Bonanno Fabrizio Giuseppe
Trauma Directorate, Chris Hani Baragwanath Hospital, Johannesburg, South Africa.
J Emerg Trauma Shock. 2012 Oct;5(4):285-95. doi: 10.4103/0974-2700.102357.
A shift of approach from 'clinics trying to fit physiology' to the one of 'physiology to clinics', with interpretation of the clinical phenomena from their physiological bases to the tip of the clinical iceberg, and a management exclusively based on modulation of physiology, is finally surging as the safest and most efficacious philosophy in hemorrhagic shock. ATLS(®) classification and recommendations on hemorrhagic shock are not helpful because antiphysiological and potentially misleading. Hemorrhagic shock needs to be reclassified in the direction of usefulness and timing of intervention: in particular its assessment and management need to be tailored to physiology.
一种从“临床试图适应生理学”到“生理学应用于临床”的方法转变，即从生理基础来解释临床现象直至触及临床冰山一角，且管理完全基于生理调节，最终正作为失血性休克中最安全、最有效的理念兴起。高级创伤生命支持（ATLS®）对失血性休克的分类和建议并无帮助，因为它们违背生理且可能具有误导性。失血性休克需要朝着干预的实用性和时机方向重新分类：特别是其评估和管理需要根据生理学进行调整。
