nach oben

Erschienen in:

2013 | OriginalPaper | Buchkapitel

5. Pathophysiology of Hemorrhagic Shock and Resuscitation

verfasst von : Fredric M. Pieracci, Walter L. Biffl

Erschienen in: Hemoglobin-Based Oxygen Carriers as Red Cell Substitutes and Oxygen Therapeutics

Verlag: Springer Berlin Heidelberg

Einloggen

Aktivieren Sie unsere intelligente Suche, um passende Fachinhalte oder Patente zu finden.

search-config

KI-gestützte Suche

Aus

Abstract

Shock may be defined broadly as a condition in which metabolic energy production is limited either by the supply or utilization of oxygen, manifest by derangement of the normal oxygen supply–demand balance, accumulation of the byproducts of anaerobic metabolism, and dysfunction of one or more organ system. In the case of massive hemorrhage, shock is due specifically to impaired oxygen delivery (VO₂) secondary to both hypovolemia and anemia. Restoration of tissue perfusion, termed resuscitation, proceeds systematically, is based upon the underlying etiology of shock, terminates upon achievement of clearly defined endpoints, and requires frequent re-evaluation. Resuscitation has been refined substantially over the previous decade, with a resultant improvement in the outcomes of critically ill patients (Brun-Buisson et al. 2004; Martin et al. 2003). Major changes have included improved accuracy of the assessment of intravascular volume status, recognition of the detrimental effects of both allogeneic blood product transfusion and excessive volume expansion, and timely, goal-directed treatment of shock and its complications. This chapter will focus on the diagnosis of shock, differentiation into hemorrhagic shock, the benefits and limitations of various measurements used to determine the adequacy of resuscitation, general resuscitative strategies, and complications of resuscitation.

Sie haben noch keine Lizenz? Dann Informieren Sie sich jetzt über unsere Produkte:

Springer Professional "Wirtschaft+Technik"

Online-Abonnement

Mit Springer Professional "Wirtschaft+Technik" erhalten Sie Zugriff auf:

über 102.000 Bücher
über 537 Zeitschriften

aus folgenden Fachgebieten:

Automobil + Motoren
Bauwesen + Immobilien
Business IT + Informatik
Elektrotechnik + Elektronik
Energie + Nachhaltigkeit
Finance + Banking
Management + Führung
Marketing + Vertrieb
Maschinenbau + Werkstoffe
Versicherung + Risiko

Jetzt Wissensvorsprung sichern!

Jetzt informieren

Springer Professional "Technik"

Online-Abonnement

Mit Springer Professional "Technik" erhalten Sie Zugriff auf:

über 67.000 Bücher
über 390 Zeitschriften

aus folgenden Fachgebieten:

Automobil + Motoren
Bauwesen + Immobilien
Business IT + Informatik
Elektrotechnik + Elektronik
Energie + Nachhaltigkeit
Maschinenbau + Werkstoffe

Jetzt Wissensvorsprung sichern!

Jetzt informieren

Vorheriges Kapitel The Role of Blood and Plasma Viscosity in Restoring Oxygen Delivery Capacity

Nächstes Kapitel Allogeneic Blood Transfusion for Surgical and Traumatic Hemorrhage

Abramson D, Scalea TM, Hitchcock R, Trooskin SZ, Henry SM, Greenspan J (1993) Lactate clearance and survival following injury. J Trauma 35:584–588 (discussion 8–9)

Alonso DR, Scheidt S, Post M, Killip T (1973) Pathophysiology of cardiogenic shock. Quantification of myocardial necrosis, clinical, pathologic and electrocardiographic correlations. Circulation 48:588–596CrossRef

Armand R, Hess JR (2003) Treating coagulopathy in trauma patients. Transfus Med Rev 17:223–231CrossRef

Bagshaw SM, Bellomo R (2007) The influence of volume management on outcome. Curr Opin Crit Care 13:541–548CrossRef

Ball CG, Kirkpatrick AW, McBeth P (2008) The secondary abdominal compartment syndrome: not just another post-traumatic complication. Can J Surg 51:399–405

Balogh Z, McKinley BA, Cocanour CS, et al (2003) Supranormal trauma resuscitation causes more cases of abdominal compartment syndrome. Arch Surg 138:637–642 (discussion 42–43)

Beck R, Halberthal M, Zonis Z, Shoshani G, Hayari L, Bar-Joseph G (2001) Abdominal compartment syndrome in children. Pediatr Crit Care Med 2:51–56CrossRef

