of the SAVA
As hypotension and hypoxia are central in the
pathogenesis of shock, cell degeneration and necrosis
are most outspoken in those cells most susceptible to
hypoxia such as neurons and cardiac myocytes as well
as cells that do not get preferred circulation during
shock (hepatocytes, renal tubular epithelium, adrenal
cortical cells and gastrointestinal epithelium).
Figure 2: Jaguar lung – shock lung with congestion, haemorrhage,
oedema and diffuse microvesicular emphysema.
Figure 3: Lion heart – paintbrush endocardial haemorrhage
in the left ventricle involving the papillary musculature.
Target tissues to be collected into 10% buffered
• Lung: congestion, oedema, hemorrhages,
alveolar epithelial necrosis, fluid flooding of
alveoli with hyaline membrane formation.
• Liver: diffuse (passive) congestion with
centrilobular necrosis (hypoxic).
• Kidney: acute renal tubular necrosis.
• Intestine: congestion, oedema, haemorrhage and
• Heart: acute hyaline degeneration and necrosis
with hypercontraction band formation.
• Brain: cerebral oedema, neuronal degeneration
and necrosis, cerebrocortical laminar necrosis.
• Adrenal gland: haemorrhage at the
Tissue Residue Analysis
Tissue residue analysis would be considered in
instances where over-dosage is suspected. As most of
the adverse drug reactions you are likely to encounter
are dose independent, tissue residue analysis may
not be of relevance. Target tissues for residue analysis
include fresh liver, kidney, peri-renal fat and brain –
transported on ice or frozen.
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