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British Medical Bulletin 55:726-743 (1999)
© 1999 The British Council
research-article |
Systemic responses to trauma
Emergency Medicine, University of Manchester, Hope Hospital Salford, UK
Correspondence to Mr Bernard A Foëx, Emergency Medicine, Clinical Sciences Building, Hope Hospital, Salford M6 8HD, UK
Abstract
The systemic responses trauma can be divided into cardiovascular, immunological, and metabolic. The cardiovascular responses are seen immediately after a traumatic insult. The Pattern of response depends on wheter the insult is mainly haemorrhagic, tissue damage, or a combination of the two. The response may be quite different for penetrating vascular trauma, compared with a crush injury to a limb. The immunological, or inflammatory, consequences of trauma usally become apparent several hours or days after the initial insult, although it is increasingly clear that they may be triggered by the very early cardiovascular changes. These have been implicated in the development of multiple organ failure. The metabolic responses are of greatest importance in the longer term: after succesful resuscitation and after the definitive treatment of the patient's injuries. The meatbolic responses need to be taken into account during the recovery from treatment and during the rehabilitation of the patient.
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