Shock

Shock, although of different pathogenesis (hypovolemic, cardiogenic, obstructive, distributive), is associated with minor perfusion and consequently oxygen deficiency of vital organs and tissue hypoxia. Haemorrhages resulting in hypovolemic shock are the common cause of microcirculatory disturbances and oxygenation deficiency in trauma patients.

Traumatic-haemorrhagic shock followed by resuscitation is often associated with inflammatory response syndrome (SIRS), which in turn if inadequate may result in failure of one or more organs (MOF) and finally in the death of patients. Research topics currently include:

  • Immune response: humoral (complement, coagulation, fibrinolysis)
  • Immune response: cellular (neutrophils, endothelial cells, monocytes/macrophages)
  • Microcirculation: hypo-reactivity (Nitric oxide, vasoactive drugs)
  • Ischemia/Reperfusion: complications (oxidative stress, endoplasmatic reticulum stress)
  • Gastrointestinal tract: permeability changes (bacterial translocation, motor of MOF)
  • Metabolomics: metabolic alterations after haemorrhage/trauma
  • Oxygenation: re-oxygenation (100%, gradual, restrictive)
  • Fluid therapy (restrictive vs. full, composition)
  • Supportive Therapies: supplemented resuscitation (stem cells/Secretome)
  • Experimental models: mimicking clinical settings closely

The research group around Soheyl Bahrami aims to discover the underlying mechanisms of post-traumatic complications, including SIRS and MOF and thereby to develop and improve new therapeutic approaches.

Selected Publications

Hofmann N, Zipperle J, Jafarmadar M, Ashmwe M, Keibl C, Penzenstadler C, Ponschab M, Jafarmadar B, Redl H, Bahrami S, Schöchl H (2018). Experimental Models of Endotheliopathy: Impact of Shock Severity. Shock May;49(5):564-571

Ponschab M, Schöchl H, Gabriel C, Süssner S, Cadamuro J, Haschke-Becher E, Gratz J, Zipperle J, Redl H & Schlimp CJ (2015). Haemostatic profile of reconstituted blood in a proposed 1:1:1 ratio of packed red blood cells, platelet concentrate and four different plasma preparations. Anaesthesia, 70(5):528-536.
(free PDF)

Schöchl H, Voelckel W & Schlimp CJ (2015). Management of traumatic haemorrhage–the European perspective. Anaesthesia, 70(Suppl 1):102-107, e35-e37.
(free PDF)

Schöchl H, Nienaber U, Maegele M, Hochleitner G, Primavesi F, Steitz B, Arndt C, Hanke A, Voelckel W & Solomon C (2011). Transfusion in trauma: thromboelastometry-guided coagulation factor concentrate-based therapy versus standard fresh frozen plasma-based therapy. Crit Care, 15(2):R83.
(free PDF)

Postl A, Zifko C, Hartl RT, Ebel T, Miller I, Moldzio R, Redl H, Kozlov AV, Bahrami S & Duvigneau JC (2011). Transient increase of free iron in rat livers following hemorrhagic-traumatic shock and reperfusion is independent of heme oxygenase 1 upregulation. Shock, 36(5):501-509.

Bahrami S, Benisch C, Zifko C, Jafarmadar M, Schöchl H & Redl H (2011). Xylazine-/Diazepam- Ketamine and Isoflurane Differentially Affect Hemodynamics and Organ Injury Under Hemorrhagic/Traumatic Shock and Resuscitation in Rats. Shock, 35(6):573-578.

Sobhian B, Jafarmadar M, Redl H & Bahrami S (2011). Nitric oxide-supplemented resuscitation improves early gastrointestinal blood flow in rats subjected to hemorrhagic shock without late consequences. Am J Surg, 201(1):100-110.

Zifko C, Kozlov AV, Postl A, Redl H & Bahrami S (2010). RONS formation under restrictive reperfusion does not affect organ dysfunction early after hemorrhage and shock. Shock, 34(4):384-389.

Duvigneau JC, Kozlov AV, Zifko C, Postl A, Hartl RT, Miller I, Gille L, Staniek K, Moldzio R, Gregor W, Haindl S, Behling T, Redl H & Bahrami S (2010). Reperfusion does not induce oxidative stress but sustained endoplasmic reticulum stress in livers of rats subjected to traumatic/hemorrhagic shock. Shock, 33(3):289-298.

Bahrami S, Zimmermann K, Szelenyi Z, Hamar J, Scheiflinger F, Redl H & Junger WG (2006). Small-volume fluid resuscitation with hypertonic saline prevents inflammation but not mortality in a rat model of hemorrhagic shock. Shock, 25(3):283-289.

Sobhian B, Jafarmadar M, Redl H & Bahrami S (2005). Hemorrhage- and resuscitation-related alterations in gastrointestinal circulation: effect of a low dose of L-NMMA. Shock, 23(3):243-247.

Kozlov A, Sobhian B, Duvigneau C, Gemeiner M, Nohl H, Redl H & Bahrami S (2001). Organ specific formation of nitrosyl complexes under instestinal ischemia/repefusion in rats involves NOS-independent mechanism(s). Shock, 15(5):366-371.