Shock circulatory

Another area of active research is the development of stable low molecular weight metal complexes, which could serve as SOD mimics. Fridovich has described a complex of mangsmese (III) with desferral, which can catalyse the dismutation of superoxide anion in vitro and can protect green algae against paraquat toxicity (Beyer and Fridovich, 1989). This manganese-desferral complex was evaluated in models of circulatory shock and also found to improve survival rate (de Garavilla etal., 1992). 

In the worst cases, the patient may go into circulatory shock and die within minutes. 

The principal function of the circulatory system is to supply oxygen and vital metabolic substrates to cells throughout the body, as well as removal of metabolic waste products. Circulatory shock is a life-threatening condition whereby this principal function is compromised. When circulatory shock is caused by a severe loss of blood volume or body water it is called hypovolemic shock, the focus of this chapter. Regardless of etiology, the most distinctive manifestations of hypovolemic shock are arterial hypotension and metabolic acidosis. Metabolic acidosis is a consequence of an accumulation of lactic acid resulting from tissue hypoxia and anaerobic... 

Circulatory shock A life-threatening condition wherein the circulatory system is unable to deliver enough oxygen and metabolic substrates to meet the demands of tissues and adequately clear metabolic waste products from those tissues. 

C1. Cabin, D. E and Buchman, T. G., Molecular biology of circulatory shock. Part HI. Human hepatoblastoma (HepG2) cells demonstrate two patterns of shock-induced gene expression that are independent, exclusive, and prioritized. Surgery 108,902-912 (1990). 

F15. Fourrier, F., Jallot, A., Leclerc, L., Jourdain, M., Racadot, A., Chagnon, J. L., Rime, A., and Chopin, C., Sex steroid hormones in circulatory shock, sepsis syndrome, and septic shock. Circ. Shock 43, 171-178(1994). 

K6. Kawamura, M Kitayoshi, T Terashita, Z., Fujiwara, S Takatani, M and Nishikawa, K Effects of TCV, a novel PAF antagonist, on circulatory shock and hematological abnormality induced by endotoxin in dogs. / Lipid Medial. Cell Signal. 9,255-265 (1994). 

Szab6, C., Alternations in nitric oxide production in various forms of circulatory shock. New Horiz. 3,2-32 (1995). 

Urban, N. and Porth, C.M., Heart failure and circulatory shock, in Pathophysiology Concepts of Altered Health States, 5th ed., Porth, C.M., Ed., Lippin-cott-Raven Publishers, Philadelphia, 1998, chap. 20. 

Dopamine exhibits its primary action of the cardiovascular system, kidneys, and mesentery. It is used as a temporary agent for treating hypotension and circulatory shock caused by myocardial stroke, trauma, kidney rejection, and endogenous septicemia. The main indication for use of this drag is shock of various origins (cardiogenic, postoperational, infectious-toxic, anaphylactic), severe hypotension, and imminent renal insufficiency. Synonyms of dopamine are dopamin and inotropin. 

DepoDur- Respiratory depression acute or severe bronchial asthma upper airway obstruction paralytic ileus head injury increased intracranial pressure circulatory shock. 

Administer opioids with caution to patients in circulatory shock, because vasodilation produced by the drug may further reduce cardiac output and blood pressure. Pancreatitis/Biliary tract disease Use opioids with caution in patients with biliary tract disease, including acute pancreatitis and in those about to undergo surgery of the biliary tract. 

These venoms induce circulatory shock and potentially death. 

When applied locally the small arteries close to the surface constrict and thereby reduce the bleeding of open wounds and the swelling of the mucosa, for example in the mouth or nose. The same a-adrenoceptor mediated effect can be used system-ically in patients with a circulatory shock which is caused by a vasodilatation. 

Dopamine is an intermediate product in the biosynthesis of noradrenaline. Furthermore it is an active transmitter by itself in basal ganglia (caudate nucleus), the nucleus accumbens, the olfactory tubercle, the central nucleus of the amygdala, the median eminence and some areas in the frontal cortex. It is functionally important, for example in the extra-pyramidal system and the central regulation of emesis. In the periphery specific dopamine receptors (Di-receptors) can be found in the upper gastrointestinal tract, in which a reduction of motility is mediated, and on vascular smooth muscle cells of splanchnic and renal arteries. Beside its effect on specific D-receptors, dopamine activates, at higher concentrations, a- and -adrenoceptors as well. Since its clinical profile is different from adrenaline and noradrenaline there are particular indications for dopamine, like situations of circulatory shock with a reduced kidney perfusion. Dopamine can dose-dependently induce nausea, vomiting, tachyarrhythmia and peripheral vasoconstriction. Dopamine can worsen cardiac ischaemia. 

