Pulse during collapse. Vascular collapse

One of acute forms vascular insufficiency is called collapse. He takes intermediate position between fainting and shock. It is characterized by a drop (collapse means fallen) pressure, dilatation of the veins and arteries with the accumulation of blood in them.

Happens with infections, allergies, blood loss, adrenal insufficiency, or exposure to strong antihypertensive drugs. Needed for treatment emergency hospitalization and the introduction of drugs that increase systemic pressure.

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Causes of acute vascular collapse

The following can lead the patient to a collaptoid state:

sharp pain;
trauma;
blood loss, general dehydration;
acute infectious processes;
short cardiac output ( , );
severe allergic reactions;
intoxication with internal (diseases of the kidneys, liver, intestines, acute inflammation) or external ( various poisonings) the entry of toxic substances into the blood;
the introduction of drugs for general or spinal anesthesia, barbiturates, an overdose of sleeping pills, drugs, medications for the treatment of arrhythmias, hypertension;
decreased synthesis of catecholamines in the adrenal glands;
drop in blood sugar or its sharp increase.

Determining the cause of the collapse is not difficult if it arose against the background of an already existing disease. At sudden development it is the first manifestation of emergency conditions (eg, ectopic pregnancy, bleeding from a stomach ulcer). In the elderly, acute vascular insufficiency often accompanies myocardial infarction or pulmonary embolism.

Deficiency symptoms

The first signs of collapse are sudden general weakness, yawning, dizziness. Then quickly join:

With fainting, a spasm of cerebral vessels occurs, and even with mild form patients lose consciousness. It is also important to distinguish collapse from shock.. In the latter case, heart failure, gross violations metabolic processes and neurological disorders. It should be noted that the border between these states (fainting, collapse, shock) is often quite arbitrary, they can pass into each other as the underlying disease progresses.

Types of collapses

Depending on the causes and the leading mechanism of development, several types of vascular collapses have been identified:

orthostatic- with a sharp change in body position in case of ineffective regulation of arterial tone (recovery from infections, taking antihypertensive drugs, a rapid decrease in body temperature, pumping fluid out of the cavities, indomitable vomiting);
infectious- a decrease in the tone of the arteries occurs under the influence of bacterial or viral toxins;
hypoxic- happens with a lack of oxygen or low atmospheric pressure;
dehydration- it leads to loss of fluid in severe infections with diarrhea and vomiting, excessive excretion of urine with forced diuresis, diabetes with high hyperglycemia, with internal or external bleeding;
cardiogenic- is associated with myocardial damage during a heart attack, cardiomyopathy;
sympathicotonic- loss of blood or dehydration, neuroinfection, proceeds with vascular spasm at normal pressure,;
vagotonic- severe pain, stress, anaphylaxis, a drop in blood sugar or a lack of adrenal hormones. The sharp difference between , ;
paralytic- severe diabetes, infectious processes, depletion of compensation reserves, paralytic vasodilation with a sharp decrease in blood circulation.

According to the severity of the patient's condition is:

easy- the pulse increases by a third, the pressure on lower border normal, pulse (difference between systolic and diastolic) low;
moderate- heart rate increased by 50%, pressure about 80-60 / 60-50 mm Hg. Art., urine output decreases;
heavy- consciousness changes to a state of stupor, lethargy, the pulse is increased by 80 - 90%, maximum pressure below 60 mm Hg. Art. or not determined, anuria, intestinal motility stop.

Features of vascular insufficiency in children

AT childhood common cause collapse, there are infections, dehydration, intoxication and oxygen starvation in diseases of the lungs, heart, nervous system.

Minor external influences can lead to vascular insufficiency in premature and debilitated children. This is due to the physiological inferiority of the mechanisms of regulation of the tone of arteries and veins, the predominance of vagotonia, the tendency to develop acidosis (shift of the blood reaction to the acid side) in this category of patients.

