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TRAUMA Perfusion Tissulaire Insuffisante Choc hémorragique- diminution du…
TRAUMA Perfusion Tissulaire Insuffisante Choc hémorragique- diminution du volume circulant
hypoxie cellualire
sécretion hormonale
Histamine, Kinines, serotinine
Troubles de microcirculation
chute de retour veineux
chute du debit cardiaque
chute de TA
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Glycolyse anaérobie
amène à un acidose
insufficance de perfusion coronaire
souffrance du myocarde
.
souffrances tissulaires
rein
hépatique
cérébrale
pulmonaire
.
ACIDOSE METABOLIQUE
depression du système nerveux
relâchement des sphincters pré-capillaires
sequestration sanguine capillaire
fuite plasmatique extravasculaire
CHUTE DU RETOUR VEINEUX
This response is characterized by increased secretion of various stress hormones such as adrenalin and cortisol, but also glucagon, growth hormone, aldosterone and anti-diuretic hormone
Afferent impulses from the site of injury stimulate the secretion of hypothalamic releasing hormones which further stimulate the pituitary gland. Cortisol is secreted by hormonal stimulation of the adrenalin cortex while adrenalin is secreted by the adrenal medulla in response to activation of the sympathetic nervous system. Noradrenalin spills over into the plasma from the sympatric nerve endings. The magnitude and duration of the hormonal response to traumatic stress correlate well with the extent of the trauma [4]. The neuroendocrine stress response interacts with the immunological response to trauma [5]. There is no evidence that hormonal treatment can improve the outcome following major trauma in humans.
insuffisance circulatoire aigue->transport o2 insuffisant pour assurer oygénation des tissues