Hemodynamic Disorders
Fluid HomeostasisHomeostasis is
maintained by the opposing effects of:
• Vascular Hydrostatic Pressure – and
• Plasma Colloid Osmotic Pressure
EdemaASCITES
Pitting EdemaPERIORBITAL (RENAL)
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
Pulmonary Edema
the alveolar capillaries are engorged, and an intra-alveolar granular pink precipitate is seen
Brain Edema
The surface of the brain with cerebral edema demonstrates widened gyri with a flattened surface. The sulci are narrowed
Brain Edema
Clinical Correlation The big problem is: There is no place for the fluid to go!
• Herniation into the
foramen magnum will kill
Effects of Lipopolysaccharide
Septic Shock
LPS = lipopolysaccharide
TNF = tumor necrosis factor
IL = interleukin
NO = nitric oxide
PAF = platelet-activating factor
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
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.
ATN
ATN in shock , extensive tubular isghaemia , note relative sparing of the glomeruli.