Signs of the onset of a collaptoid reaction are a deterioration in the child's condition - against the background of the underlying disease, there is a sharp weakness, lethargy, up to adynamia (low motor activity).

Chills, pallor of the skin, coldness of the hands and feet, an increase in the pulse, which becomes threadlike, are noted. Then the blood pressure decreases, the peripheral veins lose their tone, against the background of the preservation of consciousness, children lose their reaction to the environment, convulsive syndrome is possible in newborns.

Emergency care before the ambulance arrives

Collapse is treated only in a hospital, so emergency care should be called as soon as possible. All the time before the arrival of the doctor, the patient must be in a horizontal position with raised legs (put a blanket or clothes rolled into a roller).

It is necessary to ensure the flow fresh air- unbutton the collar, loosen the belt. If the attack occurred indoors, then you need to open the windows, while covering the victim with a warm blanket. Additionally, you can attach a warm heating pad or bottles of non-hot water on the sides of the body.

For improvement peripheral circulation rub hands, feet, auricles pressed into the hole between the base of the nose and the upper lip. You should not try to seat the patient or give him medications on his own, since the most common remedies (Corvalol, No-shpa, Validol, especially Nitroglycerin) can significantly worsen the condition, turn the collapse into shock. For external bleeding, a tourniquet should be applied.

Watch the video about first aid for fainting and vascular collapse:

Medical therapy

Before transporting the patient to the hospital, the introduction of vasoconstrictors - Cordiamin, Caffeine, Mezaton, Norepinephrine can be used. If the collapse occurred against the background of loss of fluid or blood, then the introduction similar drugs is carried out only after the restoration of the volume of circulating blood with the help of Reopoliglyukin, Stabizol, Refortan or saline solutions.

In severe cases and in the absence peptic ulcer apply hormonal preparations(Dexamethasone, Prednisolone, Hydrocortisone).

Inhalation of humidified oxygen is indicated for patients with hypoxic collapse, poisoning carbon monoxide, severe infections. In case of intoxication, infusion therapy- the introduction of glucose, isotonic solution, vitamins. In case of bleeding, either plasma substitutes are used.

Patients with heart failure additionally receive cardiac glycosides; in case of arrhythmia, it is necessary to restore the rhythm with the help of Cordarone, Atropine (with conduction blockade, bradycardia). If the collapse develops against the background of a severe attack of angina pectoris or a heart attack, then carried out intravenous administration neuroleptics and narcotic analgesics, anticoagulants.

Forecast

With the rapid elimination of the cause of the collapse, it is possible full recovery normal indicators hemodynamics and recovery of the patient without consequences. In infections and poisoning, adequate and timely therapy is often quite effective as well.

The prognosis is more severe in patients with chronic, progressive diseases of the heart, digestive organs, pathology of the endocrine system. In such patients, repeated, repeatedly recurring collaptoid conditions are especially dangerous. because of age features The collapse of the body is most dangerous for children and the elderly.

Prevention

Prevention of acute vascular insufficiency consists in:

timely diagnosis and treatment of infections, intoxications, bleeding, burns;
taking strong medications to reduce blood pressure only for medical recommendation, under the control of hemodynamic parameters;
correction of violations of metabolic processes;
maintaining the recommended blood glucose levels.

At acute infections With high temperature body is important bed rest, slow transition to a vertical position, sufficient drinking regimen especially with fever, diarrhea and vomiting.

Collapse is an acute vascular insufficiency, it happens with infection, poisoning, blood loss, dehydration, heart disease, endocrine pathology. The difference from fainting is the absence of an initial loss of consciousness. Manifestations - a decrease in pressure, severe weakness, lethargy, pallor and cooling of the skin, sticky sweat.

It is difficult to tolerate in childhood and old age. Emergency care consists in giving a horizontal position, quickly calling a doctor, providing access to fresh air. Introduced for treatment vasoconstrictors, hormones, infusion solutions and plasma substitutes. A prerequisite favorable outcome is to eliminate the cause of the collapse.

