Recent Advances In Management Of Hemorrhagic Shock

Abstract

Shock is a life threatening condition. As long as this bleeding is not controlled, neuro endocrine axes are activated, leading to release of catechol amines and non adrenergic stress hormones. However, as hemorrhage persists, these mechanisms are no longer able to compensate, progressing to hemorrhagic shock Definition of shock: condition of low blood perfusion to tissues resulting in cellular injury and inadequate tissue function. 1 –Hypo volemic Hypo volemic shock is the most common type of shock and is caused by insufficient circulating volume. Its primary cause is haemorrhage (internal and external), or loss of fluid from the circulationVomiting and diarrheaare the most common cause in children. With other causes including burns, environmental exposure and excess urine loss due to diabetic ketoacidosis and diabetes insipidusUsual lines of treatment of hemorrhagic shock Evaluation of the patient in shock requires rapid assessment of the etiology. Although hypotension in trauma patients is assumed to be caused by hemorrhage (until proven otherwise), it is critically important to evaluate and treat the patient for other potential causes of hypotension, including tension pneumo thorax, pericardial tamponade, myocardial contusion, and neurogenic shock, Recent advances in management of hemorrhagic shock. Inotropic and vaso pressor agents have increasingly being used in the management of various types of shock. Inotropes are agents administered to increase myocardial contractility and therefore cardiac index whereas vaso pressor agents are administered to increase vascular tone and thereby elevate mean arterial pressure (MAP) Key words MAP:Mean Arterial Pressure; CHF:Congestive Heart Failure; SIRS:Systemic Inflamammatory Response Syndrome; WBC - White Blood Cells.