Lactated ringer's injection in hemorrhagic shock.

Abstract

To the Editor:— The concept, recommended by Shires1and Moyer,2that administration of saline or lactated Ringer's injection along with limited amounts of blood is superior to complete replacement by blood in the treatment of hemorrhagic shock is, in my opinion, based on a misinterpretation of data derived from experiments on dogs. I agree with Moyer2that the administration of lactated Ringer's injection plus a small amount of the removed blood is superior to administration of all the removed blood in the treatment of experimental hemorrhagic shock in dogs.3,4However, it is not the Ringer's injection per se that produces this good effect. It is the absence of the shed blood which, by its treatment out of the body, has in some way been altered to promote disseminated intravascular coagulation (DIC) in the presence of shock and a slow, stagnant blood flow.3,4If care is