Intensive study and treatment of shock in man

Fluid Resuscitation Increases Inflammatory Gene Transcription After Traumatic Injury

“…2 Using this resuscitation strategy, the rate of mortality and acute renal failure decreased but a new entity of shock lung, now better known as acute respiratory distress syndrome (ARDS), was discovered. 3 Colloids have the advantage of a longer intravascular half-life that may improve organ perfusion and may cause less tissue edema. This may be a short-term effect as the interstitial oncotic pressure increases from diffusion of the colloid over time.…”

Pathophysiology and Management of Septic Shock

“…1971 even after the original hemodynamic abnormalities have been reversed. 10 The mechanism of production of the "shock lung" syndrome is unknown. Factors such as capillary thrombosis from disseminated intravascular coagulation, direct damage to capillaries by bacterial toxins, or oxygen toxicity from prolonged exposure to high inspired oxygen concentrations may be implicated.…”

“…10 Early, aggressive fluid therapy may reverse the shock state. 10 Inotropic agents-Patients with septic POSTGRADUATE MEDICINE shock suffer from variable degrees of impairment of myocardial contractility.…”

“…10 Early, aggressive fluid therapy may reverse the shock state. 10 Inotropic agents-Patients with septic POSTGRADUATE MEDICINE shock suffer from variable degrees of impairment of myocardial contractility. 7 Many tolerate aggressive fluid therapy; the CVP may actually fall, indicating improved cardiac performance possibly secondary to increased coronary perfusion.…”

“…Favorable results have been reported in some refractory shock patients, but no general agreement exists as to whether mortality rates can be reduced thereby. 10 ' 21 This form of therapy should be reserved for patients who do not respond to isoproterenol and fluid therapy. Because such therapy has a potent vasodilator effect, vascular volume may increase by up to 25 percent; large amounts of fluid should be administered.…”