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Reperfusion injury, sometimes called ischemia-reperfusion injury (IRI) or reoxygenation injury, is the tissue damage caused when blood supply returns to tissue (re-+ perfusion) after a period of ischemia or lack of oxygen (anoxia or hypoxia).
The cause of inadequate tissue perfusion (blood delivery to tissues) in distributive shock is a lack of normal responsiveness of blood vessels to vasoconstrictive agents and direct vasodilation. [4] There are four types of distributive shock.
Physiologic dead space cannot change as it is ventilation without perfusion. A shunt is a perfusion without ventilation within a lung region. [citation needed] Low tidal volume ventilation was the primary independent variable associated with reduced mortality in the NIH-sponsored ARDSNet trial of tidal volume in ARDS.
Respiratory failure is classified as either Type 1 or Type 2, based on whether there is a high carbon dioxide level, and can be acute or chronic. In clinical trials, the definition of respiratory failure usually includes increased respiratory rate, abnormal blood gases (hypoxemia, hypercapnia, or both), and evidence of increased work of breathing.
Septic shock is a result of a systemic response to infection or multiple infectious causes. The precipitating infections that may lead to septic shock if severe enough include but are not limited to appendicitis, pneumonia, bacteremia, diverticulitis, pyelonephritis, meningitis, pancreatitis, necrotizing fasciitis, MRSA and mesenteric ischemia.
Impaired perfusion leads to decreased ATP production within the endothelial cells, which ultimately leads to cellular swelling and irreversible damage of the endothelial cells. This cell damage contributes to the formation of fibrin thrombi within the microvasculature, occluding the vasculature lumen, and resulting in MVO.
Evidence [ edit ] A study by Newman et al. at Duke University Medical Center showed an increased incidence of cognitive decline after coronary artery bypass surgery (CABG), both immediately (53 percent at discharge from hospital ) and over time (36 percent six weeks, 24 percent at six months, and 42 percent at five years). [ 3 ]
While circulation is clearly a factor in the physiology of decompression, as perfusion is recognised as a limiting factor in dissolved gas transport to and from the tissues, and in the transport and distribution of vascular bubbles during decompression, there is little empirical evidence of altered risk due to compromised circulation due to ...