Biancofiore G, Bindi ML, Romanelli AM et al (2003) Intra-abdominal pressure monitoring in liver transplant recipients: a prospective study. Intensive Care Med 29:30–36

Bickell WH, Bruttig SP, Millnamow GA, O’Benar J, Wade CE (1991) The detrimental effects of intravenous crystalloid after aortotomy in swine. Surgery 110:529–536

Bickell WH, Wall MJ Jr, Pepe PE et al (1994) Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 331:1105–1109CrossRef

Bland RD, Shoemaker WC, Abraham E, Cobo JC (1985) Hemodynamic and oxygen transport patterns in surviving and nonsurviving postoperative patients. Crit Care Med 13:85–90CrossRef

Borgman MA, Spinella PC, Perkins JG et al (2007) The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital. J Trauma 63:805–813CrossRef

Brandstrup B, Tonnesen H, Beier-Holgersen R et al (2003) Effects of intravenous fluid restriction on postoperative complications: comparison of two perioperative fluid regimens: a randomized assessor-blinded multicenter trial. Annal Surg 238:641–648CrossRef

Brun-Buisson C, Meshaka P, Pinton P, Vallet B (2004) EPISEPSIS: a reappraisal of the epidemiology and outcome of severe sepsis in French intensive care units. Intensive Care Med 30:580–588CrossRef

Burlew CC, Moore EE, Biffl WL, Bensard DD, Johnson JL, Barnett CC (2012) One hundred percent fascial approximation can be achieved in the postinjury open abdomen with a sequential closure protocol. J Trauma Acute Care Surg 72 (1) :235–241, doi:10.1097/TA.0b013e318236b319

Carson JL, Noveck H, Berlin JA, Gould SA (2002) Mortality and morbidity in patients with very low postoperative Hb levels who decline blood transfusion. Transfusion 42:812–818CrossRef

Cheatham ML, White MW, Sagraves SG, Johnson JL, Block EF (2000) Abdominal perfusion pressure: a superior parameter in the assessment of intra-abdominal hypertension. J Trauma 49:621–626 (discussion 6–7)

Cheatham ML, Malbrain ML, Kirkpatrick A et al (2007) Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome II. Recommendations. Intensive Care Med 33:951–962CrossRef

Corcos AC, Sherman HF (2001) Percutaneous treatment of secondary abdominal compartment syndrome. J Trauma 51:1062–1064CrossRef

Crowell JW, Ford RG, Lewis VM (1959) Oxygen transport in hemorrhagic shock as a function of the hematocrit ratio. Am J Physiol 196:1033–1038

Czer LS, Shoemaker WC (1978) Optimal hematocrit value in critically ill postoperative patients. Surgery, Gynecol Obstet 147:363–368

Davis JW, Shackford SR, Mackersie RC, Hoyt DB (1988) Base deficit as a guide to volume resuscitation. J Trauma 28:1464–1467CrossRef

de Vaal JB, de Wilde RB, van den Berg PC, Schreuder JJ, Jansen JR (2005) Less invasive determination of cardiac output from the arterial pressure by aortic diameter-calibrated pulse contour. Br J Anaesth 95:326–331CrossRef

Duchesne JC, Hunt JP, Wahl G et al (2008) Review of current blood transfusions strategies in a mature level I trauma center: were we wrong for the last 60 years? J Trauma 65:272–276 (discussion 6–8)

Durairaj L, Schmidt GA (2008) Fluid therapy in resuscitated sepsis: less is more. Chest 133:252–263CrossRef

Dutton RP, Mackenzie CF, Scalea TM (2002) Hypotensive resuscitation during active hemorrhage: impact on in-hospital mortality. J Trauma 52:1141–1146CrossRef

Eachempati SR, Reed RL 2nd, Barie PS (2003) Serum bicarbonate concentration correlates with arterial base deficit in critically ill patients. Surg Infect 4:193–197CrossRef

Fernandes CJ, Jr., Akamine N, De Marco FV, De Souza JA, Lagudis S, Knobel E. Red blood cell transfusion does not increase oxygen consumption in critically ill septic patients. Critical care (London, England) 2001;5:362-7.

