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Autonomic Dysfunction in Shock

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Hemodynamic Monitoring

Part of the book series: Lessons from the ICU ((LEICU))

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Abstract

Circulatory shock is accompanied, and likely to be preceded, by profound alterations in autonomic function. In stable conditions, sympathetic and parasympathetic limbs of the autonomic nervous system work in a highly coordinated manner, by virtue of physical and biochemical afferent signals being transduced into coordinated neural activity to maintain homeostasis in multiple organs innervated by specialized autonomic nerves. In this chapter, we assess how normal autonomic activity is regulated and the practical implications of how perturbation of the autonomic nervous system fuels further detrimental changes in shock. We will also highlight how autonomic regulation of cardiovascular and extra-cardiovascular physiology contributes to circulatory shock and define autonomic dysfunction practically in a clinical context.

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Author information

Authors and Affiliations

  1. Translational Medicine and Therapeutics, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, John Vane Science Centre, London, UK

    Gareth L. Ackland

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  1. Gareth L. Ackland
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Correspondence to Gareth L. Ackland .

Editor information

Editors and Affiliations

  1. Critical Care Medicine Dept., University of Pittsburgh, Pittsburgh, PA, USA

    Michael R. Pinsky

  2. Bicetre University Hospital, Paris South University, Le Kremlin-Bicêtre, France

    Jean-Louis Teboul

  3. Department of Intensive Care, Erasme University Hospital, Brussels, Belgium

    Jean-Louis Vincent

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© 2019 European Society of Intensive Care Medicine

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Ackland, G.L. (2019). Autonomic Dysfunction in Shock. In: Pinsky, M.R., Teboul, JL., Vincent, JL. (eds) Hemodynamic Monitoring. Lessons from the ICU. Springer, Cham. https://doi.org/10.1007/978-3-319-69269-2_8

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  • DOI: https://doi.org/10.1007/978-3-319-69269-2_8

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-69268-5

  • Online ISBN: 978-3-319-69269-2

  • eBook Packages: MedicineMedicine (R0)

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