Connor M Bunch, Eric Chang, Ernest E Moore, Hunter B Moore, Hau C Kwaan, Joseph B Miller, Mahmoud D Al-Fadhl, Anthony V Thomas, Nuha Zackariya, Shivani S Patel, Sufyan Zackariya, Saadeddine Haidar, Bhavesh Patel, Michael T McCurdy, Scott G Thomas, Donald Zimmer, Daniel Fulkerson, Paul Y Kim, Matthew R Walsh, Daniel Hake, Archana Kedar, Michael Aboukhaled, Mark M Walsh
Irrespective of the reason for hypoperfusion, hypocoagulable and/or hyperfibrinolytic hemostatic aberrancies afflict up to one-quarter of critically ill patients in shock. Intensivists and traumatologists have embraced the concept of SHock-INduced Endotheliopathy (SHINE) as a foundational derangement in progressive shock wherein sympatho-adrenal activation may cause systemic endothelial injury. The pro-thrombotic endothelium lends to micro-thrombosis, enacting a cycle of worsening perfusion and increasing catecholamines, endothelial injury, de-endothelialization, and multiple organ failure...
2023: Frontiers in Physiology