Fidkowski C, Helstrom J (2009) Diagnosing metabolic acidosis in the critically ill: bridging the anion gap, Stewart, and base excess methods. Canadian J Anaesth (J canadien d’anesthesie) 56:247–256CrossRef

Gantt CL (1981) Red blood cells for cancer patients. Lancet 2:363CrossRef

Gattinoni L, Brazzi L, Pelosi P et al (1995) A trial of goal-oriented hemodynamic therapy in critically ill patients. SvO₂ collaborative group. N Engl J Med 333:1025–1032CrossRef

Goldsmith HL (1972) The flow of model particles and blood cells and its relation to thrombogenesis. Prog Hemost Thromb 1:97–127

Greenhalgh DG, Warden GD (1994) The importance of intra-abdominal pressure measurements in burned children. J Trauma 36:685–690CrossRef

Gross S (1872) A system of surgery: Pathological, diagnostic, therapeutic, and operative. Lee and Febiger, Philaedelphia, p 1872

Hebert PC, Wells G, Blajchman MA et al (1999) A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion requirements in critical care investigators, Canadian critical care trials group. N Engl J Med 340:409–417CrossRef

Heyland DK, Cook DJ, King D, Kernerman P, Brun-Buisson C (1996) Maximizing oxygen delivery in critically ill patients: a methodologic appraisal of the evidence. Crit Care Med 24:517–524CrossRef

Hirshberg A, Dugas M, Banez EI, Scott BG, Wall MJ Jr, Mattox KL (2003) Minimizing dilutional coagulopathy in exsanguinating hemorrhage: a computer simulation. J Trauma 54:454–463CrossRef

Holcomb JB, Wade CE, Michalek JE et al (2008) Increased plasma and platelet to red blood cell ratios improves outcome in 466 massively transfused civilian trauma patients. Ann Surg 248:447–458

Iberti TJ, Fischer EP, Leibowitz AB, Panacek EA, Silverstein JH, Albertson TE (1990) A multicenter study of physicians’ knowledge of the pulmonary artery catheter. Pulmonary artery catheter study group. JAMA 264:2928–2932CrossRef

Ivanov R, Allen J, Calvin JE (2000) The incidence of major morbidity in critically ill patients managed with pulmonary artery catheters: a meta-analysis. Crit Care Med 28:615–619CrossRef

Kashuk JL, Moore EE, Millikan JS, Moore JB (1982) Major abdominal vascular trauma–a unified approach. J Trauma 22:672–679CrossRef

Kashuk JL, Moore EE, Johnson JL et al (2008) Postinjury life threatening coagulopathy: is 1:1 fresh frozen plasma:packed red blood cells the answer? J Trauma 65:261–270 (discussion 70–71)

Kellum JA, Bellomo R, Kramer DJ, Pinsky MR (1998) Etiology of metabolic acidosis during saline resuscitation in endotoxemia. Shock (Augusta, Ga) 9:364–368

Kern JW, Shoemaker WC (2002) Meta-analysis of hemodynamic optimization in high-risk patients. Crit Care Med 30:1686–1692CrossRef

Kiraly LN, Underwood S, Differding JA, Schreiber MA (2009) Transfusion of aged packed red blood cells results in decreased tissue oxygenation in critically injured trauma patients. J Trauma 67:29–32CrossRef

Kirkpatrick AW, Brenneman FD, McLean RF, Rapanos T, Boulanger BR (2000) Is clinical examination an accurate indicator of raised intra-abdominal pressure in critically injured patients? Can J Surg 43:207–211

Krafft P, Steltzer H, Hiesmayr M, Klimscha W, Hammerle AF (1993) Mixed venous oxygen saturation in critically ill septic shock patients. The role of defined events. Chest 103:900–906CrossRef

Kudsk KA (2003) Evidence for conservative fluid administration following elective surgery. Annal Surg 238:649–650CrossRef

Kwan I, Bunn F, Roberts I (2003) Timing and volume of fluid administration for patients with bleeding. Cochrane database of systematic reviews (Online) CD002245

Ladakis C, Myrianthefs P, Karabinis A et al (2001) Central venous and mixed venous oxygen saturation in critically ill patients. Respir Int Rev Thoracic Dis 68:279–285

Latenser BA, Kowal-Vern A, Kimball D, Chakrin A, Dujovny N (2002) A pilot study comparing percutaneous decompression with decompressive laparotomy for acute abdominal compartment syndrome in thermal injury. J Burn Care Rehabil 23:190–195CrossRef

Lobo SM, Salgado PF, Castillo VG et al (2000) Effects of maximizing oxygen delivery on morbidity and mortality in high-risk surgical patients. Crit Care Med 28:3396–3404CrossRef

