Physiological derangement of the trauma patient

This chapter provides a systemic review of trauma-related physiological changes with tremendous updated information. The first part of this chapter analyzed the general physiological changes according to the following categories: (1) hemorrhage-related changes: trauma-related vicious cycle of hemorrhage, resuscitation, and coagulopathy; mechanisms of acute trauma coagulopathy (excessive activation of coagulation, hyperfibrinolysis, hypothermia, acidosis, increased capillary permeability, and platelet dysfunction). (2) Stress-related changes (behavioral activation). (3) Pain-related changes (ventilation and mental status). (4) Inflammatory changes and sepsis. (5) Metabolic changes. The second part of the chapter discussed three system-specific physiological changes after trauma: head trauma, chest and cardiac trauma, and trauma to abdominal and digestive system.