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2009 | 63 | 2 | 73-77
Article title

Wstrząs krwotoczny a czynność serca

Title variants
Haemorrhagic shock and heart function
Languages of publication
During haemorrhagic shock and resuscitation heart function is infl uenced by nervous, humoral and local factors. Nervous regulation includes threephasic changes of the sympathetic and parasympathetic system activities. In the fi rst phase, tachycardia is observed as a response to a fall in blood pressure and baroreceptor-mediated increase of the sympathetic activity. The second phase, characterized by bradycardia, is associated with a Bezold-Jarisch refl ex and increased parasympathetic activity; in the third hipophase, heart rate increases again, probably due to sympathetic stimulation. In this review, we present also humoral (testosterone, estrogens, prolactin, interleukin 6 [IL-6], hydrogen sulphide) and the local factors (tumor necrosis factor α [TNF-α]) aff ecting heart function in hemorrhagic shock.
W stanie wstrząsu krwotocznego oraz resuscytacji wpływ na czynność serca mają czynniki nerwowe, humoralne i produkowane miejscowo. W regulacji nerwowej wyróżnia się trójfazowe zmiany aktywności układu współczulnego i przywspółczulnego, a co za tym idzie, zmiany czynności serca. W pierwszej fazie dochodzi do tachykardii na skutek odbarczenia baroreceptorów tętniczych i odruchowego pobudzenia układu współczulnego, w fazie drugiej występuje bradykardia, jako następstwo odruchu Bezolda i Jarischa oraz zwiększenia aktywności układu przywspółczulnego i hamowania układu współczulnego. Trzecia faza regulacji charakteryzuje się ponownym wzrostem częstości rytmu serca, prawdopodobnie wskutek pobudzenia układu współczulnego. W pracy omówiono także wpływ na czynność serca czynników humoralnych (testosteron, estrogeny, prolaktyna, interleukina 6 [IL-6], siarkowodór) oraz produkowanych lokalnie (czynnik martwicy guza α [TNF-α]).
Physical description
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