The priority in the management of patients with traumatic hemorrhagic shock is to control the bleeding with simultaneous volume resuscitation to maintain adequate tissue perfusion. Fluid replacement remains the mainstay of initial resuscitation in hemorrhagic shock. Traditionally, vasopressors are contraindicated in the early management of hemorrhagic shock due to their deleterious consequences...

Irreversible hemorrhagic shock in dogs was associated with a progressive rise in plasma hemoglobin levels and the appearance of an abnormal hemin pigment in the plasma. Both findings were related to mucosal necrosis of the bowel occurring as a result of prolonged hemorrhagic shock. In dogs perfused through the superior mesentwic artery during hemorrhagic shock, the bowel remained normal, irreve...

BACKGROUND It is common clinical practice to administer reduced doses of opioid to patients suffering from hemorrhagic shock to minimize adverse hemodynamic consequences and to prevent prolonged opioid effect However, the scientific foundation supporting this practice is not well established. The aim of this study was to test the hypothesis that hemorrhagic shock alters both the distribution an...

OBJECTIVE Hemorrhagic shock accompanied by injury represents a major physiologic stress. Fasted animals are often used to study hemorrhagic shock (with injury). A fasted state is not guaranteed in the general human population. The objective of this study was to determine if fed animals would exhibit a different metabolic profile in response to hemorrhagic shock with trauma when compared to fast...

In previous publications we presented evidence that a bacterial endotoxin is present in the blood and tissues of the animal in hemorrhagic shock; and that if shock is sufficiently prolonged this endotoxin prevents a sustained response to infusion of all the blood removed, so that death follows soon thereafter (1, 2). Since the ingestion of circulating endotoxins, and, by inference, their detoxi...

Recently the Committee on Tactical Combat Casualty Care changed the guidelines on fluid use in hemorrhagic shock. The current strategy for treating hemorrhagic shock is based on early use of components: Packed Red Blood Cells (PRBCs), Fresh Frozen Plasma (FFP) and platelets in a 1:1:1 ratio. We suggest that lack of components to mimic whole blood functionality favors the use of Fresh Whole Bloo...

while blunt trauma of the head and neck are a common pattern of injury, significant problems related to the prompt diagnosis and optimal management of traumatic artery injuries have been reported in the literature. while patients with major artery injuries might develop hemorrhagic shock very rapidly, patients with blunt cerebrovascular injuries (bcvi) can present asymptomatic, but complication...

introduction treatment of severe hemorrhagic shock due to acute blood loss from traumatic injuries in a jehovah’s witness (jw) trauma patient is very challenging since hemostatic blood product resuscitation is limited by refusal of the transfusion of allogeneic blood products. case presentation we describe a multifaceted approach to the clinical care of a severely anemic jw trauma patient inclu...

Hemorrhagic shock is a frequent cause of liver failure and often leads to a fatal outcome. Several studies have revealed that p38 MAPK is a key mediator in hemorrhagic damage of the primary organs through the activation of proinflammatory cytokines such as tumor necrosis factor (TNF)-α and interleukin (IL)-1β. However, the precise role of these factors in liver damage following hemorrhagic shoc...

BACKGROUND Hemorrhagic shock is known to alter significantly the pharmacokinetics of fentanyl, an opioid that requires delivery to the liver for metabolism. The authors hypothesized that the pharmacokinetics and pharmacodynamics of remifentanil, an esterase metabolized opioid that does not require delivery to a metabolic organ, would be altered less by hemorrhagic shock that those of fentanyl. ...