Hemorrhagic Shock: From Physiology to Molecular Biology
Hemorrhagic shock (HS) is accompanied by a unique set of cardiovascular derangements that are well-described in standard physiology texts. The molecular basis for the physiologic and inflammatory changes during HS, however, has not been fully clarified, and research in this area is ongoing. It has been shown that many of the events which follow HS in the resuscitation and post-resuscitation phases characterize the inflammatory response. This complex series of molecular events includes cytokine upregulation, nitric oxide synthase and stress protein induction, and adhesion molecule production, to name only a few. Some of these events appear to occur due to changes in gene expression with consequent appearance of new cell phenotypes. The phenotypic alterations may vary with the severity of HS as well as with the presence or absence of resuscitation. The link between the physiology of HS and the subsequent elicitation of the inflammatory response is an area of continuing research and experimentation.
KeywordsNitric Oxide Systemic Inflammatory Response Syndrome Hemorrhagic Shock Traumatic Shock Vascular Hypo Reactivity
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