Acta anaesthesiologica Scandinavica. Supplementum
-
Acta Anaesthesiol Scand Suppl · Jan 1985
ReviewPathophysiology of shock-induced disturbances in tissue homeostasis.
A survey is given on disturbances in tissue homeostasis induced by hypovolemic shock conditions. Fluid shifts taking place between the extra- and intravascular fluid compartments are important early compensatory responses following hypovolemia. Usually the supply-to-demand ratio of oxygen in most tissues can however, not be kept up if the hypovolemic insult is severe due to deterioration of the microcirculation. ⋯ Thereby reactions leading to severe complications such as adult respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC) and multiple organ failure may be started. The aim of shock treatment should be to reverse as rapidly and as efficiently as possible the pathophysiological disturbances induced by a shock state. If the cellular hypoxic insult can be limited then the incidence of systemic complications in the post-shock period will also be reduced.
-
Acta Anaesthesiol Scand Suppl · Jan 1985
ReviewRationale for the use of colloids in the treatment of shock and hypovolemia.
The question, "Are colloids or crystalloids to be preferred for resuscitation in hypovolemic shock conditions?" is detailed in this review. The effects of these two types of fluid regimes on restitution of circulating blood volume, interstitial rehydration, microvascular blood flow, cellular metabolic recovery and on the incidence of systemic complications such as adult respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC) and multiple organ failure are considered. ⋯ Colloids do not seem to adversely affect pulmonary function. Dextran has considerable advantages over other types of colloids for the initial shock treatment due to its antithrombotic properties whereby cell aggregability is prevented and the incidence of systemic complications (microembolism syndromes) is convincingly reduced.