The microcirculation in shock

Abstract

SummarySome aspects ofblood fluidity in hypoperfusion with particular reference to the important role of the red cell are discussed. Changes in different organ beds and the internal fluidity of the rcd cell, which is of obvious importance in capillary flow are not considered.It is not certain to what extent the phenomena discussed are critical factors in morbidity and mortality in shock because of paucity of objective data but there are good reasons for assuming them to be of importance and for directing treatment towards their correction.The properties of Dextran 40 applicable to the therapy of disordered blood fluidity are described.

Traumatic shock in polytrauma: Circulatory parameters, biochemistry, and resuscitation

“…Enhanced local blood loss, interstitial spreading of the hematoma, and direct activation of the humoral tissue systems will necessarily occur and inevitably intensify the initial volume loss. This allows release into the systemic circulation of humoral factors from the damaged tissue, which further alters the circulation and organ function [2][3][4].…”

“…Activation of the sympathetic nervous system as a result of sudden hypovolemia leads to constriction of precapillary and, to a lesser degree, of postcapillary venules [2][3][4]. Due to precapillary constriction, the driving pressures and the total number of perfused capillaries are reduced.…”