Traumatic Hemorrhagic Shock
Hemorrhage remains the major cause of preventable death after trauma . In the acute phase of hemorrhage, the physician’s therapeutic priority is to stop the bleeding as quickly as possible. Hemorrhagic shock is a pathologic state in which intravascular volume and oxygen delivery are impaired. As long as this bleeding is not controlled, the physician must maintain oxygen delivery to limit tissue hypoxia, inflammation, and organ dysfunction. This procedure involves fluid resuscitation , use of vasopressors, and blood transfusion to prevent or correct traumatic coagulopathy. However, the optimal resuscitative strategy is controversial: choice of fluid for resuscitation, the target of hemodynamic goals for hemorrhage control, and the optimal prevention of traumatic coagulopathy are questions that remain. Managing trauma patients with hemorrhagic shock is complex and difficult. Despite our knowledge of the pathophysiology of hemorrhagic shock in trauma patients that we have accumulated during recent decades, the mortality rate of these patients remains high.
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