ICD-10

R55 Fainting [syncope] and collapse

General information

Collaptoid state (vascular insufficiency) is a pathology that suddenly occurs against the background of the presence of chronic or acute cardiovascular diseases. vascular system, other diseases. It is more often diagnosed in patients prone to hypotension, with myocardial infarction, total blockade of intracardiac conduction, ventricular arrhythmias. By pathogenesis and clinical signs, it resembles shock. It differs from it by the absence of characteristic pathophysiological phenomena on initial stages– pH changes, significant deterioration in tissue perfusion and disruption internal organs are not detected. The duration of the collapse usually does not exceed 1 hour, state of shock may persist for a longer period of time.

Causes of the collapse

Regulation of vascular tone is carried out using three mechanisms: local, humoral and nervous. neural mechanism consists in stimulating the vessel wall with fibers of the sympathetic and parasympathetic nervous system. The humoral method is implemented due to sodium and calcium ions, vasopressor hormones (adrenaline, vasopressin, aldosterone). Local regulation involves the appearance of ectopic foci directly in the vascular wall, the cells of which have the ability to generate their own electrical impulses. circulatory network skeletal muscle predominantly regulated in a nervous way, therefore, the causes of collapse can be any conditions in which the activity of the vasomotor center of the brain is suppressed. The main etiological factors are:

infectious processes. lead to the development of vascular insufficiency severe infections accompanied by severe intoxication. Most often, collapse occurs when lobar pneumonia, sepsis, peritonitis, meningitis and meningoencephalitis, typhoid fever, focal inflammatory diseases CNS (brain abscess).
Exogenous intoxications. Pathology is detected in case of poisoning with organophosphorus compounds, carbon monoxide, drugs that can affect vascular tone (clopheline, capoten, ebrantil). In addition, collapse can develop under the influence of drugs for local anesthesia when they are administered epidurally or epidurally.
Heart diseases. The most common reason is acute infarction myocardium. Collaptoid conditions can also be detected against the background of malformations of the heart, a decrease in myocardial contractility, tachy- or bradyarrhythmia, dysfunction of the sinoatrial node (pacemaker), failures of the atrioventricular connection (AV blockade of the 3rd degree) with discoordination of the work of the atria and ventricles.
Injuries. The main cause of vascular insufficiency in injuries is a large amount of blood loss. In this case, there is not a relative, but an actual decrease in BCC due to the physical loss of fluid. In the absence of profuse hemorrhage, a drop in vascular tone becomes a response to severe pain which is more common in children and patients with high tactile sensitivity.

Pathogenesis

The pathogenesis of collaptoid states is based on a pronounced discrepancy between the throughput vasculature and OCC. Expanded arteries do not create the necessary resistance, which leads to sharp decline HELL. The phenomenon may occur when toxic damage vasomotor center, disruption of the receptor apparatus of large arteries and veins, inability of the heart to provide the necessary volume of blood ejection, not enough fluids in the circulatory system. The fall blood pressure leads to a weakening of perfusion of gases in tissues, insufficient oxygen supply to cells, ischemia of the brain and internal organs due to a mismatch between the metabolic needs of the body and the level of its supply with O2.

Classification

The division is made according to the etiological principle. There are 14 varieties of collapse: infectious-toxic, pancreatic, cardiogenic, hemorrhagic, etc. Since the same first aid measures are performed for all types of pathology, such a classification is not significant. practical value. The systematization by stages of development is more relevant:

Sympathotonic stage. Compensatory reactions are expressed. There is a spasm of small capillaries, centralization of blood circulation, the release of catecholamines. Blood pressure is kept within normal limits or rises slightly. The duration does not exceed a few minutes, so the pathology is rarely diagnosed at this stage.
Vagotonic stage. There is a partial decompensation, the expansion of arterioles and arteriovenous anastomoses is revealed. Blood is deposited in the capillary bed. There are signs of hypotension, the blood supply to the skeletal muscles worsens. The duration of the period is 5-15 minutes, depending on the compensatory capabilities of the body.
Paralytic stage. Complete decompensation of the state associated with the depletion of the mechanisms of regulation of blood circulation. There is a passive expansion of capillaries, visible signs of vascular congestion on the skin, depression of consciousness. Hypoxia of the organs of the central nervous system develops. Without help, heart rhythm disturbances and fatal outcome.

