Answer: BCDISCUSSION:
Hemorrhagic shock is associated with a contraction of the interstitial fluid compartment because of precapillary vasoconstriction and reabsorption of interstitial fluid into the vascular compartment along hydrostatic pressure gradients. Systolic hypotension may not be evident in hemorrhagic shock until at least 30% or more of blood volume is exsanguinated. A decrease in the pulse pressure (the difference between systolic and diastolic pressures) may be observed with losses of 15% to 30% of blood volume. Treatment of hemorrhagic shock includes intravascular fluid administration and definitive control of the source of the hemorrhage. Inotropic agents should not be started before volume resuscitation but may be added to improve oxygen delivery to hypoxic tissues if volume administration alone does not produce resuscitative goals. Colloid or hypertonic saline solutions are not contraindicated in the treatment of hemorrhagic shock; however, definitive evidence that such solutions are better than standard crystalloid solutions is lacking.
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Surgery MCQs
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