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HISTORICAL PERSPECTIVE: | HISTORICAL PERSPECTIVE: | ||
*There is limited historical perspective for shock. | |||
=== Definition: === | === Definition: === | ||
Shock is defined as decrease in the oxygen delivery to the cells and tissues due to either increase in oxygen demand, decrease in oxygen consumption, inadequate oxygen utilization or a combination of these processes. | Shock is defined as decrease in the oxygen delivery to the cells and tissues due to either increase in oxygen demand, decrease in oxygen consumption, inadequate oxygen utilization or a combination of these processes. | ||
=== Classification: === | |||
*Distributive shock | |||
*Obstructive shock | |||
*cardiogenic shock | |||
*Hypovolemic shock | |||
=== Causes: === | |||
*Distributive shock can be from [[Septic Shock]], [[Systemic inflammatory response syndrome]], endocrine, toxin and drug induced, [[Anaphylactic shock]] and [[Neurogenic shock]]. | |||
*Obstructive shock can be mechanical, [[pulmonary]] or [[Vascular]] causes. | |||
*Cardiogenic shock can be from [[Cardiomyopathies|cardiomyopathy]], [[Arryhthmias]] or mechanical. | |||
*Hypovolemic shock can be [[hemorrhagic]] or non -hemorrhagic. | |||
=== Pathophysiology: === | |||
<br /> | |||
{| class="wikitable" | |||
|+Characteristics of forms of shock | |||
!Types of shock | |||
!CVP | |||
!PCWP | |||
!CARDIAC OUTPUT | |||
!SYSTEMIC VASCULAR RESISTANCE | |||
|- | |||
|Distributive | |||
|decrease | |||
|decrease | |||
|increase | |||
|decrease | |||
|- | |||
|cardiogenic | |||
|increase | |||
|increase | |||
|decrease | |||
|increase | |||
|- | |||
|obstructive | |||
|increase | |||
|may increase or decrease | |||
|decrease | |||
|increase | |||
|- | |||
|hypovolemic | |||
|decrease | |||
|decrease | |||
|decrease | |||
|increase | |||
|} | |||
# | # | ||
| Line 25: | Line 77: | ||
{{Family tree | | | | E03 | | E04 | | | | | | | | | |E03=evaluate for MI|E04=IV fluids }} | {{Family tree | | | | E03 | | E04 | | | | | | | | | |E03=evaluate for MI|E04=IV fluids }} | ||
{{Family tree/end}} | {{Family tree/end}} | ||
<references /> | |||
Latest revision as of 20:31, 7 May 2020
Shock
OVERVIEW
HISTORICAL PERSPECTIVE:
- There is limited historical perspective for shock.
Definition:
Shock is defined as decrease in the oxygen delivery to the cells and tissues due to either increase in oxygen demand, decrease in oxygen consumption, inadequate oxygen utilization or a combination of these processes.
Classification:
- Distributive shock
- Obstructive shock
- cardiogenic shock
- Hypovolemic shock
Causes:
- Distributive shock can be from Septic Shock, Systemic inflammatory response syndrome, endocrine, toxin and drug induced, Anaphylactic shock and Neurogenic shock.
- Obstructive shock can be mechanical, pulmonary or Vascular causes.
- Cardiogenic shock can be from cardiomyopathy, Arryhthmias or mechanical.
- Hypovolemic shock can be hemorrhagic or non -hemorrhagic.
Pathophysiology:
| Types of shock | CVP | PCWP | CARDIAC OUTPUT | SYSTEMIC VASCULAR RESISTANCE |
|---|---|---|---|---|
| Distributive | decrease | decrease | increase | decrease |
| cardiogenic | increase | increase | decrease | increase |
| obstructive | increase | may increase or decrease | decrease | increase |
| hypovolemic | decrease | decrease | decrease | increase |
| shock | |||||||||||||||||||||||||||||||||||||
| cold clammy extremities | warm bounding extremities | ||||||||||||||||||||||||||||||||||||
| Low cardiac output | high cardiac output | ||||||||||||||||||||||||||||||||||||
| inc JVP,crackes | Dec JVP,orthostasis | septic shock,liver failure | |||||||||||||||||||||||||||||||||||
| cardiogenic shock | hypovolemic shock | ||||||||||||||||||||||||||||||||||||
| antibiotics,IV fluids | |||||||||||||||||||||||||||||||||||||
| evaluate for MI | IV fluids | ||||||||||||||||||||||||||||||||||||