J Acute Care Surg.  2016 Apr;6(1):2-6. 10.17479/jacs.2016.6.1.2.

Pathophysiology of Hemorrhagic Shock

Affiliations
  • 1Division of Trauma Surgery, Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea. 3rdvivace@hanmail.net

Abstract

Hemorrhage is a major cause of death in trauma patients. The medical definition of hemorrhagic shock is tissue hypoperfusion resulting from a reduction of blood volume. Decreased blood pressure resulting from acute blood loss induces cardiac stimulation, systemic vasoconstriction, and volume redistribution. These effects are due to the baroreceptor reflex, the humoral compensatory mechanisms including the renin angiotensin system, and the release of catecholamine and vasopressin. Hemorrhagic shock causes acidosis, hypothermia, and coagulopathy, known as "˜the lethal triad.' Tissue hypoxia induces metabolic acidosis by producing lactic acid. The three components of the lethal triad amplify each other and form a vicious cycle, eventually causing the death of the patient. To reduce the risk of mortality in severely bleeding patients, we need to understand the pathophysiology of hemorrhagic shock and the related complications.

Keyword

Hemorrhagic shock; Lethal triad; Acidosis; Hypothermia; Consumption coagulopathy

MeSH Terms

Acidosis
Anoxia
Baroreflex
Blood Pressure
Blood Volume
Cause of Death
Disseminated Intravascular Coagulation
Hemorrhage
Humans
Hypothermia
Lactic Acid
Mortality
Renin-Angiotensin System
Shock, Hemorrhagic*
Vasoconstriction
Vasopressins
Lactic Acid
Vasopressins
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