Mace JE, White CE, Simmons JW (2009) High plasma to RBC ratio improves survival based on mechanism of combat injury in massively transfused patients. J Am Coll Surg 209:S47CrossRef

Madigan MC, Kemp CD, Johnson JC, Cotton BA (2008) Secondary abdominal compartment syndrome after severe extremity injury: are early, aggressive fluid resuscitation strategies to blame? J Trauma 64:280–285CrossRef

Malbrain ML, Chiumello D, Pelosi P et al (2005) Incidence and prognosis of intraabdominal hypertension in a mixed population of critically ill patients: a multiple-center epidemiological study. Crit Care Med 33:315–322CrossRef

Marik PE, Cavallazzi R, Vasu T, Hirani A (2009) Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature. Crit Care Med 37:2642–2647CrossRef

Martin DJ, Lucas CE, Ledgerwood AM, Hoschner J, McGonigal MD, Grabow D (1985) Fresh frozen plasma supplement to massive red blood cell transfusion. Ann Surg 202:505–511CrossRef

Martin GS, Mannino DM, Eaton S, Moss M (2003) The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 348:1546–1554CrossRef

Martin MJ, FitzSullivan E, Salim A, Berne TV, Towfigh S (2005) Use of serum bicarbonate measurement in place of arterial base deficit in the surgical intensive care unit. Arch Surg 140:745–751CrossRef

Maslow A, Comunale ME, Haering JM, Watkins J (1996) Pulsed wave Doppler measurement of cardiac output from the right ventricular outflow tract. Anesth Analg 83:466–471

McGee WT, Horswell JL, Calderon J et al (2007) Validation of a continuous, arterial pressure-based cardiac output measurement: a multicenter, prospective clinical trial. Crit Care (London, England) 11:R105

McKinley BA, Kozar RA, Cocanour CS et al (2002) Normal versus supranormal oxygen delivery goals in shock resuscitation: the response is the same. J Trauma 53:825–832CrossRef

Michard F, Teboul JL (2002) Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence. Chest 121:2000–2008CrossRef

Moomey CB Jr, Melton SM, Croce MA, Fabian TC, Proctor KG (1999) Prognostic value of blood lactate, base deficit, and oxygen-derived variables in an LD50 model of penetrating trauma. Crit Care Med 27:154–161CrossRef

Napolitano LM, Kurek S, Luchette FA et al (2009) Clinical practice guideline: red blood cell transfusion in adult trauma and critical care. Crit Care Med 37:3124–3157CrossRef

Nisanevich V, Felsenstein I, Almogy G, Weissman C, Einav S, Matot I (2005) Effect of intraoperative fluid management on outcome after intraabdominal surgery. Anesthesiology 103:25–32CrossRef

O’Dell E, Tibby SM, Durward A, Murdoch IA (2007) Hyperchloremia is the dominant cause of metabolic acidosis in the postresuscitation phase of pediatric meningococcal sepsis. Criti care Med 35:2390–2394CrossRef

Opelz G, Terasaki PI (1978) Improvement of kidney-graft survival with increased numbers of blood transfusions. N Engl J Med 299:799–803CrossRef

O’Shaughnessy DF, Atterbury C (2004) Bolton Maggs P, et al. Guidelines for the use of fresh-frozen plasma, cryoprecipitate and cryosupernatant. Br J Haematol 126:11–28CrossRef

Owens TM, Watson WC, Prough DS, Uchida T, Kramer GC (1995) Limiting initial resuscitation of uncontrolled hemorrhage reduces internal bleeding and subsequent volume requirements. J Trauma 39:200–207 (discussion 8–9)

Parra MW, Al-Khayat H, Smith HG, Cheatham ML (2006) Paracentesis for resuscitation-induced abdominal compartment syndrome: an alternative to decompressive laparotomy in the burn patient. J Trauma 60:1119–1121CrossRef

Pruitt BA Jr (2000) Protection from excessive resuscitation: “pushing the pendulum back”. J Trauma 49:567–568CrossRef

Quaknine-Orlando B, Samama CM, Riou B et al (1999) Role of the hematocrit in a rabbit model of arterial thrombosis and bleeding. Anesthesiology 90:1454–1461CrossRef

Reinhart K, Kuhn HJ, Hartog C, Bredle DL (2004) Continuous central venous and pulmonary artery oxygen saturation monitoring in the critically ill. Intensive Care Med 30:1572–1578

