L9: Hemorrhage Flashcards
etiology of Hemorrhage
Pathophysiology of Hemorrhage
Importance of local response in Hemorrhage
Stopping the bleeding.
what does local resonse in Hemorrhage include?
- Immediate VC.
- Retraction of intima of injured vessel.
- Subsequent blood clotting.
Importance of Systemic Response in Hemorrhage
- Maintaining effective circulatory volume & perfusion of critical tissues (Brain & Heart) at the expense of less critical tissues (skin, skeletal muscle & splanchnic area.
what does Systemic Response in Hemorrhage include?
- Neural factors (Rapid)
- Endocrinal Factors (Slow)
Neural factors Systemic Response to Hge
Endocrinal factors Systemic Response to Hge
- Catecholamines
- Anti-insulins
- RAAS system
- Vasopressin (ADH)
Catecholamines Systemic Response to Hge
Anti-insulins Systemic Response to Hge
RAAS System Systemic Response to Hge
Vasopessin (ADH) Systemic Response to Hge
Classification in Hemorrhage
According to:
- site
- Source
- Time of occurence
Classification in Hemorrhage according to site
Classification in Hemorrhage according to source
Classification in Hemorrhage acc to time of occurence
Clinical Features of Hemorrhage
Classes of Hemorrhage
Investigations in Hemorrhage
- Clinically
- Urinary Catheter
- CVP
- PAWP
- Arterial Canulation
- Blood Gases
- Blood Studies
- ECG
Clinical investigation in Hemorrhage
what is Normal urine output?
0.5 - 1 ml/kg/h
Def of Central Venous Pressure (CVP)
Venous pressure in right atrium
Importance of Central Venous Pressure (CVP)
As long as cardiac function is normal it reflects:
- Volume of blood returning to heart.
- The ability of heart to expel it.
Normal Range of Central Venous Pressure (CVP)
5-15 cm H2O (if zero is the mid axillary line)
