Sharon Edwards, MSc, RN, DipN, PGCEA.
Senior Lecturer, Department of Nursing and Midwifery, University of HertfordshireThe cellular changes that occur following an insult or hypoxic injury are common and an understanding of the underlying physiological principles of these changes is imperative. Once the initial insult has occurred, the neuroendocrine system and the inflammatory response (IR) are stimulated and endothelial damage initiates the clotting cascade.
Patients with a severe insult to the body (Table 1) require care and attention to the primary injury. However, there is now a sophisticated under-standing of the complex metabolic response to such injuries.
One of the earliest responses to injury is neuro-endocrine activation, which is intimately linked to control of tissue function. The increased sympathetic activity affects almost all elements of the cardiovascular system and triggers a complex series of events that lead to stimulation of the peripheral sympathetic system and adrenal medulla.
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