collapse symptoms

The clinical picture that develops in acute vascular insufficiency changes as the disease progresses. The sympathetic stage is characterized psychomotor agitation, anxiety, increased muscle tone. The patient is active, but not fully aware of his actions, cannot sit or lie still even at the request of the medical staff, tosses about in bed. The skin is pale or marble, the extremities are cold, there is an increase in the heart rate.

At the vagotonic stage, the patient is inhibited. He answers questions slowly, in monosyllables, does not understand the essence of the speech addressed to him. Muscle tone decreases, disappears physical activity. The skin is pale or gray-cyanotic, earlobes, lips, mucous membranes acquire a bluish tint. BP moderately decreases, bradycardia or tachycardia occurs. The pulse is weakly determined, has insufficient filling and tension. Decreases glomerular filtration which causes oliguria. Breathing is noisy, rapid. Nausea, dizziness, vomiting, severe weakness join.

With paralytic collapse, loss of consciousness occurs, skin (plantar, abdominal) and bulbar (palatine, swallowing) reflexes disappear. The skin is covered with blue-purple spots, which indicates capillary stagnation. Respiration is rare, periodic according to the Cheyne-Stokes type. Heart rate slows down to 40-50 beats per minute or less. The pulse is thready, blood pressure drops to critical numbers. Early stages sometimes stopped without medical intervention, due to compensatory-adaptive reactions. At the final stage of the pathology, an independent reduction of symptoms is not observed.

Complications

The main danger of collapse is considered to be a violation of blood flow in the brain with the development of ischemia. At long course disease, this causes dementia, dysfunction of the internal organs innervated by the central nervous system. When vomiting against the background of unconsciousness or stupor, there is a risk of inhalation of gastric contents. Hydrochloric acid in the respiratory tract causes burns of the trachea, bronchi, lungs. Aspiration pneumonia occurs, which is difficult to treat. Absence immediate help at the third stage leads to the formation of pronounced metabolic disorders, disruption of the receptor systems and death of the patient. A complication of successful resuscitation in such cases is post-resuscitation illness.

Diagnostics

Collapse is diagnosed medical worker, the first to be at the scene: in the ICU - an anesthesiologist-resuscitator, in a therapeutic hospital - a therapist (cardiologist, gastroenterologist, nephrologist, etc.), in surgical department- surgeon . If the pathology has developed outside the health facility, a preliminary diagnosis is made by the ambulance team medical care according to inspection. Additional Methods appointed to medical institution for the purpose of differential diagnosis. Collapse is distinguished from coma of any etiology, syncope, shock. The following methods are used:

physical. doctor discovers Clinical signs hypotension, absence or depression of consciousness, persisting for 2-5 minutes or more. A shorter time of unconsciousness with its subsequent recovery is characteristic of fainting. According to the results of tonometry, blood pressure is below 90/50. There are no signs of head trauma, including focal symptoms.
Hardware. It is performed after stabilization of hemodynamics to determine the causes of collapse. CT of the head (tumors, focal inflammatory processes), CT of the abdominal cavity (pancreatitis, cholelithiasis, mechanical damage). In the presence of coronary pain, an ultrasound of the heart is performed (expansion of chambers, birth defects), electrocardiography (signs of ischemia, myocardial infarction). Suspicion of vascular disorders is confirmed using color Doppler mapping, which allows to establish the degree of patency of arteries and venous vessels .
Laboratory. During laboratory examination determine the level of sugar in the blood to exclude hypo- or hyperglycemia. A decrease in the concentration of hemoglobin is found. Inflammatory processes lead to an increase in ESR, pronounced leukocytosis, and sometimes an increase in the concentration of C-reactive protein. With prolonged hypotension, a shift in the pH to the acid side, a decrease in the concentration of electrolytes in the plasma, is possible.

