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Role of Increased Adrenal Cortisol Secretion in the Plasma Volume Response to Hemorrhage.

Leon J. Marks, M.D., F.A.C.P.; Dennis W. King, M.D.; and Hugh McCarthy, M.D.
Ann Intern Med. 1966;64(5):1160. doi:10.7326/0003-4819-64-5-1160_2
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The permissive concept of adrenal hormone action does not explain the increased cortisol requirement of an Addisonian patient during an acute illness. In order to explain the physiological function of increased adrenal cortisol secretion during stress, the plasma volume response to acute hemorrhage was studied in 10 splenectomized dogs both before and after bilateral adrenalectomy. Ten to 20% of a dog's blood volume was removed rapidly. All food and water were withheld for the next 18 hours. The following results were obtained: (1) in a dog with intact adrenals, over 50% of the plasma deficit is restored to the circulating


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