Bradycardia during reversible hypovolaemic shock: associated neural reflex mechanisms and clinical implications

Clinical and Experimental Pharmacology & Physiology
N H SecherS Matzen

Abstract

1. Heart rate response to reversible central hypovolaemia can be divided into three stages. In the first stage (corresponding to a reduction of the blood volume by approximately 15%) a modest increase in heart rate (< 100 beats/min) and total peripheral resistance compensate for the blood loss, and a near normal arterial blood pressure prevails (preshock). During the second stage, a reduction of the central blood volume by approximately 30% results in a decrease in heart rate, total peripheral resistance and blood pressure due to activation of unmyelinated vagal afferents (C-fibres) from the left ventricle. In the third stage, blood pressure falls further as haemorrhage continues and tachycardia (> 120 beats/min) is manifest. This stage may proceed into irreversible shock with death from cardiac arrest probably related to the formation of free oxygen radicals. 2. Recognition of the vasodepressor-cardioinhibitory reaction to a reduced circulating blood volume is important and suggests the need for immediate treatment with volume expansion in critically ill patients.

References

Aug 1, 1978·The Australian & New Zealand Journal of Obstetrics & Gynaecology·R P Jansen
May 1, 1977·Scandinavian Journal of Clinical and Laboratory Investigation·L BergenwaldT Sjöstrand
Jul 1, 1978·Clinical Endocrinology·P H BaylisD A Heath
Sep 1, 1977·British Heart Journal·F Perez-Gomez, A Garcia-Aguado
May 1, 1976·Scandinavian Journal of Clinical and Laboratory Investigation·T Sjöstrand
Apr 2, 1975·Pflügers Archiv : European journal of physiology·L BergenwaldT Sjöstrand
Nov 1, 1992·Clinical Physiology·J Jacobsen, N H Secher
Nov 1, 1992·Acta Anaesthesiologica Scandinavica·J JacobsenN H Secher
Jul 1, 1991·Acta Physiologica Scandinavica·K SchmidK Gebauer
Oct 1, 1990·Acta Physiologica Scandinavica·S MatzenN H Secher
Feb 1, 1990·Acta Physiologica Scandinavica·J JacobsenN H Secher
Dec 1, 1985·Acta Physiologica Scandinavica·P SkoogP Thorén
Aug 11, 1988·The American Journal of Physiology·H Sugiya, J W Putney
Mar 25, 1989·Lancet·A Fitzpatrick, R Sutton
Nov 1, 1989·Quarterly Journal of Experimental Physiology : an International Journal of the Physiological Society·R A LittleE Kirkman
Jun 1, 1989·The Journal of Physiology·J H MitchellR G Victor
Aug 1, 1989·Journal of Applied Physiology·E P ChristianD Weinreich
Feb 9, 1989·The New England Journal of Medicine·F M Abboud
Jan 2, 1985·European Journal of Pharmacology·R ElamG Feuerstein
Jun 1, 1987·Acta Physiologica Scandinavica·M O Hakumäki
Jul 1, 1988·Acta Anaesthesiologica Scandinavica·J Jacobsen, N H Secher
Jan 1, 1987·Intensive Care Medicine·P Barriot, B Riou
Jan 1, 1986·Journal of Sports Sciences·N HolmqvistT W Schwartz
Dec 1, 1986·Journal of the Autonomic Nervous System·M G ZieglerJ A McCutchen
Aug 1, 1986·The Journal of Physiology·F M AbboudB N Gupta
Oct 1, 1986·Acta Anaesthesiologica Scandinavica·S Rørsgaard, N H Secher
Oct 1, 1986·Acta Anaesthesiologica Scandinavica·J JacobsenN H Secher
Aug 1, 1985·Clinical Physiology·N H Secher, P Bie
Nov 1, 1985·Circulation Research·H Morita, S F Vatner
Dec 1, 1985·Anesthesiology·J O ArndtK D Stühmeier

❮ Previous
Next ❯

Citations

Aug 25, 2000·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·M KawaseY Shimada
May 1, 1996·The Journal of Emergency Medicine·C A Marco, A P Marco
May 1, 1996·Acta Anaesthesiologica Scandinavica·J H SindrupN H Secher
Dec 1, 1995·Acta Physiologica Scandinavica·M PedersenN H Secher
Oct 18, 2011·American Journal of Physiology. Heart and Circulatory Physiology·Lusha XiangRobert Hester
Nov 26, 2010·Cardiovascular Diabetology·Aiji BokuHitoshi Niwa
Jun 15, 2012·Journal of Clinical Monitoring and Computing·Jasper TruijenBerend E Westerhof
Jan 7, 2010·European Journal of Applied Physiology·Jasper TruijenJohannes J van Lieshout
Oct 14, 2008·Journal of Clinical Monitoring and Computing·Paul M MiddletonNigel H Lovell
May 8, 2007·Autonomic Neuroscience : Basic & Clinical·Andriy I BatchinskyLeopoldo C Cancio
Apr 2, 2005·Experimental Physiology·Lysander W J Bogert, Johannes J van Lieshout
May 23, 2009·Experimental Physiology·Niels H Secher, Johannes J Van Lieshout
May 25, 2013·Acta Anaesthesiologica Scandinavica·M VettorelloR Fumagalli
May 16, 2006·Vascular Pharmacology·Ana M BalaszczukAndrea L Fellet
Sep 6, 2014·Frontiers in Physiology·Niels D OlesenNiels H Secher
Apr 30, 2003·Anesthesiology·Jason A Campagna, Christopher Carter
Nov 11, 2009·The Journal of Trauma·Eric J LeyDaniel R Margulies
Aug 13, 2005·Acta Anaesthesiologica Scandinavica·T KrantzN H Secher
Sep 9, 2005·Acta Anaesthesiologica Scandinavica·J J van LieshoutN H Secher
Jan 13, 2006·Clinical and Experimental Pharmacology & Physiology·Niels H Secher, Johannes J Van Lieshout
Apr 17, 2012·Anesthesia and Analgesia·Paul A StrickerDavid R Jobes
Oct 4, 2011·Anesthesia and Analgesia·George J Crystal, M Ramez Salem
Oct 12, 2011·The Journal of Trauma·Yasuaki MizushimaTetsuya Matsuoka
Apr 29, 2000·Acta Anaesthesiologica Scandinavica·T KrantzN H Secher
Jan 1, 1995·Acta Anaesthesiologica Scandinavica. Supplementum·M JenstrupN H Secher
Jan 1, 1995·Clinical Physiology·J JacobsenN H Secher
May 20, 2003·Clinical Physiology and Functional Imaging·Christoph HaberthürChristine Stebler Gysi
Dec 2, 2020·Surgical Endoscopy·Jens OsterkampMichael Achiam
Jul 1, 2021·Computational and Mathematical Methods in Medicine·Luciano CurcioAndrea De Gaetano

❮ Previous
Next ❯

Related Concepts

Related Feeds

Bradyarrhythmias

Bradyarrhythmias are slow heart rates. Symptoms may include syncope, dizziness, fatigure, shortness of breath, and chest pains. Find the latest research on bradyarrhythmias here.