Urgent care

The patient in a state of collapse is placed on a horizontal surface with legs slightly elevated. When vomiting, the head is turned so that the discharge flows freely outward, and does not fall into Airways. The VRT is cleared with two fingers wrapped gauze swab or a clean cloth. List of further therapeutic measures depends on the stage of collapse:

Sympathotonic stage. Showing procedures aimed at stopping vascular spasm. Intramuscularly injected papaverine, dibazol, but-shpu. To prevent hypotension and stabilize hemodynamics, use steroid hormones(dexamethasone, prednisone). Peripheral staging is recommended. venous catheter, control of blood pressure and the general condition of the patient.
Vagotonia and paralytic stage . To restore BCC, infusions of crystalloid solutions are carried out, to which, if necessary, cardiotonic agents are added. To prevent aspiration of gastric contents prehospital stage the patient is fitted with an airway or laryngeal mask. Glucocorticosteroids are administered once at a dose corresponding to the age of the patient, cordiamine, caffeine. Pathological breathing is an indication for transfer to a ventilator.

Hospitalization is carried out in the intensive care unit of the nearest specialized medical facility. The hospital continues medical measures, an examination is prescribed, during which the causes of the pathology are determined. Provides support for vital body functions: respiration, cardiac activity, kidney function. Therapy aimed at eliminating the causes of a collaptoid attack is being carried out.

Forecast and prevention

Since pathology develops with decompensation serious illnesses, the prognosis is often poor. Directly vascular insufficiency is relatively easy to stop, however, while maintaining its root cause, attacks occur again. Intractable collapse leads to the death of the patient. Prevention is timely treatment pathologies that can lead to sharp drop vascular tone. Competently selected therapy for heart disease, timely prescription of antibiotics for bacterial infections, complete detoxification in case of poisoning and hemostasis in case of injuries can prevent collapse in 90% of cases.

Vascular collapse occurs in a large number people and often leads to death. Death occurs within 5-10 minutes after loss of consciousness, if at this time no one is around, then the victim dies. It is very important for everyone to remember the basic clinical symptoms and "harbingers" of the disease - this will help save human lives. The provision of first aid does not require special skills and abilities, but is very effective.

Collapse

it emergency requiring urgent medical attention. Actually, collapse is an acute vascular insufficiency, characterized by a drop in vascular tone and a decrease in the volume of circulating blood.

The main pathogenetic effect is associated with a violation of the autonomic activity of the body, as a result of damage to the central and peripheral nervous systems:

The central nervous system, that is, the brain, includes several important centers for regulating the activity of the vascular system. These include: cores cranial nerves, accumulation of neurons in the substance of the brain, hypothalamus, orbital cortex, insula, hypocampus, cingulate gyrus, amygdala. Latest Research prove that any part of the brain affects the activity of the cardiovascular system. That is, if any part of the head is damaged, violations are possible, manifested in the form of bradycardia, tachycardia, hyper- or hypotension, and the like. The different orientation of the manifested signs is associated with the absence of a strict specific response to a certain type of lesion.
With activity disruption peripheral department nervous system is associated with the appearance of orthostatic hypotension. This is a condition where blood pressure drops sharply when moving from a lying position to a standing position. It is noted in children and in the elderly. The latter is characterized by the appearance of symptoms of circulatory disorders of the brain. key factor pathogenesis in this case is the pathology of the release of noradrenaline, adrenaline and renin at the right time. At the same time, the necessary vasoconstriction and increase in intravascular resistance, increase in stroke volume and heart rate do not occur. The reasons for the violation of the release of neurotransmitters are different: damage to peripheral sympathetic fibers and blocking the release of neurotransmitters. Hypotension also occurs with the pathology of postganglionic sympathetic fibers, while the amount of norepinephrine in the blood is reduced even in the supine position. When a person moves into a standing position, the level of the neurotransmitter continues to decrease.

