gangguan hemodinamik

Gangguan hemodinamik

Sirkulasi Darah

Thrombus : Vena

• Oklusi Pembuluh darah Vena• 90% pada Vena ekstremitas bawah– Femoral– Popliteal– Iliac

Thrombus

Pathogenesis

Three primary influences predispose to thrombus formation, the so-called Virchow triad:

(1) endothelial injury (2) stasis or turbulence of blood flow(3) blood hypercoagulability

High risk for thrombosis• Prolonged bed rest or immobilization• Myocardial infarction,Atrial fibrillation• Tissue damage (surgery, fracture, burns)• Cancer• Prosthetic cardiac valves• Disseminated intravascular coagulation• Heparin-induced thrombocytopenia• Antiphospholipid antibody syndrome (lupus

anticoagulant syndrome)

Lower risk for thrombosis Cardiomyopathy,Nephrotic

syndrome,Hyperestrogenic states (pregnancy),Oral contraceptive use, Sickle cell anemia,Smoking

Embolus

• Bisa berupa massa solid, liquid, or gaseous yang dibawa aliran darah.

• 90% berasal dari trombus

Embolus

Types of edema

• Transdate: protein poor (<3 gm/dl) fluid with specific gravity of <1.012 due to imbalances in normal hemodynamic forces e.g. congestive heart failure, liver and renal disease etc.

• Exudate - protein rich (>3 gm/dl) fluid with a specific gravity of >1.020 results from endothelial damage and alteration of vasular permeability e.g. inflammatory and immunologic pathology.

Pulmonary Edema

SHOCK

• Shock, or cardiovascular collapse,• Bisa disebabkan :– Perdarahan hebat– Luka Bakar– emboli paru yang massive– Sepsis Microbial

•

• Akibatnya :– Hipotensi gangguan perfusi ke jaringan– Ke Jaringan Otak irreversible

Types of shock.

• Cardiogenic shock results from myocardial pump failure e.g intrinsic myocardial infarction, ventricular arrhythmias.

• Hypovolemic shock results from loss of blood or plasma volume e.g. hemorrhage, fluid loss from severe burns, or trauma.

• Septic shock is caused by systemic microbial infection. Most commonly due to gram-negative infections (endotoxic shock), but it can also occur with gram-positive and fungal infections.