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The resuscitation after severe hemorrhage is a very delicate process which involves many biological factors with a very small time window. To successfully revive a victim of severe exsanguination, one must work quickly within the golden hour time limit. In this time period, there are various trauma that must be avoided; cardiac arrest, hypotension, hemorrhagic shock, and hypothermia to name a few. This article encompasses the current technology for resuscitation as well as future possibilities for research. The basic idea behind the resuscitation process involves the restoration of normotension in the blood stream while avoiding cardiac arrest, and hemorrhagic shock. Even when normotension is restored and cardiac arrest is avoided, hemorrhagic shock, which can cause organ failure, is often a problem.
There are 3 types of hemorrhagic shock: compensated hemorrhagic shock; uncompensated hemorrhagic shock, the shock which is reversible; and irreversible hemorrhagic shock. The most popular way of resuscitation is the use of lactated ringers solution to make up for lost blood volume by making the cells swell and in turn restores normotension. This works fairly well but it is not the optimal treatment. PATHOPHYSIOLOGY Half of the deaths that occur annually are due to acute illness or injury, and are associated with circulatory failure or shock. Some of these deaths could be avoided by the proper monitoring. The present technology is the monitoring early in the temporal course of an acute illness to observe the cardiac index, oxygen delivery and oxygen consumption.
In the future, a possibility for a very effective non-invasive monitoring device, would be one which can provide the following cardiac output readings: pulse oximetry for estimating arterial hemoglobin oxygen saturation as a reflection of pulmonary function; trans cutaneous oxygen and CO 2 tensions as reflections of tissue perfusion; and noninvasive blood pressure readings. Non- invasive systems are far more effective than invasive systems because it provides a constant display of the data and they can also be used anywhere; in the hospital or in the field. In the future, if systems like these are perfected, shock may be easily! intercepted and avoided, thus resulting in a huge number of lives saved. FUTURE STUDIES ON HEMORRHAGIC RESUSCITATION Future studies on resuscitation should be centered around shock, prevention of cardiac arrest as well as increasing oxygen transport and increasing blood volume. The validity of blood pressure as a measure of organ viability and optimum possibility of resuscitation should be investigated as well.
But mainly the resuscitation research should center around something which can do all of these quickly and efficiently so that resuscitation will save lives from the hospital to the battlefield.
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