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Hemorrhagic Shock

  • You Hwan Jo
  • Sung-Hyuk Choi
Chapter

Abstract

Hemorrhagic shock induces tissue hypoxia, organ dysfunction, and death. Cardiovascular, neuroendocrine, immunologic, and inflammatory reactions are responsible for the pathophysiology of hemorrhagic shock, and the lethal triad of acidosis, hypothermia, and coagulopathy is related with high mortality in patients with severe hemorrhagic shock. Multidisciplinary approaches including prompt assessment, diagnosis, initial resuscitation, transfusion, administration of pharmacologic agents, and bleeding control are crucial for the treatment of hemorrhagic shock. For the initial assessment, focused ultrasonography and multi-detector CT have been widely used, and the viscoelastic methods for coagulopathy are increasingly used. Damage control resuscitation, represented by permissive hypotension, avoidance of aggressive intravenous fluid, and early high ratio transfusion, has recently been emphasized for initial resuscitation. Massive transfusion protocol should be prepared for the severe hemorrhagic shock, and tranexamic acid is also recommended in traumatic shock patients. Operative management and nonoperative management including angioembolization and endovascular occlusion should be performed early for bleeding control.

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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of Emergency MedicineSeoul National University Bundang HospitalGyeonggi-doSouth Korea
  2. 2.Institute for Trauma ResearchKorea UniversitySeoulSouth Korea

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