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PHASES OF THE PROCESS OF ORGANISM'S DYING1. Preagony. It is characterized by progressive extinction of consciousness or stunning. Changes of hemodynamics: tachycardia, pulse is hardly palpated, AP dropped and, sometimes, is not defined, microcirculation is disturbed, breathing is shallow and pathologic (of Cheyne-Stokes or Kussmaul type, etc.). Reflex reactions are reduced. This condition lasts several hours or may be absent (for example, electric current injury). 2. Terminal pause. It is noted by no means always (often in blood loss). It is a transitional period between preagony and agony, being characterized by a further deepening of cerebral cortex inhibition up to its complete shutoff and temporary (from a few seconds to 1.5 min) apnea continuing until the time when increasing PC02 in blood exceeds the threshold of sensitivity of the respiratory center, and its stimulation leads to a renewal of respiration that signifies itself the onset of agony. 3. A gony. It is characterized, at first, by the increase of cardiac activity and respiration as a result of renewal of oxygenation. However, the respiration bears a character of "gasping" or "fish breathing" (a short maximum inspiration with the participation of auxiliary muscles and a rapid complete expiration), becoming progressively rare. Cardiac rhythm is slowed down (from time to time — sinus) or sharply accelerated, a weakening pulsation is defined only on great vessels. 4. Clinical death. It is characterized by the absence of blood circulation (no pulse on carotid arteries), absence of respiration and consciousness. In this period the main metabolic processes are maintained, but under anaerobic conditions are sharply reduced. The period lasts 3-5 m in. In children when the temperature of the environment is lowered and in accidental coincidence with preliminary application of antioxidants this period is extended, in elevated temperature of the environment in old people this period becomes shorter. This period is important because in acutely arised clinical death a possibility is preserved to renew all vitally important functions, including a function of cerebral cortex. 5. Social (spiritual, theological, civil) death. It is characterized by the loss of cerebral cortex function while vegetative functions are preserved. It develops in that case if resuscitation starts too late or is conducted ineffectively. Its duration depends on the degree of expression of injuries developed in the period of clinical death and carrying out a resuscitation, on quality of intensive care and nursing in the postresuscitation period (from a few hours to several months). 6. Brain death. It is a state characterized by the loss of function of the whole brain while artificial support of respiration and blood circulation continues. 7. Biological death (a true death). It is characterized by irreversible biophysiological disorders of all functions and systems of the organism. Opacification of cornea and its drying out, appearance of death spots, "cat's- eye' pupils" are typical for this stage of dying Дата добавления: 2015-02-05 | Просмотры: 839 | Нарушение авторских прав |