Anesthesiologists are involved: Anesthesiologists are involved

• Specific organ systems respond to traumatic shock in specific ways:

• The kidney and adrenal glands are prime responders to the neuroendocrine changes associated with shock; these organs produce renin, angiotensin, aldosterone, cortisol, erythropoietin, and catecholamines.

• The kidney itself maintains glomerular filtration in the face of hypotension by selective vasoconstriction and concentration of blood flow in the medulla and deep cortical area.

• Prolonged hypotension leads to decreased cellular energy and an inability to concentrate urine(renal cell hibrination), followed by patchy cell death, tubular epithelial necrosis, and renal failure

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• The heart is relatively preserved from ischemia during shock because of an increase in nutrient blood flow

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