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Hemodynamic Disorders

Hemodynamic Disorders. Fluid Homeostasis. Homeostasis is maintained by the opposing effects of: Vascular Hydrostatic Pressure and Plasma Colloid Osmotic Pressure. ASCITES . Edema. Pitting Edema. PERIORBITAL (RENAL). Pulmonary Edema.

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Hemodynamic Disorders

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  1. Hemodynamic Disorders

  2. Fluid Homeostasis Homeostasis is maintained by the opposing effects of: • Vascular Hydrostatic Pressure • and • Plasma Colloid Osmotic Pressure

  3. ASCITES Edema

  4. Pitting Edema PERIORBITAL (RENAL)

  5. Pulmonary Edema • The Lungs are typically 2-3 times normal weight • Cross sectioning causes an outpouring of frothy, sometimes blood-tinged fluid • It may interfere with pulmonary function

  6. Pulmonary Edema the alveolar capillaries are engorged, and an intra-alveolar granular pink precipitate is seen

  7. Brain Edema The surface of the brain with cerebral edema demonstrates widened gyri with a flattened surface. The sulci are narrowed

  8. Brain Edema Clinical CorrelationThe big problem is: There is no place for the fluid to go! • Herniation into the foramen magnum will kill

  9. Effects of LipopolysaccharideSeptic Shock LPS = lipopolysaccharide TNF = tumor necrosis factor IL = interleukin NO = nitric oxide PAF = platelet-activating factor

  10. ARDS/diffuse alveolar damage in shock Some of the alveoli are collapsed; others are distended. Many contain dense proteinaceous debris, desquamated cells, and hyaline membranes

  11. MYOCARDIAL NECROSIS in Shock lower field contains intact myocardium, while the upper field exhibits coagulation necrosis of myocardium. the hypoperfusion is greatest in the subendeocardium, which is perfused mainly in diastole.

  12. ATN ATN in shock , extensive tubular isghaemia , note relative sparing of the glomeruli.

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