Gastric secretory and splanchnic blood flow studies in man after severe trauma and hemorrhagic shock

A group of thirty-three patients with severe multiple trauma and hemorrhagic shock and a group of nineteen normal control subjects were studied in a special trauma research unit to determine the effect of severe acute stress on multiple aspects of human gastric secretion and splanchnic blood flow in relation to stress ulceration. Simultaneous studies of gastric acid, pepsin, nondialyzable solids, fucose, sialic acid, and total splanchnic blood flow were carried out on both patients and control subjects. These studies were performed during basal conditions over a period of two hours and also for two hours after subcutaneous injection of Histalog. On the basis of these studies, it was concluded that excessive acid or pepsin secretion or deficient quantitative or qualitative gastric mucus production was probably not a significant etiologic factor in the production of gastroduodenal stress ulceration. The splanchnic blood flow studies and the presence of blood in gastric juice samples after Histalog injection in approximately 35 per cent of the severely injured patients supported previous opinions that ischemic damage to the superficial gastric mucosa may induce stress ulceration.