Pharmacological Control of Hemorrhagic Shock : Does Hypertonic Resuscitation Qualify?
The critical function of the mammalian circulatory system is the handling of respiratory gases, required at variable levels, over the many conditions to which each individual is normally exposed during his lifetime. This problem is handled through variable blood flow. An average healthy human adult at rest produces a cardiac output of 5 1/min, but activity will change this substantially. A sedate, untrained person can raise output to 10 1/min, trained people are capable of 20 or 25 1/min, while exceptionally gifted and well conditioned athletes produce outputs in the 30 1/min range. In contrast, total blood volume (normal value 5 liters) is a relatively fixed parameter, which should not vary by more than 10% around the mean. In this sense, hemorrhage may be regarded as an unsual problem: how may large blood volume losses be reconciled with fixed (basal) cardiac output. Light blood loss is of course a very simple and trivial matter: mammals encounter it frequently during their lives and cope easily: human blood donors, regular or occasional, give 10% of their total blood volume and simply walk back to normal activity. Severe blood loss is quite a different matter: it is a fairly rare, probably a once-in-a-lifetime occurrence, and the problem it poses, and the ways in which the natural response is dealt with in a civilized therapeutical environment is the object of this discussion.
KeywordsIschemia Urea Lithium Dopamine Bicarbonate
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