Pathophysiology of massive trauma with therapeutic implications.

In addition to its local effects, severe trauma has several consequences for the whole organism. Partly, these are hormonal, humoral and neural regulatory mechanisms - negative feedback mechanisms to regain homeostasis, a balance of the "milieu intérieur". Blood loss and disturbances in the fluid compartments is one of the central pathological features. The shock period is accompanied by mobilization of defense mechanisms and energy. The length and extent of of the catabolic phase depends on the extent of the injury, the effectiveness of the therapeutic efforts and the disturbances of organ and system functions. Repair proceeds gradually aiming at anatomical and functional restitution.