Pathophysiology of haemorrhagic shock

W. B. Runciman, G. A. Skowronski

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

The immediate effect of sudden blood loss is the activation of a variety of homeostatic responses. These include increased sympathetic activity and increased release or production of renin, angiotensin, anti-diuretic hormone, aldosterone, adrenocorticotrophic hormone, beta-endorphins, glucocorticoids, glucagon, erythropoeitin, 2-3 diphosphoglycerate, prostaglandins and complement. This may be followed by the release of many substances, some initially appropriate locally, and some the products of damaged cells, which may go on to cause both local and systemic damage. These include lysozomal enzymes, kinins, histamines, serotonin, lactic acid, free oxygen radicals, neutrophil proteases, fibrinogen degradation products, endotoxins, myocardial depressant polypeptides, and passive transferable lethal factor. The early and late effects on the cardiovascular and respiratory systems, and on the blood, brain, kidneys, gut, liver, pancreas, and on overall metabolism and cellular function, are considered in turn. Although an enormous research effort has increased our understanding of the pathophysiology of haemorrhagic shock, no special measures have yet been shown to influence morbidity or mortality in man. Management still hinges on the early recognition and treatment of bleeding, on general supportive measures, and on safeguarding each link in the oxygen delivery chain.

LanguageEnglish
Pages193-205
Number of pages13
JournalAnaesthesia and Intensive Care
Volume12
Issue number3
Publication statusPublished - 1984
Externally publishedYes

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Runciman, W. B., & Skowronski, G. A. (1984). Pathophysiology of haemorrhagic shock. Anaesthesia and Intensive Care, 12(3), 193-205.
Runciman, W. B. ; Skowronski, G. A. / Pathophysiology of haemorrhagic shock. In: Anaesthesia and Intensive Care. 1984 ; Vol. 12, No. 3. pp. 193-205.
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Runciman, WB & Skowronski, GA 1984, 'Pathophysiology of haemorrhagic shock', Anaesthesia and Intensive Care, vol. 12, no. 3, pp. 193-205.

Pathophysiology of haemorrhagic shock. / Runciman, W. B.; Skowronski, G. A.

In: Anaesthesia and Intensive Care, Vol. 12, No. 3, 1984, p. 193-205.

Research output: Contribution to journalArticle

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Runciman WB, Skowronski GA. Pathophysiology of haemorrhagic shock. Anaesthesia and Intensive Care. 1984;12(3):193-205.