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Related Concept Videos

Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

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A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
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Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
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Hemorrhagic Stroke l: Introduction01:17

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A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
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Microcirculatory alterations in traumatic hemorrhagic shock.

Guillaume Tachon1, Anatole Harrois, Sebastien Tanaka

  • 11AP-HP, Service d'Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France. 2Microcirculation, Bioénergétique, Inflammation et Insuffisance Circulatoire Aiguë, Equipe Universitaire 3509, Paris VII-Paris XI-Paris XIII, Paris, France. 3Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia. 4Hôpitaux Universitaires de Strasbourg, Service d'Anesthésie-Réanimation Chirurgicale, Hôpital de Hautepierre, Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Equipe d'accueil EA 3072 "Mitochondrie, stress oxydant et protection musculaire" Strasbourg, France.

Critical Care Medicine
|February 25, 2014
PubMed
Summary

Microcirculation in traumatic hemorrhagic shock remains impaired for 72 hours, even after bleeding control. Early assessment of perfused vessels may predict organ failure.

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Area of Science:

  • Critical Care Medicine
  • Trauma Surgery
  • Hemodynamics

Background:

  • Microcirculatory dysfunction is common in septic shock.
  • Limited research exists on microcirculation in hemorrhagic shock.
  • Traumatic hemorrhagic shock presents unique challenges to tissue perfusion.

Purpose of the Study:

  • To investigate the time course of sublingual microcirculation in traumatic hemorrhagic shock.
  • To assess microcirculatory changes during the first four days post-trauma.
  • To correlate microcirculatory parameters with organ failure scores.

Main Methods:

  • Prospective observational study of 18 traumatic hemorrhagic shock patients.
  • Sublingual microcirculation assessed at baseline (D1) and daily for three days (D2-D4) post-bleeding control.
  • Utilized microvascular flow index and proportion of perfused vessels.

Main Results:

  • Sublingual microcirculation remained impaired for at least 72 hours post-intervention.
  • Patients with high Sequential Organ Failure Assessment (SOFA) scores showed greater microvascular impairment at D4.
  • Initial proportion of perfused vessels at D1 predicted high SOFA scores at D4.

Conclusions:

  • Traumatic hemorrhagic shock causes persistent microcirculatory impairment.
  • Microcirculatory alterations are linked to trauma, hypoperfusion, inflammation, and resuscitation.
  • Early microvascular assessment can predict organ dysfunction severity.