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Author Spotlight: Developing Innovative Therapeutic Strategies for Hemorrhagic Shock Research
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Traumatic shock alias posttrauma critical illness.

R M Hardaway1

  • 1Department of Surgery, Texas Tech University Health Sciences Center, El Paso 79905, USA.

The American Surgeon
|April 12, 2000
PubMed
Summary

Traumatic shock, a leading cause of death in young adults, is caused by a cell-derived shock toxin. This toxin triggers microclot formation, leading to organ failure, but can be treated by restoring circulation.

Area of Science:

  • Trauma and Shock Research
  • Cellular Biology
  • Hematology

Background:

  • Trauma is a leading cause of mortality in individuals under 45.
  • Multiple organ failure, particularly acute respiratory distress syndrome, is a common complication in trauma patients.
  • The pathophysiology of traumatic shock remains incompletely understood, despite extensive research.

Purpose of the Study:

  • To elucidate the fundamental cause of traumatic shock.
  • To review historical and current research on trauma and shock.
  • To identify the mechanism leading to multiple organ failure after trauma.

Main Methods:

  • Comprehensive literature review of over 40,000 research papers on trauma and shock from 1875 to the present.
  • Analysis of proposed mechanisms for traumatic shock, including hypovolemia and the shock toxin theory.

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  • Investigation of the cellular and molecular basis of shock toxin and its role in disseminated intravascular coagulation.

    • Main Results:

    • The historical concept of a shock toxin, first proposed during World War I, is supported by current data.
    • This shock toxin is identified as a thrombogenic aminophospholipid released from damaged cells.
    • The toxin induces disseminated intravascular coagulation (DIC), leading to microvascular obstruction and multiple organ failure.

    Conclusions:

    • Traumatic shock is primarily caused by a cell-derived shock toxin leading to DIC and microcirculatory obstruction.
    • Microclot formation obstructs blood flow to organs, resulting in multiple organ failure.
    • Therapeutic strategies aimed at lysing these microclots, such as using plasminogen activator, may restore organ circulation.