Vascular collapse is noted with the following diseases: tumors in the occipital and parietal lobes of the brain, brain stem, ventricles. Also found in Shy-Drager syndrome and multiple sclerosis.

Symptoms

There are three periods in the development of collapse:

1. Pre-syncope. Lasts from a few seconds to minutes, characterized by the appearance short-term symptoms collapse, the so-called "harbinger period". At this time, a person complains of a severe headache, blurred vision, nausea, pressure in the temples, congestion in the ears, slight dizziness, weakness and discomfort in the limbs.
2. Actually fainting. The main symptom is the absence of consciousness, lasting about five minutes on average. During this period, a person has cyanosis of the skin and mucous membranes, a slowing of the pulse, and a lack of response to pain and tactile stimuli. In severe cases, seizures occur.
3. Recovery period. At this time, a gradual restoration of consciousness is carried out. Within a few seconds, the patient begins to fully navigate in time and space.

Adverse symptoms that occur during an attack of vascular insufficiency are: shortness of breath, paroxysmal tachycardia with a frequency of more than 160 beats per minute, a decrease in heart rate less than 60 per minute, prolonged strong headache, hypotension in supine position.

Emergency help

The victim needs first aid, so it is urgent to call a medical team. Prior to her arrival, a number of mandatory instructions must be followed:

Immediately place the patient in horizontal position with raised legs. Provide airflow by unbuttoning buttons or a tie.
Carefully bring a cotton swab moistened with a solution to the temple ammonia. In the absence of any reaction, gently bring the cotton to the nasal passages. Ammonia has a stimulating effect on the respiratory and vascular centers.
At prolonged absence consciousness (more than 2 minutes) turn the victim to the side. This is necessary to prevent aspiration of the emetic contents or tongue during convulsions that have begun.
Until the arrival of an ambulance, the patient should not be left alone.
After the arrival of the doctors, report the time of the unconscious state and the complications that have arisen (vomiting, convulsions, speech disorders, etc.). Need to describe in detail possible cause occurrence of vascular collapse, precursors (headache, nausea, temperature). If a person came to his senses before the arrival of doctors, you need to pay attention to the time after which the victim began to navigate, and general state organism.

Be sure to pay attention to complaints after an attack: pain in chest, shortness of breath, double vision, speech disorders, gait and so on. The ambulance team fully examines the victim in order to identify complications: biting the tongue, injury during a fall, hidden bleeding. Be sure to pay attention to the anamnesis: similar cases in childhood, episodes of loss of consciousness among relatives, the name of the drugs used medicines, accompanying illnesses.

If a victim is found to have injuries resulting from a fall, if signs of damage appear somatic organs, deviations in history, repeated cases of vascular shock, pathological manifestations on an ECG and so on, the patient is hospitalized in a hospital.

Treatment at the hospital stage

The medical team delivers the victim to a specialized department, where a qualitative examination and diagnosis of the disease is carried out. During transportation, the patient is given the introduction of drugs. The nurse's workflow is as follows:

With a significant decrease in blood pressure (systolic less than 50 mm Hg. Art.), Midodrine is administered. Begins to act within 10 minutes positive effect up to three hours. The mechanism of action is to act on vascular receptors, which leads to their reflex constriction. Phenylephrine, which is administered intravenously, has a similar effect. Unlike Midodrine, it begins to act immediately and retains its effect on blood vessels for up to 20 minutes. Medicines contraindicated in pathology of the kidneys, adrenal glands, urination disorders, thyrotoxicosis and pregnancy.
The drug Atropine copes well with bradycardia. It is administered intravenously by stream. A small concentration of the drug in the body can, on the contrary, reduce the heart rate, so the dose of Atropine should be selected carefully. In urgent cases, there are no contraindications for the use of the drug. Use with caution in people with glaucoma intracranial pressure, ischemic disease heart disease, intestinal damage, hyperthyroidism and arterial hypertension.

