• 제목/요약/키워드: Hypovolemic shock

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급성 실혈성 쇽시의 (hypovolemic shock) 구강조직의 혈류량 변동에 관한 연구

  • 박흥기;김수경
    • 대한치과의사협회지
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    • 제19권4호통권143호
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    • pp.347-352
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    • 1981
  • This experiment was performed to estimate the changes on blood flow of the oral structures in hemorrhagic shock. Rabbits were anesthetized by intravenous injection of nembutal(30mg/kg). The Femoral artery was exposed and cannulated with polyethylene tubing filled with heparinized saline. Hypovolemic shock was induced by collecting the bloos of which amount was equaled as 2 % of body weight through arterial cannula for about 30 minutes. During hemorrhage, arterial blood pressure was recorded on recorder. In hypovolemic shock, arterial blood pressure decreased from 116.2±4.1 mmHg to 62.6±4.0 mmHg. Distribution of blood flow in oral tissues decreased to 30-50 % of control group. But blood flow of the masseter muscle was increased and the mandibular angle was not changed.

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늑막강내 Urokinase 주입후 발생된 Major Hemothorax에 기인된 Hypovolemic shock (Major Hemothorax Induced Hypovolemic Shock Fallowing Administration of Intrapleural Urokinase)

  • 김정규;정인범;손지웅;최유진;나문준;이원영;조영준
    • Tuberculosis and Respiratory Diseases
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    • 제57권5호
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    • pp.465-469
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    • 2004
  • 저자들은 패혈증이나 혈액응고장애가 이상이 없는 소방이 형성된 흉막삼출 환자에서 비교적 안전한 것으로 알려진 urokinase의 주입 후에 발생한 혈흉과 이로 인한 hypovolemic shock을 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology

  • Jung, Pil Young;Yu, Byungchul;Park, Chan-Yong;Chang, Sung Wook;Kim, O Hyun;Kim, Maru;Kwon, Junsik;Lee, Gil Jae;Korean Society of Traumatology (KST) Clinical Research Group
    • Journal of Trauma and Injury
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    • 제33권1호
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    • pp.1-12
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    • 2020
  • Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.

과도한 출혈을 동반한 다발성 안면부 외상 환자의 치험례 (MULTIPLE FACIAL TRAUMA PATIENT ACCOMPANIED WITH SEVERE BLEEDING: REPORT OF A CASE)

  • 오성섭;유대진;김일규;최진호;김형돈;오남식;황홍준
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제21권1호
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    • pp.65-68
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    • 1999
  • Multiple facial trauma patient should be carefully treated because of severe bleeding on extraoral and intraoral wound, possibilty of airway obstruction and hypovolemic shock. Hypovolemic shock may be divided to hemorrhagic shock and non-hemorrhagic shock. Also hemorrhagic shock is divided to mild, moderate and severe shock according to the degree of blood volume depletion. Mild shock occurs in blood loss of less than 20% of blood volume and moderate shock does in blood loss of 20-40% of blood volume. And Severe shock occurs in blood loss of more than 40% of blood volume. The goal of emergency care of trauma patient is that respiration and perfusion should be recovered to satisfactory level and that normal vital sign is maintained. We reported the case of multiple facial trauma patient with severe bleeding and hopovolemic shock and metabolic acidosis who was treated with adequate supply of fluid transfusion, intubation, tracheostomy and emergency operation.

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Resuscitation from a pH of 6.5: A Case Report and Review of Pathophysiology and Management of Extreme Acidosis from Hypovolemic Shock after Trauma