Rhodes A, Cusack RJ, Newman PJ, Grounds RM, Bennett ED (2002) A randomised, controlled trial of the pulmonary artery catheter in critically ill patients. Intensive Care Med 28:256–264CrossRef

Richard C, Warszawski J, Anguel N et al (2003) Early use of the pulmonary artery catheter and outcomes in patients with shock and acute respiratory distress syndrome: a randomized controlled trial. JAMA 290:2713–2720CrossRef

Rivers E, Nguyen B, Havstad S et al (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345:1368–1377CrossRef

Rutherford EJ, Morris JA Jr, Reed GW, Hall KS (1992) Base deficit stratifies mortality and determines therapy. J Trauma 33:417–423CrossRef

Sakr Y, Vincent JL, Reinhart K et al (2005) High tidal volume and positive fluid balance are associated with worse outcome in acute lung injury. Chest 128:3098–3108CrossRef

Sandham JD, Hull RD, Brant RF et al (2003) A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients. N Engl J Med 348:5–14CrossRef

Shanwell A, Kristiansson M, Remberger M, Ringden O (1997) Generation of cytokines in red cell concentrates during storage is prevented by prestorage white cell reduction. Transfusion 37:678–684CrossRef

Shires T, Coln D, Carrico J, Lightfoot S (1964) Fluid therapy in hemorrhagic shock. Arch Surg 88:688–693CrossRef

Snyder CW, Weinberg JA, McGwin G Jr, et al (2009) The relationship of blood product ratio to mortality: survival benefit or survival bias? J Trauma 66:358–362 (discussion 62–64)

Spinella PC, Perkins JG, Grathwohl KW et al (2008) Effect of plasma and red blood cell transfusions on survival in patients with combat related traumatic injuries. J Trauma 64:S69–77 (discussion 5–8)

Suistomaa M, Ruokonen E, Kari A, Takala J (2000) Time-pattern of lactate and lactate to pyruvate ratio in the first 24 hours of intensive care emergency admissions. shock. Ga, Augusta 14:8–12

Takaori M, Safar P (1966) Adaptation to acute severe hemodilution with dextran 75 in dogs. Arch Surg 92:743–748CrossRef

Teixeira PG, Inaba K, Shulman I et al (2009) Impact of plasma transfusion in massively transfused trauma patients. J Trauma 66:693–697CrossRef

Tinmouth A, Fergusson D, Yee IC, Hebert PC (2006) Clinical consequences of red cell storage in the critically ill. Transfusion 46:2014–2027CrossRef

Turner J, Nicholl J, Webber L, Cox H, Dixon S, Yates D (2000) A randomised controlled trial of prehospital intravenous fluid replacement therapy in serious trauma. Health Technol Assess (Winchester, England) 4:1–57

Velmahos GC, Demetriades D, Shoemaker WC et al (2000) Endpoints of resuscitation of critically injured patients: normal or supranormal? A prospective randomized trial. Annal Surg 232:409–418CrossRef

Vincent JL, Weil MH (2006) Fluid challenge revisited. Crit Care Med 34:1333–1337CrossRef

Warren JV (1952) Modern concepts of shock and its treatment. Gp 6:51–58

Weiskopf RB, Viele MK, Feiner J et al (1998) Human cardiovascular and metabolic response to acute, severe isovolemic anemia. JAMA 279:217–221CrossRef

Wiedemann HP, Wheeler AP, Bernard GR et al (2006) Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 354:2564–2575CrossRef

Wo CC, Shoemaker WC, Appel PL, Bishop MH, Kram HB, Hardin E (1993) Unreliability of blood pressure and heart rate to evaluate cardiac output in emergency resuscitation and critical illness. Crit Care Med 21:218–223CrossRef

Titel: Pathophysiology of Hemorrhagic Shock and Resuscitation
verfasst von: Fredric M. Pieracci
Walter L. Biffl
Verlag: Springer Berlin Heidelberg
Buch: Hemoglobin-Based Oxygen Carriers as Red Cell Substitutes and Oxygen Therapeutics
Print ISBN: 978-3-642-40716-1

Electronic ISBN: 978-3-642-40717-8

Copyright-Jahr: 2013
DOI: https://doi.org/10.1007/978-3-642-40717-8_5

Premium Partner

Marktübersichten

Die im Laufe eines Jahres in der „adhäsion“ veröffentlichten Marktübersichten helfen Anwendern verschiedenster Branchen, sich einen gezielten Überblick über Lieferantenangebote zu verschaffen.

Zur Marktübersicht