INS and Shock: In our model, a possible interpretation is that a reduced Do2 due to insufficient pump flow, severe hemodilution, or both creates a condition similar to a cardiogenic shock, leading on one side to a direct lactate formation by the dysoxic organs and on the other to a catecholamine release, insulin resistance, hyperglycemia, and lactate formation (with subsequent liver uptake and reconversion to glucose by the Cori cycle).