Resuscitation from Severe Hemorrhage
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 ringer's 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 saturationas a reflection of pulmonary function; transcutaneous
oxygen and CO2 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.