Shock-Induced Endotheliopathy (SHINE) is a pathophysiologic process that can occur in acute critical illness and that is associated with a high mortality rate.
Features of shock-induced endotheliopathy:
(1) hypotension inducing process: severe trauma, sepsis, cardiogenic shock
(2) sympatho-adrenal hyperactivation with release of catecholamines
(3) evidence of widespread endothelial damage (systemic endotheliopathy) with release of soluble thrombomodulin (sTM) and glycocalyx (syndecan-1) and capillary leakage
(4) diffuse intravascular coagulation (DIC) associated with release of procoagulant materials from the damaged endothelium with microthrombosis and hypocoagulability
Administration of beta-blockers may reduce the damage to the endothelium.
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