Therapy of Refractory Shock

Clinical Guides to Therapy of Shock

“…This, coupled with hypoxic damage to capillary membranes, allows for capillary pooling and loss of plasma water into the extracellular space. (3) Coagulation changes are associated with rouleau formation, sludging and intravascular coagulation.…”

“…To this end the optimum milieu for response of the patient's homeostatic defense mechanism must be maintained. 3 Even when hemodynamic homeostasis has been restored, ultimate therapeutic success depends on the correction of the factors responsible for the low perfusion state. This discussion deals primarily with the therapy of hemorrhagic shock.…”

“…Hyponatremia will potentiate hypotension (suboptimal vascular response to endogenous catecholamines 16 ) and in rare instances can be the cause of hypotension when hypovolemia results from the body's attempts to maintain intravascular osmolality in the face of a low plasma sodium concentration. 3 The acidosis of shock is caused by a combination of peripheral hypoxia with resultant accumulation of lactic acid and decreased renal excretion of acid products of catabolism. Bank blood is a most important source of acid.…”