If pacing is needed, the patient is referred to cardiology department. Registration of focal cerebral symptoms requires specialized treatment, so the victim is transported to the neurological department. After the treatment, up to 2-4 months of rehabilitation is necessary, after which there is a complete restoration of functions.

Collapse is a manifestation of acute insufficiency of the vascular system, due to a decrease in vascular tone or a decrease in the volume of circulating fluid (BCC). This symptom complex is often common and familiar to many representatives adolescence as well as those suffering from vegetovascular dystonia. However, the pathology of such a condition can lead to more serious consequences.

Collapse mechanisms

Collapse in itself is not a disease, it is the body's reaction to internal pathogenic factors.

There are 2 main mechanisms for the development of collapse:

1. Decrease in the tone of arterioles and venules due to the direct action of the pathogenic agent on the vascular wall or vasomotor center, which leads to an increase in capacity vascular bed and a decrease in venous inflow to the heart, a drop in blood pressure (since venous inflow largely determines the subsequent systole).

2. A rapid decrease in the volume of circulating blood with massive blood loss. When less blood is lost, the body copes with increased heart rate and spasm small vessels caused by the release of catecholamines into the blood. As the collapse develops, the data defensive reactions are simply ineffective because the blood loss is too great.

Catecholamines (contraction hormones) - adrenaline, norepinephrine. One of the functions they perform is to mobilize the internal forces of the body and prepare it for physical work. Their dual effect on human vascular tone makes these substances an important link in the development of collapse and shock.

These mechanisms are often combined. As a result of the fall in blood pressure, tissue blood supply is disrupted, hypoxia (oxygen starvation) develops. Since the function of the blood flow is not only to deliver oxygen to the tissues, but also to remove accumulated carbon dioxide (CO2), circulatory-type metabolic acidosis develops, i.e., the accumulation of waste products by cells, which leads to an increase in endothelial permeability. Violations rheological properties blood (viscosity) create the prerequisites for the development DIC-syndrome(disseminated intravascular coagulation) - the formation of microclots in the blood and even more inhibition of the body's nutrition.

If you do not provide assistance in time - a fatal outcome is inevitable.

Kinds

In medicine, there are many collapses, it would be more practical to identify the common causes that cause them:

lack of fluid;
heart pathology;
vasodilation.

Hypovolemic collapse occurs due to excessive loss of body fluid - dehydration, blood loss (external traumatic and internal abdominal and parenchymal), as a result of which the volume of blood circulating through the vessels drops sharply.

Cardiogenic collapse develops against the background of heart valve insufficiency, acute violation cardiac activity or a sharp decrease in cardiac output.

Vasodilation causes vascular dysfunction in situations of severe and infectious conditions(when we are talking about sepsis - the entry of microorganisms into the bloodstream, fibrinolytic enzymes such as streptokinases, streptodecases, which prevent normal thrombus formation, play an important role in disrupting the functionality of blood vessels), oxygen starvation, overheating, pathologies endocrine glands. Adenosine, histamine, an excess of kinins, improper use of drugs leads to an increase in resistance in the peripheral bloodstream - DIC.
Deserves special attention orthostatic collapse or orthostatic hypotension. It occurs during a sharp change in body position (usually when standing up) - the heart does not have time to respond to the increased load by increasing its own work, and due to a drop in pressure, it does not enter the brain enough blood. The result is dizziness, darkening in the eyes. After a couple of seconds, healthy person everything returns to normal, but in adolescents (whose immature the cardiovascular system naturally weak at this time) and people with weakened vascular tone may develop fainting.

Orthostatic hypotension is diagnosed if, after several minutes of standing, the following conditions are observed:

drop in blood pressure by 20 mm Hg. and more;
drop in diastolic pressure (lower) by 10 mm Hg. and more;
symptoms of brain tissue hypoxia (insufficient oxygen supply to the brain tissue) - dizziness, blackout, fainting.

