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Physiological derangement of the trauma patient (Book Chapter)

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单位： [a]Department of Anesthesiology, Tulane University, Medical Center, 1430 Tulane Avenue, New Orleans, LA 70112, United States [b]Department of Anesthesiology, Wuhan Central Hospital, 26 Shengli Street, Wuhan, 430014, China [c]Department of Anesthesiology, Wuhan Tongji Hospital, 1095 Jiefang Avenue, Wuhan, 430030, China [d]Department of Anesthesiology, LSUHSC-Shreveport, 1501 Kings Highway, Shreveport, LA 71102, United States [e]Department of Anesthesiology, Pain Services, LSU School of Medicine, 1542 Tulane Avenue, New Orleans, LA 70112, United States

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关键词： acute traumatic coagulopathy inflammatory response sepsis Trauma physiology trauma related hyperfibrinolysis trauma-induced vicious cycle

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This chapter provides a systemic review of trauma-related physiological changes with tremendous updated information. The first part of this chapter analyzed the general physiological changes according to the following categories: (1) hemorrhage-related changes: trauma-related vicious cycle of hemorrhage, resuscitation, and coagulopathy; mechanisms of acute trauma coagulopathy (excessive activation of coagulation, hyperfibrinolysis, hypothermia, acidosis, increased capillary permeability, and platelet dysfunction). (2) Stress-related changes (behavioral activation). (3) Pain-related changes (ventilation and mental status). (4) Inflammatory changes and sepsis. (5) Metabolic changes. The second part of the chapter discussed three system-specific physiological changes after trauma: head trauma, chest and cardiac trauma, and trauma to abdominal and digestive system. © 2014 Springer Science+Business Media New York. All rights are reserved.

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第一作者单位： [a]Department of Anesthesiology, Tulane University, Medical Center, 1430 Tulane Avenue, New Orleans, LA 70112, United States

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