The collapse of acute vascular insufficiency, characterized by Central nervous system depression, sharp fall of the arterial and venous pressure, decrease of mass of circulating blood and metabolic disorders. This vascular insufficiency causes decrease of oxygen content in the blood and hypoxia all organs and tissues, primarily in the brain. The body mount, non-completely oxidized products of metabolism, and consequently there acidosis.
Collapse can occur when blood loss, shock, lack of oxygen, malnutrition, trauma, sudden changes in posture (orthostatic collapse), physical activity, as well as a number of intoxications and diseases, infectious diseases, myocardial infarction, pancreatitis , and so on). Violation of the circulatory collapse is not the result of weakening of cardiac activity, and the fall of the vascular tone, caused by defeat of vasomotor centers. Heart failure develops secondarily due to insufficient blood flow and myocardial hypoxia.
Pathophysiological and biochemical effects in the collapse define and observed with him clinical picture. Oppression of mental activity up to the loss of consciousness caused by hypoxia of the brain.
The skin and the mucous membrane pale, sweat, feel cold, develops acrocyanosis, Vienna zadayutsya and become indistinguishable under the skin, reduces the frequency, content and voltage pulse, it becomes filiform. Arterial and venous pressure sharply reduced. The border of the heart is not changed or slightly reduced. The heart sounds are clean, but weakened. Breathing shallow, superficial, sometimes wrong. His eyes glaze over and sink, facial features sharpened, the legs feel cold. There may come involuntary urination and defecation. The temperature of the body drops to 35 degrees and below. During increase of the symptoms of collapse pupils dilate, reflexes fade away, there comes the agony and death.
Depending on the cause of the collapse, the range and severity of it, and the prevalence of certain symptoms. Infectious collapse, which is found in some severe acute infectious diseases (for example, lobar pneumonia, typhus, diphtheria), often develops during the crisis, then there is a sharp drop in temperature.
Gipotermiceski collapse begins with characteristic oxygen deficiency symptoms: pallor, cyanosis adinamii. The cause of ortostaticski collapse is a quick transition to a vertical position patients who were a long time in bed. In this case, a sharp change poses causes cerebral ischemia. If bleeding decrease volume of circulating blood also leads to the development of collapse because of the coming of oxygen starvation and a number of reflexive processes caused by blood loss.
About the peculiarities of the collapse of myocardial infarction - see myocardial infarction.
Treatment. First of all it is necessary to take measures for the stimulation of blood circulation and breathing. From vascular drugs most widely used camphor (5-10 ml of 20% oil solution) subcutaneously, caffeine-benzoat of sodium in Vienna (1-2 ml of 20% solution), kordiamin (1 ml) in a vein or subcutaneously. Effective hypertensive means is norepinephrine, which injected (1 ml 0.2% solution) the drip method, often with hydrocortisone (10 mg in 50 ml of liquid). For stimulation of respiration appoint Carbogen inhalation (95% oxygen and 5% carbon dioxide) and injection lobelina (0.5 ml of 1% solution), and in case of respiratory arrest spend artificial respiration.
Depending on the cause of the collapse, should assign funds for this cause (blood transfusion and blood substitutes blood loss, held for the purposes and under the supervision of a doctor; integrated antishock therapy in shock, detoxification, and so on). In all forms of collapse patient needs to create full peace, keep warm it and type in the body of large amounts of fluid (as per os and parenteral).