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    The Effects of Class IV Hemorrhagic Hypotensive Shock and Its Resuscitation with Fluids and Adjuvant Vasopressors or Cellular Energy Replenishment on the Splanchnic Microcirculatio... by Zakaria, El Rasheid

    Published 2016
    “…This was followed by phase-2 of uncontrolled hemorrhage as induced by transection of the splenic parenchyma at the two ends of the organ and severing one of the branches of the splenic artery. The transected organ was returned to the abdominal cavity for free arterial and venous bleeding until class IV hemorrhage is achieved [defined by persistent mean arterial pressure, MAP < 40 mmHg, and a shock index (ratio of heart rate and systolic arterial pressure), SI ≥ 5 for successive 10 minutes during the period of active uncontrolled bleeding]. …”
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