The pathophysiology of hemorrhagic shock

It is difficult to summarize such a complex series of problems. Both the pathophysiology of hemorrhage and the details of its treatment are far from being fully defined in spite of the inherent simplicity of the challenge involved. The questions how much, what kind, and when still apply to such fundamental issues as the fluids given for resuscitation, red cells necessary for extensive hemorrhage and the hemostatic components. We are not clear as to what, if anything, can be done to improve antibacterial and antimicrobial defense mechanisms after a major hemorrhage. There are tantalizing leads as to specific measures that can be taken to prevent other potential complications but some maneuvers that may minimize the change for one complication may worsen the chance for others. We must, of course, continue to strive to try to reduce the complications of treatment itself, which are probably small but still significant. There is certainly much yet to be learned in both the fundamental and practical spheres.