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THE USE OF CITRATED PLASMA IN THE TREATMENT OF SECONDARY SHOCK

MAX M. STRUMIA, M.D.; JOSEPH A. WAGNER, M.D.; J. FREDERICK MONAGHAN, M.D.
JAMA. 1940;114(14):1337-1341. doi:10.1001/jama.1940.02810140037011.
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This paper is concerned with offering evidence of the effectiveness of human blood plasma in the treatment of secondary shock. This work is part of a general investigation conducted by members of the staff of the Bryn Mawr Hospital for the past several years concerning the rationale of the transfusion of whole blood and of plasma.

While we are not primarily concerned in this paper in the investigation of the mechanism of secondary shock, it is opportune to mention the causative factors underlying its production. The existence of any hypothetic toxic substance responsible for secondary shock, as suggested by Cannon,1 has not been confirmed by the experimental work of Blalock and his associates2 and of O'Shaughnessy and Slome.3 The initiating factors are various and include bleeding at the site of injury (external and/or internal4), loss of plasma in the traumatized tissue,5 loss of plasma followed

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