Hemodynamically stable what does it mean

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Hypotension low blood pressure is very much a sign of hemodynamic instability, but it is by no means the first thing one will see in an unstable patient. Too often, low blood pressure has been used as a stand-in for hemodynamic instability by some healthcare providers, but the body will have reactions to fluctuations of blood pressure long before that particular vital sign can be clearly identified.

As the circulatory system fails, there are several signs of the body's attempt to fix the problem that indicates a problem. Almost all of these come from the sympathetic nervous system, the body's acceleration device and our response to stress.

The sympathetic nervous system is driven by, among other things, epinephrine also known as adrenaline and is often referred to as the "fight or flight syndrome. The idea is that the body is preparing to either fight or run from a predator.

The fight or flight syndrome is mostly about circulation. As the sympathetic nervous system is stimulated, it causes blood flow to be concentrated in large muscle groups in the arms and legs, so the fighting or running can begin. Blood flow and activity in the gastrointestinal system is reduced temporarily you can digest that cheeseburger if you live through this encounter with the mountain lion.

Blood flow to the eyes, nose, and brain increases, all the better to hear and see you with, my dear. The airways in the lungs dilate to let more airflow and the rapid heart rate ensures that blood flows faster to the lungs to stay fresh and oxygenated.

Lastly, just in case that saber-tooth tiger gets a few shots in, blood flow is shunted away from the surface of the skin to reduce bleeding and the sweat glands kick in to help cool things down as the situation heats up.

Much of that sympathetic response to stress, which is exactly the same whether the stress comes from decreased perfusion filling with blood in the brain or because the brain thinks it's about to be eaten by a zombie, is just as helpful during a medical condition as it is in a zombie apocalypse.

The skin signs—pale and cool because the blood is not flowing at the surface and wet because of the sweating diaphoresis —is giving away the fact that there is a stress response happening. Notice that nothing in here requires a low blood pressure. Indeed, in a typical fight or flight response, the blood pressure goes up, which makes the fight or flight syndrome a great response to medical conditions that result in a loss of blood pressure.

In the treatment of cardiac-related medical conditions, hemodynamic stability is the primary indicator of when it's time to intervene. A patient with bradycardia or tachycardia should be treated much more aggressively in the presence of hemodynamic instability than if she appears to be stable. Many guidelines use this as the litmus test, which makes it all that much more important to recognize it clearly.

There are ways to assess hemodynamic stability with invasive monitoring, but it is not a difficult syndrome to identify with a proper clinical assessment. Hemodynamic instability is easy to confuse with shock , but shock is a term that has several meanings and only one of them has anything to do with whether or not a patient is able to adequately move blood around his body.

The other two have to do with being emotionally overwhelmed or with electricity. Shock is a medical condition with defined types and levels, unlike hemodynamic instability. There are four types of shock: cardiogenic, distributive includes neurogenic, anaphylactic, and septic , hypovolemic includes hemorrhagic , and respiratory which some healthcare providers do not agree is a shock syndrome. It could be said that decompensated shock is a hemodynamically unstable shock patient.

As far as identifying the underlying cause of a patient's medical condition, understanding the types of shock and being able to identify them will go a lot further than simply understanding hemodynamic instability. Perfusion is one of those old terms that hold on in the medical profession after having lost its grip on the rest of modern lexicon.

It means to fill with blood and is often used specifically to refer to blood filling the capillaries. Capillaries are basically passive channels where red blood cells can enter only in single file.

Capillary beds are like sponges and will fill with blood only if there is adequate pressure to push the blood into the tiny vessels. Hypo- too little perfusion filling refers to not enough blood filling the capillary beds in the body.

Forgot Password? Hemodynamic Instability. Appointments Call or click for an in-person or virtual visit. Hemodynamic instability symptoms may include Abnormal heart rate arrhythmias Chest pain Cold hands, arms, legs, or feet, or a bluish discoloration of these areas peripheral cyanosis Confusion Decreased urine output Low blood pressure hypotension Loss of consciousness Restlessness Shortness of breath University of Miami Health System pediatric critical care doctors offer the latest approaches to treat hemodynamic instability and other blood pressure-related problems in children.

Why Choose UHealth? We're here to help. Our appointment specialists are ready to help you find what you need. Contact us today. Treatments Artificial Support In most cases, hemodynamic instability will require some type of artificial, mechanical support to maintain blood pressure and heart activity, such as extracorporeal membrane oxygenation ECMO. Thanks, you've been successfully signed up for the UHealth newsletter!

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