Figure 63-7 The "shock cascade." Ischemia in any given region of the body will trigger an inflammatory response that will have an impact on nonischemic organs even after adequate systemic perfusion has been restored. (Redrawn from Dutton RP: Shock and trauma anesthesia. In Grande CM, Smith CE [eds]: Anesthesiol Clin North Am: Trauma 17:83–95. Philadelphia: WB Saunders, 1999.)