  • Balmaceda, Alexander;Arora, Sona;Sondheimer, Ilan;Hollon, McKenzie M.
    • Journal of Trauma and Injury
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    • 제32권4호
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    • pp.238-242
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    • 2019
  • Extreme acidosis is a life-threatening physiological state that causes disturbances in the cardiovascular, pulmonary, immune, and hematological systems. Trauma patients commonly present to the operating room (OR) in hypovolemic shock, leading to tissue hypoperfusion and the development of acute metabolic acidosis with or without a respiratory component. It is often believed that trauma patients presenting to the OR in severe metabolic acidosis (pH <7.0) will have a nearly universal mortality rate despite aggressive resuscitation and damage control. The current literature does not include reports of successful resuscitations from a lower pH, which may lead providers to assume that a good outcome is not possible. However, here we describe a case of successful resuscitation from an initial pH of 6.5 with survival to discharge home 95 days after admission with almost full recovery. We describe the effects of acute acidosis on the respiratory and cardiovascular systems and hemostasis. Finally, we discuss the pillars of management in patients with extreme acute acidosis due to hemorrhage: transfusion, treatment of hyperkalemia, and consideration of buffering acidosis with bicarbonate and hyperventilation.

Juvenile Polyp associated with Hypovolemic Shock Due to Massive Lower Gastrointestinal Bleeding

  • Kim, Dong Yeop;Bae, Joon Yeol;Ko, Kyung Ok;Cheon, Eun Jung;Lim, Jae Woo;Song, Young Hwa;Yoon, Jung Min
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권6호
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    • pp.613-618
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    • 2019
  • Juvenile polyps are the most common types of polyps in children, and patients usually present with lower gastrointestinal (GI) bleeding as the predominant symptom. These lesions, which are referred to as hamartomas, usually measure approximately 2 cm in size and are benign tumors located mainly in the rectum and sigmoid colon. The most common symptom of a juvenile polyp is mild intermittent rectal bleeding. It is rare for anemic patients because the amount of blood loss is small and often not diagnosed immediately. We present the case of a 6-year-old girl with a juvenile polyp in the distal transverse colon, who developed hypovolemic shock due to massive lower GI bleeding. Pediatricians must perform colonoscopy for thorough evaluation of polyps, because their location and size can vary and they can cause massive bleeding.

중환자에서 발생한 저혈량성 쇼크 동반 복직근초 혈종 1예 (A Case of Rectus Sheath Hematoma Complicated with Hypovolemic Shock in a Critically-Ill Patient)

  • 신홍준;김윤희;지수영;반희정;권용수;오인재;김규식;임성철;김영철;김수옥
    • Tuberculosis and Respiratory Diseases
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    • 제69권6호
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    • pp.480-482
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    • 2010
  • Rectus sheath hematoma (RSH) is a rare condition caused by hemorrhage into the rectus sheath. It is usually associated with severe cough, abdominal surgery, coagulopathy, and anticoagulation treatment. RSH can be difficult to diagnose and can be misdiagnosed as acute appendicitis, as diverticulitis, or as an ovarian mass. Although RSH usually presents as a benign condition, it can be life threatening, especially in the critically-ill patient. Here, we report a case of fatal RSH due to hypovolemic shock in a critically-ill 73-year-old woman, who had received heparin treatment due to acute myocardial infarction in the intensive care unit and who had been successfully treated by conservative management.

A Neonate Diagnosed with Wolff-Parkinson-White Syndrome Presenting with Cardiogenic Shock

  • Ha, Ji Eun;Lee, Sun Hyang;Park, Ga Young;Shin, Young-Lim;Kim, Sung Shin;Jang, Mi-Ae
    • Neonatal Medicine
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    • 제28권2호
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    • pp.77-82
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    • 2021
  • We present the case of a healthy 28-day-old female full-term neonate who was admitted to the neonatal intensive care unit for severe metabolic acidosis, hypoglycemia, and an initial sinus rhythm. The first diagnostic hypothesis was hypovolemic shock, and fluid resuscitation was started immediately. During fluid therapy, cardiovascular collapse occurred with supraventricular tachycardia. The latter was successfully treated with adenosine and beta-blockers. After 8 days, electrocardiography showed ventricular pre-excitation, and Wolff-Parkinson-White syndrome was diagnosed. A novel variant of the MYL2 gene that is related to hypertrophic cardiomyopathy and conduction defect was found after discharge. Cardiogenic shock should be considered, despite being a rare cause of shock in neonates.