Orthostatic hypotension is a violation of blood pressure during vertical loads or after a change in body position, and orthostatic collapse is a violation of brain perfusion and associated changes in consciousness.

Symptoms are typical for hypotonic and pre-syncope states:

apathy;
cold sweat;
pale skin, especially around the lips;
weak, barely palpable pulse;
frequent shallow breathing possible arrhythmias.

The collapsed states of the body, unlike shock ones, are characterized by the absence of an erectile (excitatory) stage - as the progressive decline in blood pressure, consciousness turns off.

First aid

As soon as you need emergency help, call the doctors. While the specialists have not arrived, it is necessary to bring the patient to his senses as soon as possible.

Put the victim on a hard surface, slightly raise his legs (this will increase blood flow to the head), remove his outer clothing, remove everything that can hinder movement and breathing (braces, belt, backpack), provide oxygen to the room. Bring a solution of ammonia to the nose of the patient. If the victim is bleeding, you need to try to stop it.

Antispasmodics and blows to the face are ineffective.

Further treatment takes place in several directions:

1. Causal - elimination of the factors that caused the collapse. Removal of poisons, elimination of hypoxia, activation sympathetic system, normalization of cardiac activity, stopping bleeding - all this will stop the deeper development of the collapse.
2. Pathogenetic - replenishment of structures destroyed by pathogenic factors, return of lost functions. This is the restoration of the level of arterial and venous pressure, stimulation of respiration, activation of blood circulation, the introduction of blood substitutes and plasma, stimulation of the central nervous system.

Only timely medical intervention can help the patient regain lost functions and return to normal.

Collapse is a complex of disorders caused by acute vascular insufficiency, which develops as a result of the action of a wide variety of pathogenic factors. The pathophysiology of the various collapses is similar. Patients need immediate first aid, and sometimes surgery.

Almost every one of us has experienced such a painful condition as vascular collapse on own experience or from the experience of loved ones. If the collapse is accompanied by loss of consciousness, then this condition is called fainting. But quite often the collaptoid state develops against the background of intact consciousness.

Collapse is, by definition, acutely developing vascular insufficiency. The name "collapse" comes from the Latin word collapsus, meaning "weakened" or "fallen".

At the first signs of the development of cardiovascular collapse, first aid is necessary. This condition often leads to the death of the patient. To prevent negative consequences one should know the causes that cause collapse and be able to
properly prevent them.

How does acute vascular insufficiency develop?

The collapse is characterized by a decrease in vascular tone, which is accompanied by a relative decrease in the volume of blood circulating in the body. In simple words, the vessels dilate in a short period of time, and the blood available in the bloodstream becomes insufficient for the blood supply to the vital important organs. The body does not have time to quickly respond to a change in vascular tone and release blood from the blood depots. acute vascular insufficiency, collapse develops acutely and rapidly.

If the collapse is accompanied by a critical violation of the blood supply to the brain, then there is a faint, or loss of consciousness. But this does not happen in all cases.
collaptoid state.

With the development of collapse, the state of health worsens, dizziness appears, pallor of the skin and mucous membranes, cold sweat may appear. Breathing becomes frequent and superficial, the heartbeat quickens, blood pressure decreases.

Cardiovascular collapse: first aid

As a rule, collapse develops against the background of a weakening of the body after serious illnesses, infections, intoxications, pneumonia, with physical and mental overstrain, with a decrease or increase in blood sugar levels. If the collaptoid state or fainting lasts more than 1-2 minutes, then any serious illness should be suspected here and an ambulance doctor should be called.

First first aid for cardiovascular collapse and syncope should be as follows: eliminate potential hazards (electric current, fire, gas), make sure that the patient has free breathing or provide it (unfasten the collar, belt, open the window), pat on the cheeks and splash the face with cold water.

If such conditions occur repeatedly, their duration and frequency increase, then a full clinical examination is necessary to determine the cause of their occurrence.