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Hemorrhagic Shock

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Evidence-Based Critical Care

Abstract

For patients with severe hemorrhage resulting in shock, two key principles determine survival: early blood product resuscitation and hemorrhage control. Recognizing the patient in hemorrhagic shock often proves difficult as robust compensatory mechanisms often obscure the picture, yet early recognition is essential to survival. This chapter will review the essential elements for early diagnosis of hemorrhagic shock and will emphasize the current best practices in hemostatic resuscitation and early hemorrhage control. Blood product administration is central to the resuscitation strategy while current evidence also supports the use of adjunctive therapies and diagnostic tools including electrolyte repletion, hemostatic adjuncts, and viscoelastic measures of coagulation. Balloon aortic occlusion has also emerged as an appealing tool for establishing early proximal vascular control for abdominal or pelvic hemorrhage. Ultimately, these interventions are designed to sustain life while surgical, angiographic, or endoscopic hemorrhage control is achieved.

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Authors and Affiliations

  1. Division of Traumatology, Surgical Critical Care & Emergency General Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Andrew J. Young & Jeremy W. Cannon

  2. Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Jeremy W. Cannon

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  1. Andrew J. Young
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  2. Jeremy W. Cannon
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Correspondence to Jeremy W. Cannon .

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Editors and Affiliations

  1. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Robert C. Hyzy

  2. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Jakob McSparron

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Young, A.J., Cannon, J.W. (2020). Hemorrhagic Shock. In: Hyzy, R.C., McSparron, J. (eds) Evidence-Based Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-26710-0_95

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  • DOI: https://doi.org/10.1007/978-3-030-26710-0_95

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