The associated initial release of catecholamines may result in an excessive pressor response and stimulation of cardiac force and pacemaker activity. The resulting increase in myocardial oxygen consumption in a patient with ischemic heart disease may lead to ischemic pain (angina pectoris). Patients in a state of circulatory shock probably should not be administered bretylium because of its delayed sympatholytic action. 

It produces severe toxic manifestations. Either suicidal or accidental intake of toxic doses of barbiturates is characterized by depressed respiration, circulatory shock, pupils are initially constricted then dilated due to asphyxia, hypothermia, renal failure and pulmonary complications such as acute pulmonary edema. 

Chronic adrenocortical insufficiency is characterized by weakness, fatigue, weight loss, hypotension, hyperpigmentation, and inability to maintain the blood glucose level during fasting. In such individuals, minor noxious, traumatic, or infectious stimuli may produce acute adrenal insufficiency with circulatory shock and even death. 

An increase in pulmonary blood flow (increased cardiac output) slows the rate of rise in arterial tension, particularly for those anesthetics with moderate to high blood solubility. This is because increased pulmonary blood flow exposes a larger volume of blood to the anesthetic thus, blood "capacity" increases and the anesthetic tension rises slowly. A decrease in pulmonary blood flow has the opposite effect and increases the rate of rise of arterial tension of inhaled anesthetics. In a patient with circulatory shock, the combined effects of decreased cardiac output (resulting in decreased pulmonary flow) and increased ventilation will accelerate the induction of anesthesia with halothane and isoflurane. This is not likely to occur with nitrous oxide, desflurane, or sevoflurane because of their low blood solubility. 

Gathiram P, Wells, M.T., Brock-Utne, J.G., Gaffin, S.L. Antilipopolysaccharide improves survival in primates subjected to heat stroke. Circulatory Shock 23 (1987) 157. 

The blood concentration of free morphine as a metabolite of diamorphine also correlates well with the survival time, at least over 24 hours. Average blood concentrations of morphine observed in cases where death has occurred from circulatory shock and respiratory arrest less than 3 hours after administration are 3 to 10 times greater than those seen after deaths following prolonged coma (3 to 24 hours). 

Feuerstein, G., and Siren, A.L. 1988. Mechanisms of anatoxin a induced shock. Circulatory Shock 24, 278-278. 

Oral morphine is subject to extensive presystemic metabolism (mainly conjugation in gut wall and liver) and only about 20% of a dose reaches the systemic circulation the initial oral dose is about twice the injected dose. Given s.c. (particularly) or i.m., morphine is rapidly absorbed when the circulation is normal, but in circulatory shock absorption will be delayed and morphine is best given i.v. 

Even though the pathophysiology of hepatic changes during circulatory shock and in chronic liver congestion is very complex, two single mechanisms may be held jointly responsible for the impairment of metabolic and excretory liver functions ... 

After perforation (60-80% of patients), an aneurysm becomes manifest in the form of abdominal pain, which can be very severe. (129) When an intrahepatic haema-toma reaches the bile ducts, haemobilia may result (about 40% of cases) (133), just as compression of the excretory bile ducts may lead to the development of jaundice (in some 50% of cases). (134,138) Heavy bleeding into the free abdominal cavity constitutes an acute abdomen with signs of circulatory shock. Bleeding into the intestinal tract or into the portal vein is less frequent. Lethality due to rupture is 30-50% the prognosis for massive bleeding with haemoperitoneum is even poorer. 

Kilboum RG, Szabo C and Traber DL, Beneficial versus detrimental effects of nitric oxide synthase inhibitors in circulatory shock lessons learned from experimental and clinical studies. Shock 7(4) 235-46, 1997. 

The age of the patient should influence the behaviour of the injection as ageing will affect vascular blood flow and fatty deposits, but age has not been specifically isolated as a factor in studies to date. In some disease states it is possible to predict that the outcome of an i.m. injection might be different from that in normal patients for example, in patients with circulatory shock, hypotension, congestive heart failure and myxoedema, where blood flow to skeletal muscle is decreased. 

Templeton C B, Bottoms G D. Fessler J F et al 1987 Endotoxin-induced hemodynamic and prostaglandin changes in ponies effects of flunixin meglumine, dexamethasone, and prednisolone. Circulatory Shock 23 231-240... 

Malcolm D S, Friedland M, Moore T et al 1993 Hypertonic saline resuscitation detrimentally affects renal function and survival in dehydrated rats. Circulatory Shock 40 69-74... 

Capillary narrowing in hemorrhagic shock is rectified by hyperosmotic saline-dextran reinfusion. Circulatory Shock 31 407-418... 

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