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    Hemorrhagic Shock

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    mutiara rizki
    Hemorrhagic shock is caused by an imbalance between oxygen demand and supply that results in inadequate tissue perfusion. It can be categorized as hypovolemic, cardiogenic, obstructive, or distributive. Common causes include bleeding from trauma, gastrointestinal sources, or obstetrical complications. Trauma is a leading cause of death worldwide. Treatment focuses on damage control resuscitation to address the lethal triad of coagulopathy, acidosis, and hypothermia through permissive hypotension, hemostatic resuscitation using blood products early, and controlling hemorrhage sources. Outcomes depend on the underlying cause, patient age, comorbidities, and response to interventions.

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    Hemorrhagic Shock

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    mutiara rizki
    277 views14 pages
    Hemorrhagic shock is caused by an imbalance between oxygen demand and supply that results in inadequate tissue perfusion. It can be categorized as hypovolemic, cardiogenic, obstructive, or distributive. Common causes include bleeding from trauma, gastrointestinal sources, or obstetrical complications. Trauma is a leading cause of death worldwide. Treatment focuses on damage control resuscitation to address the lethal triad of coagulopathy, acidosis, and hypothermia through permissive hypotension, hemostatic resuscitation using blood products early, and controlling hemorrhage sources. Outcomes depend on the underlying cause, patient age, comorbidities, and response to interventions.

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    Hemorrhagic Shock (1)

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    Hemorrhagic shock is caused by an imbalance between oxygen demand and supply that results in inadequate tissue perfusion. It can be categorized as hypovolemic, cardiogenic, obstructive, or distributive. Common causes include bleeding from trauma, gastrointestinal sources, or obstetrical complications. Trauma is a leading cause of death worldwide. Treatment focuses on damage control resuscitation to address the lethal triad of coagulopathy, acidosis, and hypothermia through permissive hypotension, hemostatic resuscitation using blood products early, and controlling hemorrhage sources. Outcomes depend on the underlying cause, patient age, comorbidities, and response to interventions.

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    Download as pptx, pdf, or txt
    277 views14 pages

    Hemorrhagic Shock

    Uploaded by

    mutiara rizki
    Hemorrhagic shock is caused by an imbalance between oxygen demand and supply that results in inadequate tissue perfusion. It can be categorized as hypovolemic, cardiogenic, obstructive, or distributive. Common causes include bleeding from trauma, gastrointestinal sources, or obstetrical complications. Trauma is a leading cause of death worldwide. Treatment focuses on damage control resuscitation to address the lethal triad of coagulopathy, acidosis, and hypothermia through permissive hypotension, hemostatic resuscitation using blood products early, and controlling hemorrhage sources. Outcomes depend on the underlying cause, patient age, comorbidities, and response to interventions.

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    Hemorrhagic Shock

    Disampaikan oleh :
    Ricco Firmansyah (G1A218069)
    Rachilla Arandita Saraswati (G1A218070)

    Pembimbing :
    dr. Dedy Fachrian, Sp.An
    INTRODUCTION
    Syok imbalance O2 demands and supply 
    inadequate perfusion of tissues.
    4 categories of shock :
    Hypovolemic   intravascular vol. to the end point of
    cardiovascular compromise.
    Cardiogenic
    Obstructive
    Distributive
    ETIOLOGY
    Bleeding  external or internal (chest, abdomen,
    retroperitonemum)
    Blunt or penetrating Trauma.
    Upper and lower gastrointestinal sources
    Obstetrical, vascular, iatrogenik, urological

    Localizing and controlling the sources of bleeding !


    EPIDEMIOLOGY
    Trauma  leading cause of death worldwide.
     In the US in 2001, trauma  the 3rd leading cause of death
    overall and aged 1 to 44 years

     As patients age, physiological reserves decrease the


    likelihood of anticoagulant use  and the number of
    comorbidities  .
     Elderly patients may decompensate more quickly.
    PATHOPHYSIOLOGY
    HISTORY AND PHYSICAL
    EVALUATION
    Recognition!
    Tachycardia, tachypnea, and narrowing pulse  initial
    signs.
    Cool extremities and delayed capillary refill 
    peripheral vasoconstriction .

    In trauma  primary and secondary surveys is


    suggested by ATLS.
    Physical exam and radiological evaluation can help
    localize sources of bleeding.
    TREATMENT/MANAGEMENT
    Simple massive transfusion  “Damage Control
    Resuscitation”
    Per He He
    mi mo mo
    The concept of damage control resuscitation focuses on:
    ssi stat rrh
    ve ic ag
    hy res e
    pot usc co
    ens itat ntr
    ion ion ol

    to adequately treat the “lethal triad” of coagulopathy,


    acidosis, and hypothermia that occurs in trauma.
    TREATMENT/MANAGEMENT
    Hypotensive resuscitation has been suggested for the
    hemorrhagic shock patient without head trauma.
    to achieve a systolic blood pressure of 90 mmHg

    Permissive hypotension  restricting fluid


    administration until hemorrhage is controlled while
    accepting a short period of suboptimal end-organ
    perfusion.
    TREATMENT/MANAGEMENT
    Hemostatic resuscitation  pushes for early use of blood
    products rather than an abundance of crystalloids.

    In addition to blood products, products that prevent the


    breakdown of fibrin in clots, or antifibrinolytics, have been
    studied for their utility in the treatment of hemorrhagic
    shock in the trauma patient .

    Damage control resuscitation is to occur in conjunction


    with prompt intervention to control the source of bleeding.
    DIFFERENTIAL DIAGNOSIS
    PEARLS AND OTHER ISSUES
    Trauma is the most common cause of hemorrhagic shock,
    but causes can span multiple systems.
    Tachycardia  the first abnormal vital sign of
    hemorrhagic shock.
    Cold extremities, delayed capillary refill  signs of
    peripheral vasoconstriction.
    The “lethal triad” of trauma is acidosis, hypothermia, and
    coagulopathy.
    Trauma-induced coagulopathy can occur in the absence
    of the hemodilution of resuscitation.
    PEARLS AND OTHER ISSUES
    Damage control resuscitation is based on three principles:
    permissive hypotension
    hemostatic resuscitation
    Hemorrhage control  damage control surgery.

    Permissive hypotension targets a systolic blood pressure


    of 90 mmHg.
    The outcomes depend on the cause, patient age,
    associated comorbidity and patient responses to
    treatment.
    THANK YOU !

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