The marked metabolic alterations that occur in hemorrhagic shock have been ascribed to tissue anoxia occasioned by hypovolemia. Other investigators, utilizing different shock models, have explained the initial metabolic changes as secondary to humoral changes. In skeletal muscle, anoxia is known to cause an increased glucose uptake, whereas epinephrine causes a decreased uptake. The present work was undertaken to explore some alterations in carbohydrate metabolism during hemorrhagic shock in rats, when both tissue anoxia and an altered humoral state are present. Hemidiaphragms from rats subjected to a standardized hemorrhagic shock procedure and from control rats were excised and incubated aerobically in bicarbonate buffer containing glucose. After 1 hr of incubation aliquots of the media were analyzed for glucose and lactate. The results demonstrated a significantly greater glucose uptake and lactate production by the diaphragms from the bled rats. The data suggest that, during hemorrhagic shock in rats, tissue anoxia leads to a predominance of anaerobic metabolism and a severe depletion of intracellular energy, resulting in an increased uptake of glucose in skeletal muscle despite the concomitant altered humoral state which ordinarily would inhibit glucose uptake.
