World Journal of Surgery

, Volume 7, Issue 1, pp 26–30 | Cite as

Traumatic shock in polytrauma: Circulatory parameters, biochemistry, and resuscitation

  • Konrad F. W. Messmer
Progress Symposium—Advances in the Care of the Multiple Trauma Patient

Abstract

Traumatic shock in multiple trauma patients essentially represents hypovolemic shock in association with the effects and sequelae of tissue damage. The primary factor rendering the patient at peril to develop multi-organ failure is the persistence of impairment of the microcirculation. Resuscitation must take place efficiently to prevent shock if possible or to treat shock when manifest. Primary volume replacement with red cell-free solutions, preferably with a long-lasting colloid, is recommended as the most important single step in resuscitation. Sequential analysis of circulatory and biochemical parameters, together with evaluation of clinical symptoms, is needed to reverse traumatic shock as a prerequisite for surgical management.

Résumé

Le choc chez le polytraumatisé répond à un choc hypovolémique associé aux effets et conséquences des attritions tissulaires. Le facteur essentiel qui menace le blessé d'une défaillance plura-organique est représenté par les altérations de la microcirculation. Le réanimation se doit de les prévenir ou de les traiter dès qu'elles se manifestent. La correction immédiate de l'hypovolémie par une suspension de globules rangés dans une solution colloïdale à longue durée est indispensable et constitue la première étape de la réanimation. L'analyse répétée des paramètres biochimiques et circulatoires aussi que la juste appréciation des manifestations cliniques est nécessaire pour contrôler le choc traumatique avant l'intervention chirurgicale.

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Copyright information

© Société Internationale de Chirurgie 1983

Authors and Affiliations

  • Konrad F. W. Messmer
    • 1
  1. 1.Department of Experimental Surgery, Surgical CenterUniversity of HeidelbergHeidelbergWest Germany

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